Cholinomimetic Agents Flashcards
Carbachol clinical application and action
Direct ACh Agonist. Glaucoma, pupillary contraction, and relief of intraocular pressure. ‘CARBoncopy of acetylcholine.’
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Bethanechol clinical application & action
Direct ACh Agonist. Postoperative & neurogenic ileus & bladder.
Activates bowel and bladder smooth muscle. Resistant to AChEsterase!
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Pilocarpine clinical application and action
Direct ACh agonist. Potent stimulator of sweat, tears, and saliva. Contracts ciliary muscle of the eye (open angle), pupillary sphincter (narrow angle). Resistant to AchEsterase.
‘You drool, sweat, and cry on your pillow’
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Methacholine clinical application and action
Direct ACh agonist. Challenge test for asthma. Stimulates muscarinic receptors in airway when inhaled.
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Neostigmine clinical application and action
Anticholinesterase. Postoperative & neurogenic ileus and bladder, myasthenia gravis, reversal of postop. neuromuscular junction blockade. New no CNS penetration.
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Pyridostigmine clinical application and action
Acetylcholinesterase. Myasthenia gravis (long acting). Does Not penetrate CNS. “Gets RID of myasthenia”
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Edrophonium clinical application and action
Anticholinesterase. Diagnose myasthenia gravis. Extremely short acting.
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Physostigmine clinical application and action
Anticholinesterase. Trt Glaucoma (crosses the CNS) and atropine overdose.
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Echothiopate clinical application and action
Anticholinesterase. Trts Glaucoma. “ECHO in the eye for glaucoma”
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
Donepezil clinical application and action
Anticholinesterase. Trt Alzheimer’s disease.
As with all choline mimetic agents watch for exacerbation of COPD, asthma, and peptic ulcer in susceptible pts.
What happens in cholinesterase inhibitor poisoning? And what is it due to usually ?
DUMBBELSS. Causes diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle & CNS. Lacrimation, Sweating & Salivation. Often due to organophosphate such as parathion that irreversibly inhibits AChE.
How do you treat cholinesterase inhibitor poisoning? How do you treat insecticide organophosphate poisoning.
Atropine + pralidoxime (regenerates active AChEsterase)
