Lecture 6 - Cholinergic Agonists Flashcards
Do nicotinic receptors have preganglia of symp or para?
Both
Do nicotinic receptors have postganglia of symp or para?
Para
Where are nicotinic receptors found?
Skeletal muscle
Even numbered muscarinic receptors are ____
Inhibitory
Odd numbered muscarinic receptors are _____
Stimulatory
Sweat glands are stimulated by ____ NS but most are _____ synapses
- Symp
- Cholinergic
Do you sweat when symp system is activated?
Yes
Do you sweat when cholinergic agonists are used?
Yes
In which part of the body are sweat receptors adrenergic?
Palms
All preganglionic synapses (para and symp) are ______
Cholinergic
What is the major side effect of modulating acetylcholine?
Psychological effects
Skeletal muscle works through _____ receptors
Acetylcholine
Does acetylcholine cross the BBB as a drug?
No
What does acetylcholine activate?
- All autonomic ganglia (para and symp)
- Skeletal muscle receptors
What type of effects does acetylcholine cause?
The same effects as stimulating the para system
Is acetylcholine used for systemic use?
No, it is too non-specific
What is acetylcholine as a drug used for?
Eye surgery
What does pilocarpine have a similar effect to?
Acetylcholine, except pilocarpine can cross the BBB so has psychological effects
Is acetylcholine used more often than pilocarpine?
No, pilocarpine is used more often because it crosses the BBB and lasts longer
What is pilocarpine primarily used for and why?
Severe acute glaucoma because it causes immediate opening of drainage system of the eye
What is the function of acetylcholinesterase?
Degrades acetylcholine in the synapse
What will inhibition of acetylcholinesterase cause?
Increased activity of acetylcholine in the synapse
Can acetylcholinesterase treat a disease?
No, only helps with symptoms
What is myasthenia gravis?
Autoimmune destruction of acetylcholine receptors at neuromuscular junction (NMJ)
What can help the symptoms of myasthenia gravis?
Drugs that increase acetylcholine activity
What is alzheimer’s disease?
Decreased activity and then death of cholinergic neurons in brain
What can help treat some symptoms of alzheimer’s disease?
Drugs that increase acetylcholine activity in the brain
What are 2 examples of acetylcholinesterase inhibitors?
- Neostigmine
- Donepazil
What does neostigmine do?
- Stimulates bladder and GI tract
- Aids symptoms of myasthenia gravis (increases muscular strength and response)
What does donepazil do?
Stimulates cholinergic neurons in brain to treat symptoms of Alzheimer’s
What is an example of a cholinergic antagonist and what does it do?
- Atropine
- Increases heart rate and blood pressure
- Antispasmodic effects on GI tract
- Dilates pupils
What is scopolamine do?
- Strong CNS effect
- Most effective anti-nausea drug
What is tiotropium used in?
Inhaled bronchodilators
What are some side effects of blocking cholinergic system?
- “Sandy eye syndrome” and loss of near vision
- Dry, pasty saliva
- No gut movement and sustained acid, leading to nausea, vomiting, constipation, and pain
- No sweat
- Flaccid bladder and contracted sphincter
- “No see, no spit, no pee, no shit”
When are NMJ blockers used?
In surgery to decrease the amount of anesthesia needed
What is the order of muscular paralysis?
1) Eyes
2) Face
3) Fingers
4) Limbs
5) Trunk
6) Diaphragm
* Recovery is opposite order
What is the effect of NMJ blockers?
Paralysis
Are NMJ blockers depolarizing?
Some, while others are non-depolarizing
What is the only depolarizing NMJ blocker?
Succinylcholine
What does succinylcholine do to the body?
Causes twitching at first, then flaccid paralysis
