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Cholinergic Agonists - Coggle Diagram

- - - - edrophonium
        
        short duration of action
        
        poor GI absorp
        
        admin IV
    - - physostigmine, neostigmine, pyridostigmine
        
        intermed duration of action
        
        poor GI absorp
  - - - malathion, chlorpyrifos, dichlorvos
        
        very long duration of action
        
        rapid absorp
        
        widely distrib
  - - - edeophonium
        
        give via injection
        
        musc weakness improving after injection is diag for MG
      - pyridostigmine or neostigmine
        
        give orally or via injection
        
        trtmt for MG
    - - neostigmine or pyridostigmine
        
        give via injection to reverse neuromusc blockade from curare-like drugs
        
        always give AFTER blocking muscarinic recep
        
        will otherwise cause life-threatening side effects
- - - - stim then desensi the nAChRs
    - - musc twitches
      - mild hyperkalemia
      - some muscarinic
        
        SLUD, bradycardia
    - - cholinesterase inhib (neostigmine) will potentiate succinylcholine-induced paralysis
      - no antidote, but ulrashort acting
        
        dogs recover slower
- - - - salivation, lacrimation, urination, defecation/diarrhea
      - vom + CNS effects
      - miosis
    - - severe bradycardia
      - AV block
      - dyspnea
        
        due to bronchoconstric and bronchorrhea
      - reversed by mAChR antagonists (atropine)
  - - - skel musc twitches
      - inc HR and atrial P
      - seizures
    - - hypotension
      - severe bradycardia
      - CNS depression/coma
      - respir paralysis
- - - - smooth musc contrac
      - exocrine secre, cardiac nodes
    - - odd # = linked to Ca release
      - even # = dec cAMP
      - M1: PNS and CNS
      - M2: heart, smooth musc, neurons
      - M3: exocrine gl, blood ves, eyes, bronchioles, bladder, neurons
      - M4 and M5: CNS neurons
  - - - skel musc contrac (somatic nerves)
      - ganglionic transm
    - - N skel musc: skel musc endplates
      - ACh binds to alpha-subunits
      - N neuronal: automonic ganglia
- - - - miosis: pupillary constric
      - lens --> accomodtion for near vision inc
    - - detrusor musc contrac + trigone and sphincter musc relaxa
        
        inc urination
    - - inc intest motil
    - - bronchoconstric and bronchorrhea (inc mucus secre) --> dyspnea
    - - inc saliv
      - inc perspir
      - inc lacri
      - inc gastric acid and intes secre = lead to diarrhea
    - - vasodila and hypotension
      - dec AV nodal conduc
        
        can lead to AV block
      - bradycardia
  - - - desensi nicotinic recep to produce a depolariz neuromusc block
    - - inhib cholinesterase activity and inc endogenous ACh in synapses
        
        reverse non-depolariz neuromusc block produced by competitive nicotinic recep agonists
        
        alleviate myasthenia gravis