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Drugs

The document discusses several cholinergic drugs and their mechanisms and uses: 1. Pilocarpine is used to treat glaucoma by contracting the iris sphincter muscle and ciliary muscle, facilitating aqueous humor outflow through the canal of Schlemm. 2. Pyridostigmine is commonly used to treat myasthenia gravis symptoms by inhibiting cholinesterase in the periphery but not crossing the blood-brain barrier. Additional immunotherapy is often also required. 3. Atropine antagonizes muscarinic effects of nerve agents. Pralidoxime regenerates cholinesterase activity at nicotinic and muscarinic sites for moderate to severe nerve agent

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ALISYA SOPHIA MOHAMMAD ABU SHAHID CHRIS
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21 views

Drugs

The document discusses several cholinergic drugs and their mechanisms and uses: 1. Pilocarpine is used to treat glaucoma by contracting the iris sphincter muscle and ciliary muscle, facilitating aqueous humor outflow through the canal of Schlemm. 2. Pyridostigmine is commonly used to treat myasthenia gravis symptoms by inhibiting cholinesterase in the periphery but not crossing the blood-brain barrier. Additional immunotherapy is often also required. 3. Atropine antagonizes muscarinic effects of nerve agents. Pralidoxime regenerates cholinesterase activity at nicotinic and muscarinic sites for moderate to severe nerve agent

Uploaded by

ALISYA SOPHIA MOHAMMAD ABU SHAHID CHRIS
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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O

l 7 C 7 C )

a-
a) pilocarpine
In glaucoma:
- Drainage might be compromised due to blockade of canal of Schlemm →
increased intraocular pressure → glaucoma
1 MOA: acts on M3 receptor→contraction of the iris sphincter muscle, producing a
small pupil diameter (miosis) & contraction of the ciliary muscle (opens the trabecular
network)→facilitate outflow of aqueous humor through the canal of Schlemm.

Currently the symptoms of myasthenia gravis are most commonly treated with
pyridostigmine, a quaternary cholinesterase inhibitor that does not cross the blood

:
brain barrier. However most patients also require additional immunotherapy at some
point in their illness (e.g. prednisone, azathioprine, cyclosporine).

Atropine as antidote: antagonizes the muscarinic effects of the nerve agent


• Pralidoxime (2-PAM) given in cases where moderate to severe symptoms develop, and before
aging occurs (usually within 24 hours), acts at both nicotinic and muscarinic sites to regenerate
cholinesterase activity.
• pralidoxime & benzodiazepines should not be used for mild cases

hyoscine
Antispasmodic in IBS
y Prevention of motion sickness

pyrenzepine
• Inhibit gastric acid secretion in the stomach
s • Muscarinic adverse reaction like dry mouth and difficulty of
accommodation is less common in pirenzepine compared to atropine

ipratropivm bromide
> atropine

• Quaternary derivatives of atropine


6 • Use for pts with asthma that cannot take adrenergic agonist
conventional doses ±→

- constipation ,,

-
mydriasis n atropine
F - broncho dilation
-
dy mouth

muscarinic
S : salivation %
agonist
L : lacrimation
② u : urination
D: diaphoresis
G : G1 effect

C- : emesis

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