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Cholinergic effects

- Pupilary constriction/decrease intraoptic pressure
- Bronchoconstriction and increase secretions
- Vasodilation
- Decrease heart rate (neg chronotropic effects)
- Think "WET" - increased salivation, voiding, sweat
- Sweat: "think vasovagal reaction"
- Increases GI tract secretions and increases peristalsis

Nicotinic receptors

In motor nerves and skeletal muscles of parasympahetic nervous system - causes muscles contraction

Muscarinic receptors

In most intertal organs -> increases secretions

Cholinergic prototype

Protoytpe: neostigmine (Prostigmine)
- Some meds in this category mimic action of acetylcholine
- Some meds in this category inhibit acetylcholine destruction
(i.e. anticholinesterase: destroys cholinesterase (whose job it is to destroy acetylcholine in muscle junction) so allows more acetylcholine to get to muscles

Cholinergic uses

- Bladder/GI tract atony (release bladder/sphincer)
- Dx and Tx of myestenia gravis
- Antidote (to paralysis drug given during surgery)
- Glaucoma
- Alzheimers

Cholinergic: contraindications

-Urinary or GI tract obstruction
- Asthma
- Peptic ulcer
- Pregnancy

Cholinergic: adverse reactions

Common: increase salivation, increase sweating (diaphoresis), abd cramping, N+V, diarrhea
Serious: bradychardia, hypotension, can be so severe -> leads to shock

Anti-cholinergic prototype

Prototype: Atropine

Anti-cholinergic actions

- Increase heart rate
- Bronchodilate
- "DRY" decrease secretions/saliva/sweat
- Dry mouth!
- Dilate pupils
- Increase intraoptic pressure
- Decrease GI motility/secretions
- Decrease sweating
- Urinary retention
- Stimulation of CNS

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