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


? 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 Muscarinic action, bradycardia, increased excretion, bronchoconstriction, inc in GIT, dilate BV Urinary retention, esp postpartum/postopertive Hypotension, bronchoconstriction, excessive excretion, dysrhythmia in hyperthyroid pt Urinary obstruction, hyperthyroid pt Oral, 1 hr
3.1.3 Pilocarpine Topical appl to produce rapid meiosis, cilliary contraction Glaucoma by lowering of intra-ocular pressure Blurred vision, nightblind, brow ache Topical, 4-8 hrs
3.2 Indirect acting
3.2.1 Anti-cholinesterases, leading to accumilation of ACh, broad spectrum
3.2.2 Neostigmine ChE splits N slower than ACh, bradychardia, bronchoconstriction, incr excretion, urination, GI motility Myasthenia Gravis Excessive muscarinic stim: salivation, inc GI, urinary urgency, bradychardia, sweating, miosis GI/Urinary obstruction, peptic ulcer, asthma, hyperthyroidism Orally
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 Muscarinic block, incr HR, decrease secretions, bronchorelaxarion, decrease GI/Urinary, mydriasis, mild CNSstimulation Pre-anaesthetic to prevent brachycardia Xerostomia, inc intra-ocular P, urinary retention, constipation, anhydrosis Antihistamine Hallucinations, children are sensitive Orally, topically, IV, IM, suncutaneous Reverse effect
4.2.3 Scopolamine Anti-motion sickness, block short-term memory, sedation Topical patch Anti motion sickness and post operative nausea and vomiting Dry mouth, blurred vision, tachycardia, urinary retention. CNS – restless, confusion, hallucinations
4.3 NM-Blockers
4.3.1 De-polarising Binds to Ach receptor, but then remains in state of depolarisation Succinylcholine See above. Constant depolarization causes muscle paralysis, pesists until drug levels decline and dissociate from receptors IV, 1-10 min Muscle relaxation (endotracheal intubation, endoscopy) Hyperkalemia, postop muscle pain, malignant hyperthermia, apnea Don't mix
4.3.2 Non-depolarising Compete with Ach, do not depolarise motor end-plate Cisantracurium Block activation of Ach, muscle relaxes IV, 1 min - 1hr Skeletal muscle relaxation (surgery, mech ventilation, endotracheal intubation, hypotension d/t release of histamine/block nicotinic receptors, no effect on CNS 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 Constrict pupil Empty bladder/bowel
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