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Pharm Autonomic NS
Cholinergic Agonists
| Question | Answer |
|---|---|
| cholinergic agonists also known as | parasympathomimetics or muscarinic agonists; promote or mimic the action of acetylcholine |
| 3 categories in this class: | 1. muscarinic agonists 2. cholinesterase inhibitors 3. ganglionic stimulants |
| MUSCARINIC AGONISTS: | 1. acetylcholine[Miochol] 2. carbachol[Isopto Carbachol] 3. pilocarpine[Isopto Carpine] 4. bethanechol[Urecholine] 5. methacholine[Provocholine] |
| muscarinic receptors[acetylcholine] are located in: | eye, heart, blood vessels, lung, GI tract, urinary bladder, sweat glands |
| MAs are used clinically to tx | glaucoma and to improve GI and urinary bladder tone |
| ACh is destroyed rapidly by | cholinesterase and Miochol has too short of a half-life so its use is restricted to pupil constriction for procedures |
| methacholine is only used for | dx of bronchiol airway hyper-reactivity by specialists |
| carbachol and pilocarpine are used to tx | glaucoma pilocarpine comes in an oral form that can also be used to tx xerostomia by increasing salivary gland secretion |
| bethanechol[Urecholine] increases the tone of the | detrusor urinae muscle and produces contraction strong enough to initiate micturition and empty the bladder |
| bethanechol also stimulates | gastric motility |
| bethanechol is not destroyed by cholinesterase as quickly as acetycholine | so its effects are more prolonged |
| bethanechol is contraindicated in: | PUD[can cause excessive secretion of gastric acid that could lead to perforation], intestinal obstruction[d/t increased peristalsis], urinary obstruction or weak bladder wall[d/t increase urinary tract pressure] |
| also contraindicated in: | bronchospastic disease[stimulation of muscarinic receptors in lungs resulting in bronchoconstriction] preexisting hypotension, bradycardia, CVD hyperthyroidism |
| other adverse rxns | increased tearing, miosis of pupils, facial flushing |
| Muscarinic poisoning can occur from overdosage and also from certain poisonous mushrooms. Sx are abdominal cramps, salivation, flushing, n/v. Antidote: | Atropine subq |
| drug interactions include nicotine which could create | a critical fall in BP |
| drugs that have antimuscarinic activity and decrease the effects of muscarinic agonists are: | H1 blockers, pheonothiazines, quinidine, procainamide |
| clinical indications: | neurogenic atony of the bladder with retention |
Created by:
heatherbrown2020
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