PHARMACOLOGY

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  1. Cholinergic drugs are called as parasympathomimetics. They produce an effect similar to the stimulation of parasympathetic nervous system.

Adrenergic drugs are called as sympathomimetics. They produce an effect similar to the stimulation of sympathetic nervous system.

 

  1. Cholinergic Drugs
  2. a) Directly acting drugs that produce actions similar to acetylcholine.
  • Choline esters: Acetylcholine

Methacholine

Carbachol

Bethenechol

  • Alkaloids: Pilocarpine

Muscarine

 

  1. b) Anticholine esterases, which increase the availability of acetylcholine at the receptor sites.
  • Reversible : Physostigmine

Neostigmine

  • Irreversible: Organophosphates

 

  1. Cholinergic drugs brings about the various actions described earlier in point (8)

Cholinomimetics

Direct agonists

Clinical applications

Action
Bethanechol

 

 Postoperative and nurogenic ileus and urinary retention Activates bowel and bladder smooth muscle

 
Carbachol,

pilocarpine

 Glaucoma

 Activates ciliary muscle of eye (open angle), pupillary sphincter (narrow angle)
Indirect agonists

(anticholinesterases)

Neostigimine

 

Pyridostigmine

Edrophonium

 Posoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade (postoperative)

Myasthenia gravis

Diagnosis of myasthenia gravis (extremely short acting)

  

↑ endogenous ACh

 

 

↑ endogenous ACh; ↑ strength

↑ endogenous ACh
Physostigmine

 Glaucoma (cross blood-brain barrier- CNS) ↑ endogenous ACh

Echothiophtate

Glaucoma

↑ endogenous ACh

 

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