Cholinergic Drugs

Nicotinic signs: Neuromuscular (twitching, fasciculation, paralysis)

Central signs: Headache, drowsiness, disorientation, coma or generalized convulsion

Muscarinic signs: Miosis, nausea, salvitation, vomiting, diarrhea, sweating, bradycardia, bronchial constriction.

Treatment: Atropine (muscarinic receptor antagonist), diazepam (for convulsion) and pralidoxime or obidoxime (reactivators)

Parkinson’s disease

blurred vision

fast heartbeats

vomiting or constipation

little or no urination

hallucinations

dry mouth

constipation

dryness of skin

tachycardia

urine retention

Blocking of acetylcholine

Reversible inhibitor of acetylcholinesterase (Indirect acting cholinergic agonist)

Alzheimer’s disease, dementia

quite well absorbed by oral route and crossing well the blood brain barrier

Organophosperus poisoning

Parkinson´s Disease

symptomatical dehydration

Dilation of the pupil (connected with examination before & after surgery)

Mydriasis

Countering of Opiod abuse opthalamic symptoms

Donepezil

Rivastigmine

Gelantamine

Increased Salivation, sweating, lacrimation

Bradycardia, Block, Hypertension

Generally subsides within 2 Hours

Dyspnoe, blurrred vision, abdominal pain with nausea and diarrhea

The specific antigen is Atropine

Reversible Inhibitor of acetylcholinesterase

Prioritizes Digestive tract and Bladder over CVS & CNS

Treatment in myasthenia gravis, posoperative atony (intestine/bladder)

neostigmine indirectly stimulates both nicotinic and muscarinic receptors

reversible cholinesterase inhibitor

Bradycardia, Hypotension, Coronary insufficiency

Cardiac Block

Hyperthyroidism

Asthma

peptic Ulcers

peripheral effects similar to those of atropine

sedative and tranquillizing action and has an amnestic effect

treat abdominal cramping and irritable bowel syndrome
=> antispasmodics acting on the smooth musculature

used as an antiemetic agent in the prevention of motion sickness

antidote in muscarinic poisoning

biliary and renal colic pain
used as antispasmodic for painful smooth muscle spasms

cardiology: treatment of bradykardia and block.

anesthesiology : prevention of respiratory tract secretion

● bronchospasm
● laryngospasm
● reflexes

Atrial Fibrilation

D1 – stimulated at low concentration. Induces renal, mesenteryc and coronary vasodilation. Increase renal blood flow and GFR, Na excretion.

B1 – Stimulated at higher concentration.
Postitive inotropic effect

A1 stimulated at high concentrations.Induces vasoconstriction

fear anxiety, restlessness, tremor

hypertension & Cardiac arrythmias, can cause anginal pain

cerebral haemorrhage

Worse in hyperthyroid and hypersensitive patients.

bradycardia

atrioventricular block

Salbutamol (short-acting β2 adrenergic receptor agonist)

Terbutaline (beta‑adrenergic agonist)

Ritodrine (short-acting β2 adrenoreceptor agonist)

Epinephrine for asthma attacks: Stimulates α1, α2, β1, β2, β3 adrenergic receptors

Ipratropium / Atrovent; Muscarinic receptor antagonist reduce the effects of acetylcholine

Salbutamol Inhalator relaxing SMC in the airways by acting on β2 receptors (short acting)

done by using beta1 and beta2 agonists.

Isoprenaline

orciprenaline

atropine with clinical monitoring

sudden numbness, weakness, or cold feeling anywhere in your body

hypertension

reduced blood flow in organs, kidney, liver, brain

necrosis at site of administration

problems with vision, speech, or balance; or severe headache, blurred vision, pounding in your neck or ears

Phenylepinephrine

Naphazoline

Tymazoline

Ksylometazoline

Anaphylactic Shock

Cardiac arrest

Asthma attack

Glaucoma

used with local anaesthesia to reduce their effusion from injection site

primarily used in congestive heart failure and shock with low cardiac output

β1 agonist

ide effects include a fast heart rate, an irregular heart beat, and inflammation at the site of injection

positive ionotropic action

Salmeterol,

formoterol

bambuterol

Ipratropium