Cholinergic Pharmacology Flashcards
Bethanechol
Muscarinic receptor agonist
Urinary retention
Reverse postoperative abdominal distension
Reverse gastric atony or stasis
Carbachol and Pilicarpine
Muscarinic receptor agonist
Glaucoma- decrease intraocular pressure
Induce miosis
Methacholine
Diagnosis of airway hyperreactivity
Homatropine
Muscarinic receptor antagonist
Ophthalmologic examination
Mydriatic effects promote examination of retina and optic disk
Cycloplegic effects facilitate measurement of refractive errors
Atropine
Muscarinic receptor antagonists
Used to reverse muscarinic poisoning and peripheral muscarinic effects of Cholinergic agents
Toxic doses will cause CNS stimulation, even higher doses will cause CNS depression
Glycopyrrate
Muscarinic receptor antagonist
Suppresses peripheral muscarinic effects of cholinergic agents such as neostigmine and pyridostigmine
Benztropine and Truhextphenidyl
Muscarinic receptor antagonists
Parkinsonism, extrapyramidal disease
Scopolamine
Muscarinic receptor antagonist
Prophylactic treatment of motion sickness
Succinylcholine
Depolarizing NMJ blocking drug
Nicotinic receptor agonist
Stays bound to nicotinic receptor- leads to muscle relaxation
Can cause malignant hyperthermia
Can cause hyperkalemia- cardiac arrest
Dantrolene
Blocks Ca2+ release from sarcoplasmic reticulum and relaxes skeletal muscle
Used to treat malignant hyperthermia
Nicotine
Low dose stimulates nicotinic receptor
High dose will first induce Nn and Nm but is followed by a depolarization block at Nn and Nm
Reversible anticholinesterases
Edrophonium Physostigmine Pyridostigmine Tacrine Donepezil Rivastigmine
Compete with ACh anionic site
Neostigmine
Anticholinesterase
Carbamylate esteratic site
Slow hydrolysis of the carbamylating drug by AChE will lead to increase ACh
Organophosphate inhibitors
Isoflurophate, echothiophate, insecticides, nerve gases
Phosphorylate esteratic site- irreversible
Edrophonium
Anticholinesterase
Quaternary ammonium
Rapid onset and short duration
Myasthenia gravis: diagnosis