Cholinergic drugs

• helps promote DUMBBELSS


  Acetylcholine
• promotes urination


  Bethanechol
• stimulates miosis for eye surgery of glaucoma to lessen the amount of fluid in the eye

  Carbachol
• DOC for glaucoma


  Pilocarpine
• treatment for xerostomia; promotes salivation


  Cevimeline
• DOC for emergency lowering of IOP (intraocular pressure) and angle closure glaucoma

  Pilocarpine
• exhibits muscarinic activity and used primarily in ophthalmology

  Pilocarpine
• Test to diagnose Myasthenia Gravis


  Tensilon test
• positive result of tensilon test

  increase in strength and decrease in ptosis
• drug to diagnose myasthenia gravis

  Edrophonium
• drooping or falling upper eyelids

  Ptosis
• tx for overdose of anticholinergic drug

  Physostigmine
• MOA: stimulates muscarinic receptors which then increase the intestinal motility and tone having the relaxation of trigone and sphincter muscles = urination

  Bethanechol
• MOA: mimics the effect of ACh leading to miosis and spasm of accommodation = ciliary muscle of the eye in constant state of contraction (miosis)

  Carbachol
• MOA:


  rapid miosisand contraction of ciliary Muscles → spasm of accommodation → vision is Fixed → focuspilocarpine
• MOA: Binds reversibly to the active center of AChE preventing hydrolysis of ACh

  Edrophonium
• Tertiary amine; substrate for AChE leading to reversible inactivation


  Physostigmine
• MOA: stimulates muscarinic, nicotinic sites of the ANS and nicotinic receptors of the NMJ


  Physostigmine
• Increases intestinal and bladder motility → beneficial for atony


  Physostigmine
• DOC for paralytic anatomy for surgery


  Neostigmine
• greater skeletal muscle effect compared to Physostigmine

  Neostigmine
• Reversibly inhibits AChE in a manner similar to Physostigmine

  Neostigmine
• antidote for competitive neuromuscular blocking agents; and for the management of MG symptoms


  Neostigmine
• chronic management of MG

  Pyridostigmine and Ambenonium
• tx of loss of cognitive function associated with Alzheimer's disease

  Tacrine
• Delay progression of Alzheimer's disease


  Donepezil,Rivastigmine and Galantamine
• Deficiency of cholinergic neurons

  Alzheimer's disease
• Treatment for Alzheimer's disease

  cholinergic agonist because we need to address the deficiency of cholinergic neurons
• 2nd line treatment for glaucoma

  Echothiophate
• MOA: organophosphate that covalently binds via the phosphate group at the active site of the AChE → permanent inactivation

  Echothiophate
• Drug that Treats to:

  Reduce the pressure to prevent the glaucomaEchothiophate
• Example of Nerve Gases

  Sarin, Soman, Tabun
• Organophosphates


  parathion and malathion
• MOA: Reactivates the inhibited AChE; this would serve as an antagonist

  Pralidoxime
• Weak AChE inhibitor and at high doses can exhibit S/E similar to other AChE inhibitors

  Pralidoxime
• Prevent muscarinic side effects

  Atropine
• Reduce persistent convulsion


  Diazepam
• Tertiary amine belladonna alkaloid; High affinity for muscarinic receptors

  Atropine
• MOA: Binds competitively and prevents ACh from binding to desired sites (reversible)

  Atropine
• tx for bradycardia; antispasmodic agent; antisecretory agent

  Atropine