Cholinergic Drugs

Lindie Metz
Mind Map by Lindie Metz, updated more than 1 year ago
Lindie Metz
Created by Lindie Metz about 4 years ago
30
1

Description

? Pharmacology Mind Map on Cholinergic Drugs, created by Lindie Metz on 03/06/2016.

Resource summary

Cholinergic Drugs
1 Receptor: Muscarininc
1.1 Heart, smooth muscles, brain, exocrine glands
2 Receptor: Nicotinic
2.1 CNS, adrenal medulla, autonomic ganglia, NMJ
3 CH Agonist
3.1 Direct acting
3.1.1 Parasympathomimetics. Mimics Ach by binding directly to Ch receptors. Longer duration.
3.1.2 Bethanecol
3.1.2.1 Muscarinic action, bradycardia, increased excretion, bronchoconstriction, inc in GIT, dilate BV
3.1.2.1.1 Urinary retention, esp postpartum/postopertive
3.1.2.1.1.1 Hypotension, bronchoconstriction, excessive excretion, dysrhythmia in hyperthyroid pt
3.1.2.1.1.1.1 Urinary obstruction, hyperthyroid pt
3.1.2.1.2 Oral, 1 hr
3.1.2.2
3.1.3 Pilocarpine
3.1.3.1 Topical appl to produce rapid meiosis, cilliary contraction
3.1.3.1.1 Glaucoma by lowering of intra-ocular pressure
3.1.3.1.1.1 Blurred vision, nightblind, brow ache
3.1.3.1.2 Topical, 4-8 hrs
3.1.3.2
3.2 Indirect acting
3.2.1 Anti-cholinesterases, leading to accumilation of ACh, broad spectrum
3.2.2 Neostigmine
3.2.2.1 ChE splits N slower than ACh, bradychardia, bronchoconstriction, incr excretion, urination, GI motility
3.2.2.1.1 Myasthenia Gravis
3.2.2.1.1.1 Excessive muscarinic stim: salivation, inc GI, urinary urgency, bradychardia, sweating, miosis
3.2.2.1.1.1.1 GI/Urinary obstruction, peptic ulcer, asthma, hyperthyroidism
3.2.2.1.2 Orally
3.2.2.2
4 CH Antagonist
4.1 Agents that bind to Ch receptors to prevent action
4.2 Anti-muscarinic
4.2.1 Parasympatholitic. Block muscarinic receptors. Little effect on skeletal NMJ or autonomic ganglia
4.2.2 Atropine
4.2.2.1 Muscarinic block, incr HR, decrease secretions, bronchorelaxarion, decrease GI/Urinary, mydriasis, mild CNSstimulation
4.2.2.1.1 Pre-anaesthetic to prevent brachycardia
4.2.2.1.1.1 Xerostomia, inc intra-ocular P, urinary retention, constipation, anhydrosis
4.2.2.1.1.1.1 Antihistamine
4.2.2.1.1.1.1.1 Hallucinations, children are sensitive
4.2.2.1.2 Orally, topically, IV, IM, suncutaneous
4.2.2.2
4.2.2.3 Reverse effect
4.2.3 Scopolamine
4.2.3.1 Anti-motion sickness, block short-term memory, sedation
4.2.3.1.1 Topical patch
4.2.3.1.2 Anti motion sickness and post operative nausea and vomiting
4.2.3.1.2.1 Dry mouth, blurred vision, tachycardia, urinary retention. CNS – restless, confusion, hallucinations
4.3 NM-Blockers
4.3.1 De-polarising
4.3.1.1 Binds to Ach receptor, but then remains in state of depolarisation
4.3.1.2 Succinylcholine
4.3.1.2.1 See above. Constant depolarization causes muscle paralysis, pesists until drug levels decline and dissociate from receptors
4.3.1.2.1.1 IV, 1-10 min
4.3.1.2.1.2 Muscle relaxation (endotracheal intubation, endoscopy)
4.3.1.2.1.2.1 Hyperkalemia, postop muscle pain, malignant hyperthermia, apnea
4.3.1.2.2 Don't mix
4.3.2 Non-depolarising
4.3.2.1 Compete with Ach, do not depolarise motor end-plate
4.3.2.2 Cisantracurium
4.3.2.2.1 Block activation of Ach, muscle relaxes
4.3.2.2.1.1 IV, 1 min - 1hr
4.3.2.2.1.2 Skeletal muscle relaxation (surgery, mech ventilation, endotracheal intubation, hypotension d/t release of histamine/block nicotinic receptors, no effect on CNS
4.3.2.2.1.2.1 Respiratory arrest, hypotension
4.3.3 Blocks nicotinic receptors @ NMJ, causing skeletal muscle relaxation
5 Parasympathetic
5.1 Slows HR
5.1.1 Increase gastric secretion
5.1.1.1 Constrict pupil
5.1.1.1.1 Empty bladder/bowel
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