Pharm5 Flashcards
Cholinomimetic Agents:
- Direct Agonists
Bethanechol
Carbachol
Pilocarpine
Methacholine
Cholinomimetic Agents:
- Indirect Agonists (anticholinesterases)
Neostigmine Pyridostigmine Edrophonium Physostigmine Donepezil
Treatment for:
- Postoperative ileus
- Neurogenic ileus
- Urinary retention
Bethanchol
- Activates bowel and bladder smooth muscle
*Resistant to AChE
Treatment for:
- Glaucoma
- Pupillary contraction
- Relief of intraocular pressure
Carbachol
- Carbon copy of acetylcholine
Treatment for:
- Open-angle & Closed-angle gluacoma
- Potent stimulator of sweat, tears, saliva
PIlocarpine
- contracts ciliary muscles (open-angle)
- contracts pupillary sphincter (closed-angle)
*Resistant to AChE
Treatment for:
- Challenge test for diagnosis of Asthma
Methacholine
- stimulates Muscarinic receptors in airway when inhaled
Treatment for:
- Postoperative & Neurogenic ileus
- Urinary retention
- Myasthenia Gravis
- Reversal of NM junction blockage (post-op)
Neostigmine
- INcreases endogenous ACh
“Neo CNS = NO CNS penetration”
Treatment for:
- Myasthenia Gravis (long acting)
Pyridostimine
- INcreases endogenous ACh
- INcreases strength
*NO CNS pentrations
Treatment for:
- Diagnosis of Myasthenia Gravis
Edrophonium
- INcreases endogenous ACh
Treatment for:
- Anticholinergic Toxicity (crosses BBB)
Physostigmine
- Atropine overdose antidote
Treatment for:
- Alzheimer’s disease
Donepezil
- INcreases endogenous ACh
When giving a cholinomimetic what should you watch for in susceptible patients?
Exacerbation of:
- COPD
- Asthma
- Peptic ulcers
Cholinesterase inhibitor poisoning is often due to what?
Organophosphates (i.e. parathion)
- Irreversibly inhibit AChE
*Seen in insecticides - farmers
What are the s/s of Cholinesterase inhibitor poisoning?
"DUMBBELSS" Diarrhea Urination Miosis Bronchospasm Bradycardia Excitation of skeletal muscle & CNS Lacrimation Sweating Salivation
What is the antidote for Cholinesterase inhibitor poisoning?
Atropine + Pralidoxime (regenerates active AChE)
