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bethanecol (urecholine)
- muscarinic agonist
- stimulates detrusor muscle of bladder to contract, and relaxation of bladder sphincter.
- stimulates urination after abd surgery
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Cholinesterase Inhibitors
- increases ACh activity by blocking inactivation of ACh (insecticides and nerve gas)
- If ACh is continually stimulated it can cause profuse salivation, pooping, peeing, bronchoconstriction
- ACh is the transmitter at the neuromuscular junction and if continually stimulated can cause respiratory paralysis, can be fatal
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Atrophine
- cholinergic (muscarinic) antagonists
- Pre-op to decrease GI motility and secretion
- increases heart rate treats bradycardia
- antidote for poisoning ( insectic, ner gas, shrooms) that inhibit acetylcholinesterase.
- it was used by ophthmologists to causemydriasis (dial pupils) low half life had to replace
- tropicamide (mydriacyl) 3-4 hour half life causes pupil to dialate also acts as a anticholinergic
- Bella donna plant enlarges pupils
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Ipratropium bromide (atrovent)
- cholinergic (muscarinic) antagonist
- anticholinergic drug used by inhaler treats emphysema and chronic bronchitis
- starts working in 15 min lasts 3-4 hours
- usually used with albuterol it reduces symptoms, does not slow progress of disease
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what are the 5 cholinergic (muscarinic) antagonists?
- atropine
- ipratropium bromide (atrovent)
- tiotropium bromide (spiriva)
- oxybutynin (ditropan and ditropan XL)
- tolterodine (detrol detrol LA)
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Tiotropium bromide (spiriva)
- cholinergic (muscarinic) antagonists
- new anticholinergic
- dry powder inhaler
- onset 15 min lasts 5-6 days
- major advantage over ipratropium it has a longer half life
- major disadvantage it is under patent and $$$
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Oxybutynin (ditropan and ditropan XL)
- cholinergic (muscarinic) antagonist
- antispasmodic
- treats nocturia,incontinence,and frequent peei
- given bid or tid
- available as ditropan XL, taken qd, and as a biweekly patch
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tolterodine (detrol and detrol LA)
- cholinergic (muscarinic) antagonists
- new bladder antispasmodic to compete with ditropan
- given qd and as biweekly patch
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