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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:

Selective cholinergic

drugs affects:

Directacting

Cholinergics

Indirect-acting

Cholinergics

(acetylcholinesterase

inhibitor)

Muscarinic receptors Muscarinic receptors

(or)

Drugs act on receptors

to active tissue

response

Drugs inhibit the action

of cholinesterase

enzyme

(acetylcholinesterase)

Nicotinic receptors Nicotinic receptors Bethanechol chloride

(Urecholine)

increases urination

Neostigmine reduce

IOP and treats urinary

retention.Metoclopramide HCI

(Reglan) treats reflux

disease increasing

gastric emptying time.

Pyridostigmine

increase muscle

strenght

Pilocarpine constrict

the pupils

Echothiopate reduces

IOP

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By inhibiting or destroying the enzyme cholinesterase, more acetylcholine is available tostimulate 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. Stimulate bladder2. Stimulate GI tone3. Constrict pupils of eyes (miosis)4. Increase neuromuscular transmission5. Decrease heart rate6. Decrease blood pressure7. Increase salivary, GI and bronchial glandular secretions

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Anticholinergic ( sympathetic)

- Inhibits the actions of acetylcholine receptors called Anticholinergics orparasympatholytics.

- Major body tissue and organs affected: heart, respiratory tract, GI tract, urinary bladder,eyes and exocrine glands.

Anticholinergics major responses:

1. Increase GI motility2. Decrease salivation3. Dilation of pupil (mydriasis)4. Increase pulse rate5. 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

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Adrenergic, Anti-adrenergic, Cholinergic and Anti-cholinergic

Question Answer

Epinephrine is a _____________drug? Adrenergic

Propranolol is a ______________drug? Adrenergic blocker

Bethanechol is a ______________drug? Cholinergic

Atropine is a _______________drug? Anti-cholinergic (cholinergic blocker)

What 2 drug classes work alike?Adrenergic and Anti-cholinergicAdrenergic

blocker and Cholinergic

What drug classes dilate pupils, dilate bronchioles, increase

rate and depth of breathing, increases HR, constricts

vessels, and increases BP?

Adrenergic and anti-cholinergic

What drug classes constrict pupils, constrict bronchioles

(esp. beta blockers), decreases HR, dilates vessels,

decreases BP?

Adrenergic blocker and Cholinergic

What drug classes relax smooth muscle in the GI tract,

relaxes bladder muscles and increases contraction of

bladder sphincter.

Adrenergic and Anti-cholinergic

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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

mimic the effects of _____________ , ____________ ,

____________.

sympathomemeticsnorepinephrine,

epinephrine, and dopamine