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Cholinergics and Anticholinergics Estherlee Newbold-Thompson Nurs 112 - Notes

Two drugs that affect the parasympathetic nervous system: 1. Cholinergics (parasympthomimetics) 2. Anticholinergics (parasympatholytics)

Cholinergic Drugs that stimulate the parasympathetic nervous system. They mimic acetylcholine ( parasympathetic neurotransmitter) Also called cholinergic stimulants or agonists.

Two types of Cholinergics: Muscarinic receptors: stimulate the smooth muscle and slow the heart rate. Nicotinic receptors: (neuromuscular) affects the skeletal muscles.

Nonselective cholinergic drugs affect: Muscarinic receptors

Selective cholinergic drugs affects:

Direct acting Cholinergics

Muscarinic receptors (or)

Drugs act on receptors to active tissue response Bethanechol chloride (Urecholine) increases urination Metoclopramide HCI (Reglan) treats reflux disease increasing gastric emptying time. Pilocarpine constrict the pupils

Nicotinic receptors

Nicotinic receptors

Indirect-acting Cholinergics (acetylcholinesterase inhibitor) Drugs inhibit the action of cholinesterase enzyme (acetylcholinesterase) Neostigmine reduce IOP and treats urinary retention. Pyridostigmine increase muscle strenght Echothiopate reduces IOP

By inhibiting or destroying the enzyme cholinesterase, more acetylcholine is available to stimulate the receptor and remain in contact longer.

Parasympathetics: Eye pupil constriction Lungs bronchioles constriction and increase secretions Heart decrease heart rate Blood vessel dilate Gastrointestinal - increase peristalsis and secretions Bladder contracts Salivary gland increased salivation

Cholinergics major responses: 1. 2. 3. 4. 5. 6. 7. Stimulate bladder Stimulate GI tone Constrict pupils of eyes (miosis) Increase neuromuscular transmission Decrease heart rate Decrease blood pressure Increase salivary, GI and bronchial glandular secretions

Anticholinergic ( sympathetic) Inhibits the actions of acetylcholine receptors called Anticholinergics or parasympatholytics. Major body tissue and organs affected: heart, respiratory tract, GI tract, urinary bladder, eyes and exocrine glands.

Anticholinergics major responses: 1. 2. 3. 4. 5. Increase GI motility Decrease salivation Dilation of pupil (mydriasis) Increase pulse rate Decrease bladder contraction (can result in urinary retention, decrease rigidity and tremor)

Anticholinergic drugs: Scopolamine Atropine relaxes smooth muscles of the GI tract and decreases peristalsis

Adrenergic, Anti-adrenergic, Cholinergic and Anti-cholinergic

Question Epinephrine is a _____________drug? Propranolol is a ______________drug? Bethanechol is a ______________drug? Atropine is a _______________drug? What 2 drug classes work alike?

Answer Adrenergic Adrenergic blocker Cholinergic Anti-cholinergic (cholinergic blocker) Adrenergic and Anti-cholinergicAdrenergic blocker and Cholinergic

What drug classes dilate pupils, dilate bronchioles, increase rate and depth of breathing, increases HR, constricts Adrenergic and anti-cholinergic vessels, and increases BP? What drug classes constrict pupils, constrict bronchioles (esp. beta blockers), decreases HR, dilates vessels, decreases BP? What drug classes relax smooth muscle in the GI tract, relaxes bladder muscles and increases contraction of bladder sphincter.

Adrenergic blocker and Cholinergic

Adrenergic and Anti-cholinergic

What drug classes increase GI motility and increase peristalsis, sphincter muscles relax, constricts bladder muscles and decreases constriction of bladder sphincter?

Adrenergic blocker and Cholinergic

Adrenergics stimulate the ___________ and are also called sympathetic nervous systemadrenergic ___________ ______________. agonists Adrenergics are also known as _____________, because the sympathomemeticsnorepinephrine, mimic the effects of _____________ , ____________ , epinephrine, and dopamine ____________.