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Flashcards in Parasympathetic NS Deck (24)
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1

What two categories do PSNS drugs fall into?

1. Parasympathomimetic
2. PSNS Blockers

2

What two sub groups do Parasympathomimetics breakdown into?

1. Acetylcholinesterase inhibitors
2. Pure muscarinic agonists

3

Name two Acetylesterase inhibitors?

1. Neostigmine
2. Malathion

4

Name one pure muscarinic agonist?

1. Pilocarpine

5

What category of PSNS drugs are muscarinic antagonists?

PSNS Blockers

6

What is the MOA of Neostigmine?

- Indirectly and reversibly increases Ach levels by inhibiting Ach-esterase
- Stimulates muscarinic receptors

- Miosis (pupil constriction)
- Increases peristalsis and bladder voiding
- Slows heart rate
- Bronchoconstriction

7

What is the therapeutic use of Neostigmine?

- Diagnosis of myasthenia gravis (Edrophonium)
- Alzheimer's treatment (Rivastigmine)

8

What are the adverse effects / contra-indications of Neostigmine?

- Asthma
- Bradycardia
- Diarrhea
- Salivation

9

What is the MOA of Malathion?

- Indirectly and irreversibly increases Ach levels by inhibiting Ach-esterase.
- All post-ganglionic muscarinic receptors in GIT and bronchial muscles stimulated

- Miosis (pupil constriction)
- Increases peristalsis, mucous production and bladder voiding
- Slows heart rate
- Bronchoconstriction

10

What is the therapeutic use of Malathion?

- HIGHLY toxic pesticide
(antidote = atropine)

11

What are the adverse effects / contra-indications of Malathion?

- Patients drown in own secretions (salivation and mucous production)
- Bradycardia
- Asthma
- Diarrhea

12

What is the MOA of Pilocarpine?

- Stimulates muscarinic receptors
- Miosis
- Opens trabecular network in the canal of Schlemm (fluid can leave eye)

13

What is the therapeutic use of Pilocarpine?

- Allows aqueous humour outflow from eye (lowers intra-occular pressure)
- Used in conjuction with other preparations
- Glaucoma

14

What are the adverse effects / contra-indications of Pilocarpine?

- Asthma
- Diarrhea
- Bradycardia
- Salivation

15

Name three muscarinic antagonists?

1. Atropine
2. Hyasine
3. Ipratropium (bromide)

16

What is the MOA of Atropine?

- Blocks post-ganglionic muscarinic receptors
- Causes cycloplegia (paralysis of cilliary muscles - fail to accommodate for near vision)
- Decreases salivation, mydriasis (pupil dilation), salivary gland secretion and perstalsis
- Prevent bladder voiding (increases sphincter muscle tone)
- Increases heart rate
- Bronchodilation

17

What is the therapeutic use of Atropine?

- Antidote for organophosphate (pesticide) poisoning
- Bradycardia
- Stops vagal induced effects and decreases salivation (presurgery)

18

What are the adverse effects / contra-indications of Atropine?

- Blurred vision
- Dry mouth
- Tachycardia
- Constipation
- Urine retention
- Mydriasis (pupil dilation)
- Glaucoma

19

What is the MOA of Hyoscine?

- Blocks post-ganglionic muscarinic receptors
- Causes cycloplegia (paralysis of cilliary muscles - fail to accommodate for near vision)
- Decreases salivation, mydriasis (pupil dilation), salivary gland secretion and perstalsis
- Prevent bladder voiding (increases sphincter muscle tone)
- Increases heart rate
- Bronchodilation

20

What is the therapeutic use of Hyoscine?

- IBS (Irritable Bowel Syndrome)

* Doesn't cross blood-brain barrier easily

21

What are the adverse effects / contra-indications of Hyoscine?

- Blurred vision
- Dry mouth
- Tachycardia
- Constipation
- Urine retention
- Mydriasis (pupil dilation)
- Glaucoma

22

What is the MOA of Ipratropium?

- Blocks post-ganglionic muscarinic receptors
- Causes cycloplegia (paralysis of cilliary muscles - fail to accommodate for near vision)
- Decreases salivation, mydriasis (pupil dilation), salivary gland secretion and perstalsis
- Prevent bladder voiding (increases sphincter muscle tone)
- Increases heart rate
- Bronchodilation

23

What is the therapeutic use of Ipratropium?

- Asthma (bronchodilator)
- COPD

* Spray/inhalant

24

What are the adverse effects / contra-indications of Ipratropium?

- Blurred vision
- Dry mouth
- Tachycardia
- Constipation
- Urine retention
- Mydriasis (pupil dilation)
- Glaucoma