Muscurinic Drugs (2)

Front 1

cholinergic agonists' effects on cardiovascular effect
blood vessels- what receptor

Back 1

Blood vessels- M3
circulating ACH act on M3R in vascular endo- release NO
decrease TPR, BP
tachycardia due to baroreflex
vasoconstriction due to direct effects on vascular sm

Front 2

cholinergic agonists' effect on Heart, what receptor

Back 2

Heart- M2
SA: decreased pacemaker current/ increased repolarizing current
decreased HR, SA-AV nodal conduction velocity
atrial muscle, decreased atrial contractility
SN terminals (M2) presynaptic-heteroreceptor, inhibiting NE release

Front 3

cholinergic agonists

effects on respiratory system
PS ganglion neurons

Bronchial sm

PSN ending

Back 3

PS ganglion neurons (M1)
stimulate ACH release
bronchoconstriction and secretion

bronchial sm (M2/M3)

M3-contraction of sm directly
bronchoconstriction

bronchial glands: M3, increase secretions

PSN ending M2: presynaptic autoreceptor, inhibit ACH release, reduce bronchoconstriction/secretion

Front 4

urinary system

bladder sm

detrusor mus/sphincter

Back 4

Bladder sm (M2/M3)

contraction of detrusor m/relaxation of sphincter

voiding

Front 5

GI

receptor

effects

Back 5

GI

myenteric plexus M1

increase resting tone, peristaltic activity and force of contraction of sm

increase gastric secretion

may cause cramps, nausea, vomitting, and diarrhea

Front 6

Methacholine

class of drugs
pharmacological actions
dosage
clinical use

Back 6

metacholine

cholinergic agonist
no nicotinic effect, given Iv
dosage: somewhat resistant to ACHE, longer duration

diagnostic tool for belladonna alkaloid poisoning

for peripheral vascular disease and paroxymal atrial tachcardia

Front 7

carbochol

class of drug
pharmacological actions
dosage
clinical use

Back 7

Carbacol

cholinergic agonist

actions: greater nicotinic effects than ACh
muscurinic effect on GI, urinary bladder and iris
less effective as muscurinic agonist on cardiovascular system

dosage: ophthalmic solution
resistant to ACHE

use: wide-angle glaucoma, used to produce miosis during eye surgery

Front 8

side effects with local ophtalmic application of carbachol

Back 8

systemic side effects-rare
pupillary constriction
accomodative spasm/headach
conjunctival hyperemia

Front 9

Bethanechol
class of drug
action
dosage
clinical uses

Back 9

Bethanechol
cholinergic agonist
action: similar to carbahol
no nicotinic effect
dosage: totally resistant to ACHE
given orally/subcutaneously
uses: tx: urinary retention, post-op or neurogenic types
post-op abdominal distention
antimuscurinic-rare

Front 10

side effects of bethanechol

Back 10

flushing/sweating
epigastric distress, abdominal cramps, salivation/diarrhea
headache/difficulty in visual accommodation

Front 11

contraindications of cholinergic agonists

Back 11

peptic ulcer or damaged GI wall
asthma
coronary insufficiency
caution with bradycardia/hypotension

Front 12

Drug interactions for cholinergic agonist

Back 12

Quinidine/procaiamide antagonize effects of bethanechol

combined with drugs that deplete serotonin (reserpine)--hypothermia

Front 13

treatment for muscurine poisoning

can muscurine cross BBB

Back 13

atrophine

muscurine: absorbed from GI, cross BBB

Front 14

pilocarpine

class of drug
actions
dosage
use

Back 14

pilocarpine

natureal alkaloid-cholinergic agonist
actions: mostly muscurinic effect some nicotinic activy
Cardiovas sys is less sensitive than other organ systems

dosage: ophthalmic solution

use: reduce pressure in glaucoma

Front 15

side effects of pilocarpine

Back 15

ciliary spams
conjuctival vascular congestion
headache
reduced visual acuity