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Cholinergic drugs 2
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Direct acting cholinomimetic drugs

Akshaya Ranade is teaching live on Unacademy Plus

Akshaya Ranade
BAMS, MA Political Science with 4+ years of teaching experience; Appeared for UPSC mains 5 times and MPSC Mains twice.

U
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Superb teaching Sir.
  1. Drugs acting on ANS


  2. Cholinergic receptors M1: ON SECRETORY GLANDS: salivation, acid secretion, lacrimation N: SKELETAL MUSCLE END PLATE: contraction N AUTONOMIC GANGLIA, ADRENAL MEDULLA: epinephrine secretiorn M2: HEART: HEART RATE M3: SMOOTH MUSCLES: contraction, bronchospasm, urination M3: PUPIL,CILIARY MUSCLES: miosis, aqueous humour flow


  3. Cholinergic drugs Also called parasympathomimetic drugs or cholinomimetic drugs Stimulate the action of parasympathetic system as does ACh Types Direct acting Indirect acting


  4. Direct acting cholinergic agonists sLUDD-MB Bind directly to receptors, lipid insoluble Effects are peripheral as they do not enter CNS readily Acetylcholine, Methacholine, Carbachol, Muscarine, Pilocarpine, Common effects: 1. Cardiovascular: bradycardia, vasodilation 2. GIT: increase gastric secretion, salivation, git motility, urinary frequency 3. Pupil constriction, sweating 4. Respiratory: bronchoconstriction


  5. BETHANCHOL Not hydrolysed by acetylcholinesterases Stimulates M receptors, detrusor muscles of bladder Used in: urine retention, paralytic ileus, post-op atony of git/bladder, GERD Dose 10-50 mg PO or 10-20 mg SC * TDS/QID Contraindicated in GIT obstruction/bladder obstruction, bradycardia, peptic ulcers, asthma, COPD


  6. PILOCARPINE Lipid soluble, Locally used as eye drops, produces rapid miosis, contraction of ciliary muscles Used in: Glaucoma, causes drainage of aqueous humor, IOP decreases rapidly