PHA 3112 Chapter Notes - Chapter 14-16: Acetylcholinesterase Inhibitor, Muscarinic Agonist, Cholinergic
10 Dec 2016
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Drugs are bethanechol (prototype) & cevimeline, pilocarpine, & muscarine. Disease pathophysiology: urinary retention in postoperative & postpartum patients. Pilocarpine is used to treat dry mouth in sj gre(cid:374)"s sy(cid:374)dro(cid:373)e & to treat glau(cid:272)o(cid:373)a (cid:271)y i(cid:374)(cid:272)reasi(cid:374)g intraocular pressure. Muscarinic poisoning can result from ingesting certain mushrooms & overdose w 2 kinds of medications: (1) direct-acting muscarinic agonists (eg, bethanechol, pilocarpine), and (2) cholinesterase inhibitors (indirect-acting cholinomimetics). Symptoms: profuse salivation, lacrimation (tearing), visual disturbances, bronchospasm, diarrhea, bradycardia, & hypotension. Management is direct & specific: administer atropine (a selective muscarinic blocking agent) which blocks muscarinic agonists access to their receptors & reverse most toxicity signs. Drugs are atropine (prototype), ipratropium for asthma, scopolamine for motion sickness, several for overactive bladder. Adverse effects: xerostomia (dry mouth, blurred vision & photophobia, elevation of intraocular pressure, urinary retention. 9. centrally acting muscarinic antagonists can cause hallucinations & delirium. Safety alert: anticholinergic drugs are potentially inappropriate for use in geriatric patients.
