Pharm - Autonomic Parasympathetic drugs Flashcards
Bethanechol
Sketchy: Beth with cola
MOA:
Cholinomimetic
EFFECTS:
Activates bowel and bladder smooth muscle
USES:
Non-obstructive GI dysmotility (post-operative ileus, neurogenic ileus)
Urinary retention
ADVERSE EFFECTS:
Exacerbation of asthma, COPD, or peptic ulcers
Carbachol
Sketchy: tenant upstairs apt hiding from ‘carbon’ fumes
MOA:
Cholinomimetic
EFFECTS:
Constricts pupils
USES:
Relieves intraoccular pressure in open-angle glaucoma
ADVERSE EFFECTS:
Exacerbation of asthma or COPD, or peptic ulcers
Methacholine
Sketchy: “Marathon challenge”
MOA:
Cholinomimetic
EFFECTS:
Stimulates muscarinic receptors in airway
USES:
Methacholine challenge instigates asthma for pulmonary testing
ADVERSE EFFECTS:
Exacerbation of COPD, asthma, peptic ulcers
Pilocarpine
Sketchy: Pile o’ carp
MOA:
Cholinomimetic
EFFECTS:
Contracts ciliary muscle of the eye and pupillary sphincter
USES:
Stimulation of sweat, tears, and saliva
Open- and closed-angle glaucoma
Xerostomia (Sjogren Syndrome)
ADVERSE EFFECTS:
Exacerbation of COPD, asthma, peptic ulcers
Donepezil
Sketchy:
Done puzzle with brain under Alzheimer’s gala
MOA:
Acetyl-cholinesterase inhibitors
EFFECTS:
Increases ACh
USES:
Alzheimer’s
Galantamine
Sketchy:
Alzheimer’s GALA
MOA:
Acetyl-cholinesterase inhibitors
EFFECTS:
Increases ACh
USES:
Alzheimer’s
Rivastigmine
Sketchy:
“Reverse the stigma” under Alzheimer’s gala
MOA:
Acetyl-cholinesterase inhibitors
EFFECTS:
Increases ACh
USES:
Alzheimer’s
Edrophonium
Sketchy: phone booth
MOA:
Acetyl-cholinesterase inhibitor
EFFECTS:
Increases ACh
USES:
Short-acting relief of symptoms of Myasthenia Gravis (not used for this)
Tensilon test for diagnosis (Myasthenic crisis vs. Cholinergic crisis)
Neostigmine
Sketchy: neon sign
MOA:
Quaternary Acetyl-cholinesterase inhibitor (no CNS penetration)
EFFECTS:
Increases ACh
USES:
Treatment of Myasthenia Gravis
Reversal of non-depolarizing neuromuscular blockage during anesthesia
Physostigmine
Sketchy: Phys Ed center
MOA:
Tertiary acetyl-cholinesterase inhibitors (crosses BBB - CNS effects)
EFFECTS:
Increases ACh
USES:
Treatment of Atropine (muscarinic antagonist) overdose
Pyridostigmine
Sketchy: community PRIDE lady cleaning graffiti
MOA:
Quaternary acetyl-cholinesterase inhibitors (no CNS penetration)
EFFECTS:
Increases ACh
USES:
Treatment of Myasthenia Gravis (long acting)
Anti-cholinesterase toxicity (Causes, effect, treatment)
Often caused by organophosphates (e.g. Parathion, Malathion, Echothiophate - components of insecticides) which irreversibly inhibit AChE
DUMBBELSS: D - Diarrhea U - Urination M - Miosis B - Bronchospams B - Bradycardia E - Excitation of skeletal muscle and CNS L - Lacrimation S - Salivation S - Sweating
Treatment: Atropine (competitive inhibitor - central effects) + Pralidoxime (regenerates anticholinesterase - peripheral effects)
Atropine
Sketchy: Alice
MOA:
Non-selective muscarinic antagonist (M1, M2, M3)
EFFECTS: Increase pupil dilation and cycloplegia (paralysis of ciliary muscle - no accommodation) Decrease stomach acid secretion Decrease gut motility Decrease bladder contraction Decrease sweating
USES: Mydriasis Cycloplegia Reverse bradycardia Reverse effects of DUMBBeLSS
ADVERSE EFFECTS: Hyperthermia (due to decreased sweating) Rapid pulse Dry mouth Dry, flushed skin Cycloplegia (Blurred vision) Constipation Disorientation Mydriasis (can lead to acute angle glaucoma in elderly) Urinary retention in men with prostatic hyperplasia
“Hot as a hare, mad as a hatter, dry as a cracker, blind as a bat, high pressure as a kettle)
Benztropine
Sketchy: Benz car
MOA:
M1-selective muscarinic antagonist
Effect:
CNS activity
Uses:
Parkison’s
Dystonia (extra-pyramidal side effects caused by antipsycotics)
Glycopyrrolate
Sketchy: NONE
MOA:
Muscarinic antagonist
Effects:
GI, respiratory activity
Uses:
Preoperative use to reduce airway secretions
Drooling, peptic ulcer
