Intro to ANS & Cholinergic Drugs Flashcards
NE effects what receptors
A1, A2, B1, B2, B3
Ach effects what receptors
M1, M2, M3
NN
autonomic ganglia
NM
neuromuscular junction
M1
Neuronal
M2
cardiac
M3
all smooth muscles
what has ONLY PARASYMPATHETIC innervations
ciliary muscle and gastric glands
what has ONLY SYMPATHETIC innervations
blood vessels and spleen
inhibits the breakdown acetylcholine
what does it cause
acetylcholine esterase inhibitors
increase in Ach
Botulinum toxin
inhibits VAMPs and SNAPs
Hemicholiniums
inhibits CHT
Vesamicol
inhibits VAT
Cholinergic esters
Acetylcholine, methacholine
reversible Anticholinesterases
Physostigmine, Neostigmine, Pyridostigmine, Edrophonium (shortest acting)
actions of Ach on heart
negative chrono/dromo/iontropic
actions of Ach on blood vessels
vasoconstriction
actions of Ach on smooth muscles
GIT: increase peristalsis
Bronchus: constriction
Glands: secretion
Bladder: detrusor contraction, trigone and sphincter relaxation
actions of Ach on eye
contraction of circular muscles -> miosis
Pilocarpine
prominent muscarinic action
penetrates cornea: miosis, ciliary muscle contraction, decrease IOP
Mushroom poisoning
treated with atropine
irreversible anticholinesterases
organophosphates, Parathion
used as insecticides or pesticides
lipid soluble agents
produce CNS effects
lipid insoluble agents
No CNS effects
lipid insoluble agents effects on ganglia
higher dose causes blockade of transmission
lipid insoluble agents effects on CVS
bradycardia
hypotension
lipid insoluble agents uses
Glaucoma (physostigmine)
Myasthenia Gravis (pyridostigmine, neostigmine)
Paralytic ileus (bethanecol)
decurarization (neostigmine)
Belladonna/atropine poisoning (physostigmine)
Alzeheimers (tacrine, rivastigmine, donepezil)
organophosphates muscarinic effects
Diarrhea Urination Miosis Bradycardia Emesis Lacrimation Sweating Salivation
organophosphates poisioning
Atropine
Pralidoxime
signs of adequate atropinization
moderately dilated pupils
Pralidoxime
reactivates acetylcholinesterase
contraindicated in carbamate poisoning
decreases aqueous humor formation
Timolol
Dipivefrine
Apraclondine
Dorzolamide/Brinzolamide (topical)
increases aqueous humor drainage
Pilocarpine
Latanoprost
Myasthenia Gravis treatment
Neostigmine (+atropine for muscarinic side effects)
Myasthenia Gravis test
Edrophonium test
Nicotinic toxicity
Varenicline