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Cholinergic Drugs
Descripción
? Pharmacology Mapa Mental sobre Cholinergic Drugs, creado por Lindie Metz el 06/03/2016.
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pharmacology
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Mapa Mental por
Lindie Metz
, actualizado hace más de 1 año
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Lindie Metz
hace más de 8 años
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Resumen del Recurso
Cholinergic Drugs
Receptor: Muscarininc
Heart, smooth muscles, brain, exocrine glands
Receptor: Nicotinic
CNS, adrenal medulla, autonomic ganglia, NMJ
CH Agonist
Direct acting
Parasympathomimetics. Mimics Ach by binding directly to Ch receptors. Longer duration.
Bethanecol
Muscarinic action, bradycardia, increased excretion, bronchoconstriction, inc in GIT, dilate BV
Urinary retention, esp postpartum/postopertive
Hypotension, bronchoconstriction, excessive excretion, dysrhythmia in hyperthyroid pt
Urinary obstruction, hyperthyroid pt
Oral, 1 hr
Pilocarpine
Topical appl to produce rapid meiosis, cilliary contraction
Glaucoma by lowering of intra-ocular pressure
Blurred vision, nightblind, brow ache
Topical, 4-8 hrs
Indirect acting
Anti-cholinesterases, leading to accumilation of ACh, broad spectrum
Neostigmine
ChE splits N slower than ACh, bradychardia, bronchoconstriction, incr excretion, urination, GI motility
Myasthenia Gravis
Excessive muscarinic stim: salivation, inc GI, urinary urgency, bradychardia, sweating, miosis
GI/Urinary obstruction, peptic ulcer, asthma, hyperthyroidism
Orally
CH Antagonist
Agents that bind to Ch receptors to prevent action
Anti-muscarinic
Parasympatholitic. Block muscarinic receptors. Little effect on skeletal NMJ or autonomic ganglia
Atropine
Muscarinic block, incr HR, decrease secretions, bronchorelaxarion, decrease GI/Urinary, mydriasis, mild CNSstimulation
Pre-anaesthetic to prevent brachycardia
Xerostomia, inc intra-ocular P, urinary retention, constipation, anhydrosis
Antihistamine
Hallucinations, children are sensitive
Orally, topically, IV, IM, suncutaneous
Reverse effect
Scopolamine
Anti-motion sickness, block short-term memory, sedation
Topical patch
Anti motion sickness and post operative nausea and vomiting
Dry mouth, blurred vision, tachycardia, urinary retention. CNS – restless, confusion, hallucinations
NM-Blockers
De-polarising
Binds to Ach receptor, but then remains in state of depolarisation
Succinylcholine
See above. Constant depolarization causes muscle paralysis, pesists until drug levels decline and dissociate from receptors
IV, 1-10 min
Muscle relaxation (endotracheal intubation, endoscopy)
Hyperkalemia, postop muscle pain, malignant hyperthermia, apnea
Don't mix
Non-depolarising
Compete with Ach, do not depolarise motor end-plate
Cisantracurium
Block activation of Ach, muscle relaxes
IV, 1 min - 1hr
Skeletal muscle relaxation (surgery, mech ventilation, endotracheal intubation, hypotension d/t release of histamine/block nicotinic receptors, no effect on CNS
Respiratory arrest, hypotension
Blocks nicotinic receptors @ NMJ, causing skeletal muscle relaxation
Parasympathetic
Slows HR
Increase gastric secretion
Constrict pupil
Empty bladder/bowel
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