cholininomimetic drugs Flashcards
bethanechol: class, application, and action
cholinomimetic. direct agonist. used for post-operative ileus, neurogenic ileus, and urinary retention. activates bowel and bladder smooth muscle. resistant to AChE.
carbachol: class, application, and action
cholinomimetic agent; direct agonist.
used for glaucoma, pupillary constriction, and relief of intraocular pressure.
pilocarpine: class, application, and action
potent stimulator of sweat, tears, and saliva. used for open and closed angle glaucoma.
contracts the ciliary muscle, which is good for open angle glaucoma, and contracts the pupillary sphincter, good for closed angle glaucoma. (you cry, drool, and sweat on your PILO). resistant to AChE
Methacholine
used as a challenge test for asthma. stimulates the muscarinic receptors in the airway when it is inhaled
Neostigme: uses, class, special considerations
used for post op and neurogenic ileus, myasthenia gravis, and post-op reversal of the NMJ blockade. No CNS penetration
pyridostigmine: uses, class, special considerations
used for myasthenia gravis, doesn’t penetrate the CNS.
itis stronger than other anticholinesterases.
physostigmine: uses, class, special considerations
used for anticholinergic toxicity becasue it can cross the BBB and penetrate the CNS. it is used to treat atropine overdose. anticholinesterase
Edrophonium: uses, class, special considerations
historically used to diagnoses myasthenia gravis (very short-acting). We now use anti-AChR Ab test. anticholinesterase
Potential side effects of all cholinomimetic agents
COPD exacerbation, asthma, and peptic ulcers.
What might be seen with cholinesterase inhibitor poisoning?
Too much cholinergic activity! see diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, and salivation
Antidotes for cholinesterase inhibitor poisons
atropine (competitive inhibitor) + pralidoxime (regenerates AChE if given early enough)
