Cholinergics Flashcards
M1 receptors
activates myenteric plexus
M2 receptors
decreases heart rate and contraction
“M2s are where the heart is”
M3 receptors
contracts circular ciliary mm.
bronchiolar/GI smooth mm.
Secretions of the glands
succinylcholine
nicotinic receptor antagonist, muscle relaxant
causes depolarizing block
contraindicated in patients with familial hyperthermia
Nn receptor
postganglionic cells in the autonomic ganglia
Nm receptor
skeletal mm. membranes
nicotine
Nn receptor agonist
acetylcholine
nicotinic and muscarinic receptor agonist
methacholine
primarily a muscarinic receptor agonist
carbachol
muscarinic and nicotinic receptor agonist
reduces IOP (post cataract, glaucoma)
miotic agent
bethanechol
selective muscarinic receptor agonist of the GI tract/bladder
muscarine
selective muscarinic receptor agonist
pillow-carpine
selective muscarinic agonist
glaucoma drug
cry, drool, and sweat on your pillow
neostigmine
reversible cholinesterase inhibitor
Nm receptor agonist
used to treat myasthenia gravis
edrophonium
reversible cholinesterase inhibitor
Nn agonist
used to make differential diagnosis between myasthenia gravis and ACh overstimulation
physostigmine
reversible cholinesterase inhibitor
long lasting
indicated in atropine poisoning
crosses BBB so it counteracts delirium
donepezil
reversible cholinesterase inhibitor in the CNS, used in treatment of alzheimers
organophosphates
irreversible cholinesterase inhibitor (most not used clinically)
causes DUMBBELSS symptoms
DUMBBELSS
what are they? what causes them?
symptoms of organophosphate toxicity Diarrhea Urination Miosis Bronchorrhea Bradycardia Excitation Lacrimation Sweating Salivation
treatment of severe organophosphate poisoning
- mechanical ventilation
- oral secretion suction
- atropine
- 2-PAM
echothiophate
irreversible cholinesterase inhibitor
used clinically for long term miosis
atropine
muscarinic antagonist (know the 5 Ps)
5 Ps of atropine
- peeing (decreased urgency)
- pooping (decreased motility of the colon)
- poisoning (decreased effect of organophosphates)
- pupils (causes mydriasis)
- pumping (reverse bradycardia)
scopolamine
muscarinic antagonist
minimize secretions for surgery
minimize nausea following surgery
glycopyrrolate
muscarinic antagonist to prevent overstimulation of the gut
2PAM
cholinesterase inhibitor antidote given following atropine administration
reactivates alkylphosphorylated AChE
sarin gas
an organophosphate