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Cholinergic Agonists
Pharm - Fundamentals
8
Medical
Graduate
08/24/2012

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Term
Acetylcholine
Definition
Agonist at all AChRs (duh.) Limited clinical use: used intraocularly to produce miosis, intracoronary use causes vasodilation, can be used to diagnose vasospastic angina.
Term
Methacholine
Definition
Can be used to diagnose asthma through a challenge test. Inhalation of this drug causes bronchoconstriction by acting at muscarinics. Must be used very carefully.
Term
Carbachol
Definition
Treatment for wide-angle glaucome when other cholinomimetics have failed. Causes pupillary contraction and relief of intraocular pressure.
Term
Bethanechol
Definition
Used postoperatively to reduce bladder/bowel distension (BBB). Can be used as an alternative to pilocarpine for treatment of xerostomia.
Term
Pilocarpine
Definition
Potent stimulator of sweat, tears and saliva. Used for wide-angle glaucoma and to treat xerostomia. Also used for emergency treatment of narrow-angle glaucoma with an AChE inhibitor (although this condition requires immediate surgical attention). Prolonged use can cause reduced night vision and difficulty in focusing on far objects.
Term
Side effects of choline esters
Definition
All related to activity at muscarinics (and nicotinics in the case of carbachol) - diarrhea, decreased blood pressure, urination, miosis, bronchoconstriction, bradycardia, excitation of skeletal muscle, lacrimation, salivation and sweating (DDUMBBELSS)
Term
Contraindications for choline ester use
Definition
Asthma, COPD, urinary obstruction and peptic ulcers/disease can all be exacerbated with use.
Term
Muscarine
Definition
Poisoning with this compound from mushrooms develops rapidly (30-60 mins) and can be readily reversed with atropine. Symptoms are salivation and lacrimation, nausea and vomiting, headache and visual disturbances, bronchospasm, bradycardia and hypotension, shock.
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