Drugs of the Parasympathetic NS

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Part of chapter 12: Cholinergic drugs affecting the autonomic nervous system
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Resource summary

Drugs of the Parasympathetic NS
  1. Cholinergics/Parasympathomimetics: Stimulate the parasympathetic NS
    1. Rest and digest response
      1. Direct acting: Bind to cholinergic receptors to produce rest and digest resposne
        1. Relatively resistent to achetylcholenesterase, so they last longer than Ach
          1. Poorly absorbed in Gi tract, do not cross blood-brain barrier
            1. Also called muscarinic agonists
            2. Indirect acting: Inhibit action of AchE, allowing endogenous Ach to avoid rapid destruction and bind with cholinergic receptors for longer
              1. Also called cholinesterase inhibitors
                1. Affects a lot more sites.
                2. Very few of these are widely used because of high potential for serious adverse effects
                  1. Some are used for affect on skeletal muscle (see pg. 135)
                    1. Can cause a cholinergic crisis
                  2. Cholinergic blocking/Anticholinergics: Inhibits the parasympathetic nervous systm
                    1. Fight or flight respose
                      1. Called muscarinic antagonists b/c they're selective for Ach muscarinic receptors
                        1. Competes with Ach for binding with muscarinic receptors,
                          1. Causes sympathetic NS actions to dominate
                          2. Relatively high incidence of side effects
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