 Direct acting drugs can be muscurinic or nicotinic

 Pilocarpine is alkaloid and muscurinic direct acting

cholinomimetic drug
 Edrophonium is short acting and indirect acting drug
 In patients with mysthenia an acute worsening of symptoms
usually relieved by increasing cholinesterase inhibitor treatment
of cholinergic crisis
 M3 receptors are Gq coupled and causes increase in IP3
 Varenicline is a newer nicotinic agonist with partial agonist
properties
 Muscurinic toxicity includes CNS stimulation, miosis, spasm of
accomodation, bronchoconstriction, excessive gastrointestinal
and genitourinary smooth muscle activity

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 Due to cholinomimetic drugs activation of neuromuscular end
plates occurs and skeletal muscle contracts
 Bronchi contraction occurs in response to cholinomimetic drugs
 Exocrine gland secretion increases due to cholinomimetic drugs
 Varnecline is partial agonist at N receptors
 Edrophonium is amplifier of endogeneously released Ach
 Parathion is used as an insecticide
 Rivastigmine is a drug for alzheimer's disease
 Sarin and tabun are used as nerve gases and threat against
terrorist
 Varnecline is used for smoking cessation
 Bethanicol activates muscurinic receptors and increases IPE and
DAG
 Pyridostigmine is used for treatment of mysthenia
 Physostigmine is used for the reversal of severe atropine
poisoning
 Nicotine is used for smoking cessation
 Bethanicol is used for bladder and bowel agony
 Pilocarpine is used in sjogren syndrome
 Bethanicol causes cyclospasm, diarrhea, urinary urgency,
vasodilation, reflex tachycardia

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Important seqs from KATZUNG:
 Classification
 Cholinoceptor types and their post receptor mechanisms.. table
7.2
 Effects of cholinomimetic on major organ system
 Clinical uses of indirect acting cholinomimetics
Important tables from katzung…
 7.1
 7.2
 7.3
Important topics from lipponcott…
 Acetylcholine… page# 121
 Pilocarpine… page# 123
 Edrophonium… page# 124
 Physostigmine…page# 125
 Neostigmine… page# 126
 Ecothiophate… page# 127
Important figures from lipponcott…
 4.7
 4.9
 4.10

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SUMMARY TABLES AND HHIGH YIELD TABLES FROM KATZUNG
ARE IMPORTANT

Copyrights: Medical Globe 2020

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