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Cholinomimetics
Drug | Moa | Uses | Side effects |
---|---|---|---|
Methacholine | Muscurinic receptors in airway (M2 agonist) | Methacholine challenge test Diagnosis of asthma | |
Bethanechol | M3 blockade - bowel and bladder | Post-op paralytic ileus and urinary retention | |
Pilocarpine | Contracts ciliary muscle and pupillary sphincter of eye Stimulates sweat, tears, saliva | Open angle and closed angle glaucoma Sjogrens syndrome- xerostomia | |
Donepezil, rivastigmine,galantamine | Reversible Anticholinesterase (lipid soluble can cross BBB) | Alzheimer's | |
Physostigmine | Reversible AChE inhibitors ( lipid soluble can cross BBB) | Antidote for naticholinergic toxicity - atropine overdose | |
Neostigmine | Reversible AChE inhibitors ( water soluble can't cross BBB) | Post op and neurogenic ileus and urinary retention Reversal of NMJ blockade Myasthenia grevis | |
Edfophonium | Reversible AChE inhibitors ( water soluble can't cross BBB) | Diagnosis of myasthenia grevis previously | |
Pyridostigmine | Reversible AChE inhibitors ( water soluble can't cross BBB) | Long acting - used in myasthenia grevis | |
Carbamates and orgnophosphates | Irreversible AChE inhibitors | Poisoning - Diarrhea Urination Miosis Bronchospasm Bradycardia Emesis Salivation Sweating | Rx - atropine 0.6mg/kg Pralidoxime 30mg/kg IV bolus +8mg/kg/hr infusion |