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33 Cards in this Set

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choline esters
Acetylcholine (Miochol)
Methacholine (Provocholine)
Carbachol (Miostat)
Bethanechol (Urecholine)
Acetylcholine (Miochol)
short t1/2 (secs in blood)
opthalmic for glaucoma or Sx
cataracts, eye exam
causes miosis (para-symp)
Acetylcholine (Miochol)
acts by contraction of sphincter muscles of iris
contraction of ciliary muscle
leads to accomodation (for near vision)
Acetylcholine stimulate?
stimulate ciliary muscles,
opening traebeclear network, & increasing aqueous humor flow
Methacholine (Provocholine)
beta-methyl group gives more muscarinic activity
longer duration than Ach
main use of Methacholine?
in vivo dx of airway hyperactivity in asthmatics
Keep emergency meds ready for asthmatic type rxn
adverse reactions of Methacholine?
headache
dizziness
pruritis
route of Methacholine
inhalation
Carbachol (Miostat)
resistant to AchE hydrolysis due to carbamyl group
effects of Carbachol?
nicotinic & muscarinic effects
use of Carbachol?
antiglaucomic
miosis induction for Sx/exam
much longer duration than Ach (6-8 hrs in eye)
adverse rxn of Carbachol?
stinging/ burning of eye
corneal clouding
may cause systemic effects
(salivation, GI cramps, N/V)
SLUDGE
salivation
lacrimation
urination
defication
GI distress
emesis
Bethanechol (Urecholine)
beta-methyl group + carbamyl group
muscarinic mainly, slow hydrolysis
Bethanechol (Urecholine) used for?
urinary retention & to stimulate GI motility (old)
only urinary retnsion now
counteraction of anticholinergic effects of trycyclic antidepressants
effects of Bethanechol?
minimal CV effects
stimulates detrusor muscle (bladder), which decrease bladder capacity & triggers urination
relaxes urinary sphincters
why is Bethanechol good for paraplegics?
b/c it is direct acting and CNS pathway not needed
Bethanechol, GI?
stimulate peristalsis
increase GI motility
decrease sphincter tone
triggers defecation
Bethanechol
not destroyed by AchE (at least very slowly)
for post partum & post-op urinary retntion
not well absorbed cia oral dosing
onset of Bethanechol?
onset: 30-90 min
duration: 1 hr (oral), 2hr (SQ)
alkaloids and synthetic analogs
Pilocarpine (Isopto Carpine) (Salagen tabs)
Muscarine
Arecholine
Pilocarpine (Isopto Carpine) (Salagen tabs)
alkaloid from Pilocarpus microphyllus
Pilocarpine (Isopto Carpine) (Salagen tabs)active on?
sweat glands and eyes
directly stimulates muscarinic receptors
Pilocarpine (Isopto Carpine) (Salagen tabs)used for?
used to tx glaucome
used as miotic for exma/Sx
Occusert
an ocular slow release system for glaucoma
Salagen Tabs
tx of symptoms of Sjogren's syndrome
Sjogren's syndrome
a choronic auto-immune disorder affecting the exocrine glands, resuling in dry eyes, dry mouth, dry skin, fatigue, and aching joints
Pilocarpine (Isopto Carpine) (Salagen tabs)
in open angle glaucoma?
contracts ciliary muscle,
increasing outflow of aqueous humor
Pilocarpine (Isopto Carpine) (Salagen tabs)
in closed angle glaucoma?
miosis opens angle of anterior chamber- allowing aqueous humor to exit
Pilocarpine (Isopto Carpine) (Salagen tabs)
oral dose?
given orally, stimulates glandular secretions, including salivary flow
duration of Pilocarpine
duration: opthalmic 4-14 hrs for solution
18-24 hrs for gel
orally: 3-5 hrs
Muscarine
from Amanita muscaria
muscarinic agonist only
poisoning treated with Atropine
Arecholine
from Betel nut
no therapeutic use
CNS effects similar to nicotine and habit forming