NICOTINIC ANTAGONIST

- Competitive inhibition of ACh
- Be aware with interactions with cholinesterase inhibitors, inhalation anesthetics, certain antibiotics, and Ca blockers
- Be aware of disease interactions: reduced plasma cholinesterase, malignant hyperthermia, pts with soft tissue damage, muscular disorders

MUSCARINIC ANTAGONIST

- Competitive inhibition of ACh
- Tertiary amine (penetrates into CNS)
- Preferred over scopolamine except for selected treatments
- Order of effects: 1) Secretions, 2) Eye function, 3) GI and UT function, 4) Gastric acid secretion

GANGLIONIC NICOTONIC ANTAGONIST

- Equate to withdrawal of autonomic tone (NOT just sympathetic tone)

NEUROMUSCULAR NICOTONIC ANTAGONIST

- Depolarizing agent
- Be aware with interactions with cholinesterase inhibitors, inhalation anesthetics, certain antibiotics, and Ca blockers
- Be aware of disease interactions: reduced plasma cholinesterase, malignant hyperthermia, pts with soft tissue damage, muscular disorders

GENERAL ACH RECEPTOR AGONIST

- Low concentrations stimulate muscarinic receptors
- High concentrations stimulate both muscarinic and nicotinic receptor

MUSCARINIC AGONIST

- Resistant to BChE and AChE
- Effects pronounced in GI and UT smooth m
- Must be given orally or subcutaneously, IV or IM negatives specificity and increases toxicity
- Treats urinary retention, GI stasis, diagnosis of anticholinergic intox, local admin into eye

MUSCARINIC AGONIST

- Tertiary amine, rarely used systemically
- Prominent action in cardiovascular system, effects in CNS
- Potent diaphoretic

MUSCARINIC ANTAGONIST

- Shorter half-life than atropine

MUSCARINIC ANTAGONIST

- Tertiary amine (does not penetrate CNS), preferred over atropine when CNS effects not desired

- Inhaled preparations useful for asthma (not as effective as adrenergic drugs, but useful for adjunct therapy)

AChE INHIBITOR, CARBAMOYLATING AGENT

- Tertiary amine

AChE INHIBITOR, CARBAMOYLATING AGENT

- Quaternary amine

AChE INHIBITOR, COMPETITIVE ANTAGONIST

- Short acting, quaternary amine

AChE INHIBITOR, COMPETITIVE ANTAGONIST

- Longer acting, tertiary amine

CHOLINESTERASE REACTIVATOR

- Only useful against phosphorylated enzyme

- Give rapidly, because aged inhibited AChE cannot be reversed

GANGLIONIC NICOTINIC ANTAGONIST

- Quaternary sulfonium
- Equate to withdrawal of autonomic tone (NOT just sympathetic tone)

NEUROMUSCULAR NICOTONIC ANTAGONIST

- Depolarizing agent
- Fast action (rapidly hydrolized by BChE)
- Be aware with interactions with cholinesterase inhibitors, inhalation anesthetics, certain antibiotics, and Ca blockers
- Be aware of disease interactions: reduced plasma cholinesterase, malignant hyperthermia, pts with soft tissue damage, muscular disorders

NEUROMUSCULAR NICOTINIC ANTAGONIST

- Competitive inhibitor
- Be aware with interactions with cholinesterase inhibitors, inhalation anesthetics, certain antibiotics, and Ca blockers
- Be aware of disease interactions: reduced plasma cholinesterase, malignant hyperthermia, pts with soft tissue damage, muscular disorders