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Autonomic Nervous System (Cholinergic Agonists)
Unit III
10
Pharmacology
Undergraduate 2
10/28/2013

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Term
Acetylcholine (AcH)
Definition
↓↓↓ HR,CO, BP (causes vasodialation bc of activation of muscarinic receptors)
↑↑↑ Salivary Secretion, Intestinal Motility, Bladder Motility and Urinary Expulsion
-Miosis

(has no therapeutic use)
Term
Bethanechol
Definition
-stimulates muscarinic receptors, causing ↑ intestinal motility, and detrusor muscle stimulation in bladder.
Therapeutic applications:
1) atonic bladder stimulation (post-op, post-partum)
2) treatment of neurogenic atony and urinary retention
Adverse Effects:
genaralized cholinergic stimulation (hypotension, increased salivation, bronchospasm, etc.)
Term
Carbachol
Definition
-rarely used therapeutically
--> except in eye as a miotic agent to treat glaucoma (↓ I.O pressure)
Term
PILOCARPINE (**)
Definition
- exhibits muscarinic activity
- produces rapid miosis and ciliary muscle contraction
Therapeutic Effects:
- glaucoma treatment
- drug of choice in emergency I.O pressure lowering
Adverse Effects:
(most potent secretion stimulator)
generalized cholinergic stimulation
Term
EDROPHONIUM (**)
Definition
-short-acting AchE inhibitor
-used in diagnosing myasthenia gravis
Term
PHYSOSTIGMINE (**)
Definition
-ANS muscarinic and nicotinic receptor stimulant
-↑↑↑ intestinal and bladder motility
-opthalmic agent in eye, causing miosis and lowering of I.O. pressure
-used for glaucoma treatment and anticholinergic drug overdose (as an antidote)
Term
NEOSTIGMINE (**)
Definition
-effect on skeletal muscle greater than physostigmine
-stimulate GI and bladder
-tubocurarine antidote
-myasthenia gravis treatment
Adverse Effects: General Cholinergic stimulation
Term
PYRIDOSTIGMINE & ABENOMIUM (**)
Definition
-chronic management of myasthenia gravis
Term
TACRINE, DONEPEZIL, RIVASTIGMINE, GALANTAMINE (**)
Definition
- AchE inhibitors
- alzheimers
Term
ORGANOPHOSPHATE COMPOUNDS (ECHOTHIOPHATE)
Definition
- irreversible AchE inhibitors
(insecticides)
-causes skeletal muscle paralysis and generalized cholinergic stimulation
-but used for chronic treatment of glaucoma
atropine-antidote
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