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