Direct Cholinergic Agonists Flashcards
QACs
Acetylcholine
Bethanechol
Carbachol
Methacholine
Plant alkaloids
Muscarine
Arecoline
Pilocarpine
Nicotine
Bind M only
Bethanechol
Muscarine
Pilocarpine (partial)
Bind M and N
Acetylcholine
Carbachol
Methacholine
Arecoline
Bind N only
Nicotine (N > M)
Activates Bowel and Bladder
Bethanechol
Diagnosis of bronchial hyperactivity in asthma
Methacholine
Ganglion blocker in high dose
Nicotine
Can cause hypotension with rapid, weak pulse
Nicotine
No clinical uses
Muscarine
Arecoline
PS and S activity on sweat glands
Acetylcholine
M3 vasodilation and reflex tachy at low doses
Hypotension and brady at high doses
Acetylcholine
Miosis and contraction of ciliaris
Carbachol
Ciliaris contraction
Sweat, salivary, lacrimal, bronchial secretion
Pilocarpine
Tertiary amines
Pilocarpine
Nicotine
N effects of Acetylcholine
Stim autonomic ganglia
Epi secretion from medulla
Skeletal muscle - Increase HR, BP
Low dose nicotine effects
Ganglion depol (S + PS)
CVS - sympathomimetic
GI + UG - parasympathomimetic
Parasympathomimetic effects of nicotine
N/V/D, voiding, salivation, bronchial secretion
High dose effects of nicotine
Ganglion blocker (prolonged depol)
Smoking cessation therapy
Nicotine
Acute close-angled glaucoma
Pilocarpine
Full close angle glaucoma regimen
Pilocarpine Timolol Apraclonidine Acetazolamide Mannitol or Glycerol
Second line for open angle glaucoma
Pilocarpine
1st is timolol
2nd line for close angle glaucoma
Carbachol (decrease intraocular pressure)
Intraocular surgery
Carbachol
Rapid miosis in cataract surgery
Acetylcholine
Post surgical, postpartum urinary retention
Bethanechol
Hypotonic/atonic, myogenic, neurogenic bladder
Bethanechol
Ileus, gastroparesis, congenital megacolon
Bethanechol
No CNS effects
Acetylcholine
Makes acetate
Acetylcholine
Makes Carbamate
Bechanechol
Carbachol
Hydrolysis by AchE
Acetylcholine
No hydrolysis by AchE
Bethanechol
Carbachol
Cannot cross BBB
Bechanechol
External use only
Carbachol
Slow AchE hydrolysis
Methacholine
Crosses placenta
Nicotine
Highly liposoluble
Nicotine
AE DUMBBELLSS
Acetylcholine
Bethanechol
Carbachol
Methacholine
What is muscarinic syndrome
Diarrhea Urination Miosis Bradycardia Bronchoconstriction Emesis Lacrimation Lethargy Salivation Sweating
CNS disturbances
Sweating
Salivation
Pilocarpine
Effects of acute nicotine poisoning
N/V/D Salivation Abdominal pain Cold sweat Confusion
Death from resp arrest
Nicotine