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Pharm2 Lect 4

Pharm2 Cholinomimetics

QuestionAnswer
Direct Muscarinic Agonists 1.Acytelcholine. 2.Methacholine. 3.Bethanechol. 4.Pilocarpine. 5.Carbachol. 6.Cevimeline. 7.Muscarine.
Adverse effects of direct Muscarinic Agonists 1.Inc Salivation. 2.Inc Sweating. 3.Intestinal cramps. 4.Aggravate Ulcer. 5.VD/Hypotension (Endothelial NO). 6.Bradycardia or reflex tachycardia (M2). 7.Asthma. 8.Near vision (lense rounding). 9.Miosis.
Direct Muscarinic Agonists: Acetylcholine & Methacoline Mech of action: Directly binds to M receptors.
Direct Muscarinic Agonists: Pilocarpine 1.Mech of action: Direct M agonist causing salivation, Inc aq humour outflow/drainage for Open & narrow angle glaucoma. 2.Oral, Topical-EYE. 3.Used to treat Open & Narrow Angle glaucoma, Sjogren's syndrome, radiation induced dry mouth.
What is the only drug used to treat NARROW angle Glaucoma (all others are for open angle)? Pilocarpine
How does Pilocarpine affect Open angle glaucoma differently from Narrow angle glaucoma OAG-Contracts ciliary m.: pulls on trabecular meshwork: open holes: Inc outflow of aq humor NAG-contract the iris sphincter smooth m.: induce miosis: pulls the iris away from the trabecular meshwork: Inc outflow of aq humor: dec IOP
Direct Muscarinic Agonists: Bethanechol 1.Mech of action: directly activates M receptors. 2.Used to treat Post-op abdominal distention & urinary retention, Neurogenic atony of the bladder w/o retention. **used to treat NONOBSTRUCTIVE symptoms.
Direct Muscarinic Agonists: Carbachol 1.Mech of action: Directly M agonist that contracts ciliary muscles Inc outflow/drainage of aq humour. 2.used as a 2nd line of defense after Pilocarpine for OAG.
Direct Muscarinic Agonists: Cevimeline 1.Mech of action: Direct M agonist selective on salivary glands. 2.Bioav: longer lasting salivation effect (4-6hrs). 3.Used to treat Sjogren's syndrome (newer than Pilocarpine)
Direct Muscarinic Agonists: Muscarine 1.Mech of action: direct M agonist. 2.From: Mushrooms.
Problems with ACh as a drug? 1.Very short half life. 2.Activates N & M receptors. 3.TOO MANY SIDE EFFECTS.
What M agonist would be best to treat Urinary bladder and GI issues? Bethanechol
Would Bethanechol be good to treat BPH? NO!! it is and OBSTRUCTIVE urinary bladder w/ retention. **Bethanechol only affects NONOBSTRUCTIVE.
What is Sjogren's Syndrome? Autoimmune disease attacking salivary and tear glands. **Treat with: 1.Pilocarpine, 2.Cevimeline (longer lasting and fewer side effects).
Created by: WeeG
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