Indirect Cholinergic Agonists Flashcards
Dx for Myasthenia Gravis
Edrophonium
Tx for anticholinergic overdose
Physostigmine
Reversal of NMJ block by non-depol agents
Neostigmine
Edrophonium
Tx of Myasthenia Gravis
Pyridostigmine
Reversible AchE/Butylcholinesterase inhibitor
Edrophonium
Contraindicated in TCA overdose
Physostigmine
Aggravates cardiac conduction depression
Not Liposoluble
Echothiophate
Obsolete
Echothiophate
QAC
Edrophonium
Neostigmine
Pyridostigmine
Carbamate
Physostigmine
Neostigmine
Pyridostigmine
Covalent AchE/ButylChE inhibitor
Physostigmine
Neostigmine
Pyridostigmine
Does not enter CNS
Neostigmine
Pyridostigmine
Organophosphates
Ecthiophate Malathion Parathion Tabun Sarin Soman
Phosphorylate active site
Ecthiophate Malathion Parathion Tabun Sarin Soman
Aging to make reversal difficult
Ecthiophate Malathion Parathion Tabun Sarin Soman
Activated by conversion to O analogs
Malathion
Parathion
Nerve agents
Tabun
Sarin
Soman
CNS effects of amines
Convulsion
Coma
Resp arrest
PS effects of amines
Eye
Resp
GI
UG
CVS effects of amines
Decrease CO and BP (hypotension)
NMJ effects of amines
Increase contraction in weak muscles
Used for intestinal or bladder atony
Physostigmine
2nd line Myasthenia Gravis
Neostigmine
Prevention and Tx of Urinary retention
Neostigmine
Chronic open angle glaucoma
Echothiophate
Insecticides
Malathion
Parathion
Used for terrorism
Tabun
Sarin
Soman
Used in Alzheimer’s
Tacrine
Donepezil
Rivastigmine
Galantamine
Orally active
Tacrine
Donepezil
Rivastigmine
Galantamine
Only lasts for 2-10min
Edrophonium
Spontaneous hydrolysis (30min - 6hrs)
Physostigmine
Neostigmine
Fully distributed organophosphates (enter CNS)
Malathion Parathion Tabun Sarin Soman
Tx for organophosphate overdose
Atropine
Pralidoximine
CNS toxicity
Pyridostigmine Malathion Parathion Tabun Sarin Soman
AE for Neostigmine
N/D Hypotension Salivation Flushing Abdominal pain Bronchospasm
AE for Physostigmine (high dose)
Convulsions
SkM paralysis
Bradychardia
Action of TCAs
Block Na+ channels
Organophosphate poisoning Tx (before aging)
Pralidoxime
When is Pralidoxime not used
Carbamate poisoning (reversible, short)
Does Pralidoxine enter the CNS
No