Autonomic Drugs

• cholinomimetic agent (direct agonist)
• application:
• - postoperative and neurogenic ileus
• - postoperative and neurogenic urinary retention
• action:
• - activates bowel and bladder smooth muscle
• - resistant to achetylcholine esterase

• cholinomimetic agent (direct agonist)
• application:
• - glaucoma
• - pupillary contraction
• - release of intraocular pressure

• cholinomimetic agent (direct agonist)
• application:
• - potent stimulator of sweat, tears, and saliva
• action:
• - contracts ciliary muscle of eye (open angle)
• - contracts pupillary sphincter (narrow angle)
• - resistant to acetylcholine esterase

• cholinomimetic agent (direct agonist)
• application:
• - challenge test for diagnosis of asthma
• action:
• - stimulates muscarinic receptors in airway when inhaled

• cholinomimetic agent (indirect agonist)
• application:
• - postoperative and neurogenic ileus
• - postoperative and neurogenic urinary retention
• - myasthenia gravis
• - reversal of neuromuscular junction blockade (postoperative)
• action:
• - increases endogenous ACh by blocking AChE
• - no CNS penetration

• cholinomimetic agent (indirect agonist)
• application:
• - myasthenia gravis (long acting)
• action:
• - increase endogenous ACh by blocking AChE
• - increases strength
• - no CNS penetration

• cholinomimetic agent (indirect agonist)
• application:
• - diagnosis of myasthenia gravis (very short acting)
• action:
• - increase endogenous ACh by blocking AChE

• cholinomimetic agent (indirect agonist)
• application:
• - glaucoma (crosses BBB)
• - atropine overdose
• action:
• - increase endogenous ACh by blocking AChE

• cholinomimetic agent (indirect agonist)
• application:
• - glaucoma
• action:
• - increase endogenous ACh by blocking AChE

• Diarrhea
• Urination
• Miosis
• Bronchospasm
• Bradycardia
• Excitation of skeletal muscles and CNS
• Lacrimation
• Sweating
• Salivation

• - antidote - atropine (muscarinic antagonist) and pralidoxime (chemical antagonist to regenerate active cholinesterase)
• - cause - parathion and organophosphates (irreversible inhibitors)

• muscarinic antagonist
• organ system: eye
• application: produce mydriasis and cycloplegia

• muscarinic antagonist
• organ system: eye
• application: produce mydriasis and cycloplegia

• muscarinic antagonist
• organ system: eye
• application: produce mydriasis and cycloplegia

• muscarinic antagonist
• organ system: CNS
• application: Parkinson's Disease

• muscarinic antagonist
• organ system: CNS
• application: motion sickness

• muscarinic antagonist
• organ system: Respiratory
• application: asthma and COPD

• muscarinic antagnoist
• organ system: Genitourinary
• application: reduce urgency in mild cystitis and reduce bladder spasms

• muscarinic antagnoist
• organ system: Genitourinary
• application: reduce urgency in mild cystitis and reduce bladder spasms

• muscarinic antagonist
• organ system: gastrointestinal
• application: peptic ulcer treatment

• muscarinic antagnoist
• organ system: gastrointestinal
• application: peptic ulcer treatment

• muscarinic antagonist
• - increase pupil dilation, cycloplegia
• - decrease secretions
• - decrease acid secretion
• - decrease motility
• - decrease urgency in cystitis

• Hot as a hare (increased body temperature)
• Dry as a bone (decreased secretions, dry mouth)
• Red as a beet (dry, flushed skin)
• Blind as a bat (cycloplegia)
• Mad as a hatter (disorientation)
• Bloated as a toad (constipation)

*can cause acute angle glaucoma in elderly, urinary retention in men with BPH, and hyperthermia in infants

• nictonic antagnoist
• application: ganglionic blocker; used in experimental models to prevent vagal reflex responses to changes in blood pressure
• use: help smokers to quit
• toxicity: severe orthostatic hypertension, blurred vision, constipation, sexual dysfunction

• 1. oxybutynin
• 2. tolteridine
• 3. darfenacin
• 4. solifenacin
• 5. trospium

• direct sympathomimetic
• mechanism: α1, α2, β1, β2 (low doses β1 selective)
• applications:
• - anaphylaxis
• - glaucoma (open angle)
• - asthma
• - hypotension

• direct sympathomimetic
• mechanism: α1, α2 > β1
• applications: hypotension (decreases renal perfusion)