Drug List – Autonomics and Cardiovascular
CHOLINERGIC DRUGSMuscarinic Agonists – ch. 4
– Eye (M3): topical application produces rapid miosis andcontraction of ciliary muscle
accommodation and loss of far vision. One of themost potent stimulators of secretions (sweat, tears, saliva, etc.) but is non-specifica.
lowering intraocular pressure of bothnarrow-angle (closed angle) and wide angle (open angle) glaucoma b.
Side Effects: can enter the brain and cause CNS disturbances; stimulates profuse sweating and salivation. Stinging and local irritation as well2.
– directly stimulates muscarinic receptors, causing
intestinalmotility and tone. Also stimulates the detrusor muscles of the bladder, but not thetrigone and sphincter
expulsion of urine. PO, renal excretion,
not degraded bycholinesterase
Clinical: stimulates atonic bladder (particularly in non-obstructive urinaryretention) b.
Side effects: generalized cholinergic stimulation including: sweating,salivation, flushing,
BP, nausea, abdominal pain, diarrhea, bronchospasm, and miosis.c.
Contraindications: asthmatics (due to bronchoconstriction)3.
– has both muscarinic and nicotinic actions. Effects both the CVsystem and the GI system because of its ganglion-stimulating activity, maystimulate then depress these systems. Can cause epinephrine release from theadrenal medulla by nicotinic action. In the eye, it mimics the effects of ACh
Clinical: glaucoma treatment in the eye as a miotic agent by causing papillary constriction
intraocular pressure b.
Side effects: none when used ophthamalogically
Anticholinesterases – ch. 4
– has cholinergic, nicotinic, and muscarinic actions. It is acholinesterase inhibitor, but is also a tertiary amine and therefore
can cross the BBB
intestinal and bladder motility for atony. In the eye
miosisand spasm of accommodation (glaucoma). Also used to treat overdoses of anticholinergics (atropine, phenothiazine, and tricyclic anti-depressants) b.
Side effects: convulsions, respiratory and cardiovascular depression.Possible paralysis of skeletal muscle, but rare in therapeutic doses5.
– cholinesterase inhibitor
carbamylates cholinesterase’s activesite making the enzyme resistant to hydration (preventing activation)
accumulation of ACh at the neuromuscular junction.
Bowel and bladder smoothmuscle
motility, sphincter relaxation.
: reversesnondepolarizing (i.e. competitive) neuromuscular blockade. Also used for sympathetic and parasympathetic stimulation of the heart (parasympatheticdominates). Effects last 30min – 2hr