-
Parasympathomimetics(cholinergics):
Directly acting drugs.
- Pilocarpine:pupil,miosis, M3.
- Bethanechol:bladder increased outflow.
- Used to relieve urinary retention.
Methanechol(myocardium):decrease HR.
-
AchE inhibitors(indirectly acting):
- Reversible:
- Lipid soluble-physostigmine.
- Water soluble-neostigmine.
- Irreversible:
- Organophosphates.
- Carbamates.
They are highly lipid soluble.
-
Antidote for atropine poisoning:
Physostigmine.
-
Atropine blocks which receptors:
- M1,M2,M3.
- But not nicotinic receptors.
-
Physostigmine not given in alzheimer's dzs >60 yrs:
- Memory improves but more S/E present.
- Acts in M1,M2,M3.
- and act in nicotinic receptors.
-
Newer drugs for alzheimer's dzs:
- @Dr.Gobinda:
- D-donepezil.
- R-Rivastigmine.
- G-Galantamine.
-
Water soluble:
- Neostigmine.
- Pyridostigmine.
Edrophonium:used to diagnose MG.
-
Myasthenia gravis:
Auto Abs against ACH(R) on post synaptic membrane.
-
Neostigmine+atropine
Neostigmine is acetylcholine esterase inhibitors.acts on nicotinic receptors,increases ACH.
Atropine inhibits only muscarinic receptors.
-
Use of neostigmine and atropine:
- Cobra bite.
- Reversal of muscle relaxants.
-
AchE reactivators:
- PAM.
- DAM(diacetylmonoximes).
-
Parasympatholytics(anticholinergics):
- Atropine.
- Ipratropium bromide.
- Darifenacil.
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