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Cholinergic - Coggle Diagram
Cholinergic
Pyridostigmine
Contraindication
Contraindication
cases of mechanical intestinal or urinary obstruction and should be used with caution in patients with bronchial asthma
Side effects
Side effects
upset stomach, diarrhea, vomiting, drooling, pale skin, cold sweats, blurred vision, watery eyes, increased urge to urinate, anxiousness and feelings of panic muscle weakness
Storage conditions
Storage conditions
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Route of Administration
Route of Administration
Orally, intravenous
Indication
Indication
Pyridostigmine is indicated for the treatment of myasthenia gravis. When administered intravenously, it is indicated for the reversal or antagonism of the neuromuscular blocking effects of nondepolarizing muscle relaxants, prophylactic agent against irreversible organophosphorus acetylcholinesterase inhibitors, primarily in a military capacity
Mechanism of Action
Mechanism of Action:
Pyridostigmine is a reversible acetylcholinesterase inhibitor that increases extracellular acetylcholine levels in the neuromuscular junction by impairing its breakdown by acetylcholinesterase. The increased acetylcholine leads to increased neural transmission across the junction, which drastically improves myasthenia gravis symptoms. In addition to its use in myasthenia gravis and in reversing neuromuscular blocks, pyridostigmine is also a common first-line treatment in congenital myasthenic syndromes (CMS), of which there are multiple subtypes caused by mutations in more than 30 distinct genes. CMS present similarly to myasthenia gravis, albeit due to distinct underlying causes, and often benefit from pyridostigmine. However, in some subgroups, treatment with pyridostigmine is detrimental; detailed genetic testing is required before starting therapy.
Pilocarpine
Side effects
Side effects
Nausea, occasional headache, visual disturbance
Storage conditions
Storage conditions:
store in room temperature, protect from excessive
Contraindication
Contraindication:
hypersensitivity to pilocarpine, angle-closure glaucoma , hyperthyroidism, urinary obstruction asthma,
Route of Administration
Route of Administration:
Eye drops
Indication
Indication:
glaucoma and radiation-induced xerostomia or ocular hypertension
Mechanism of Action
Mechanism of Action:
Pilocarpine is a cholinergic parasympathomimetic agent. It increases secretion by the exocrine glands, and produces contraction of the iris sphincter muscle and ciliary muscle (when given topically to the eyes )by mainly stimulating muscarine receptors
Neostigmine
Side effects
Side effects:
: • salivation, increased mucus, muscle twitching, bowel or abdominal cramps, nausea, vomiting, diarrhea,, decreased pupil size
Storage conditions
Store in room temperature, protect from light and away from reach of children
Contraindication
Contraindication:
hypersensitivity to neostigmine, and peritonitis or mechanical obstruction of the intestinal or urinary tract.
Route of Administration
Can be administered intraveneously and orally
Indication
INDICATION:
is for the reversal of the effects of non-depolarizing neuromuscular blocking agents after surgery.
Mechanism of Action
Mechanism of Action:
Acetylcholine is the neurotransmitter in the body that is made, stored, and released by the end motor nerve terminals. Acetylcholine is metabolized by an enzyme called acetylcholinesterase that hydrolyzes acetylcholine in the neuromuscular junction. Neostigmine one of the drug in the class of acetylcholinesterase inhibitors. Neostigmine is an oxy-diaphoretic inhibitor of the acetylcholinesterase enzyme, which means that it binds and inhibits via acid-transferring (or binding to the anionic site of the enzyme creating a covalent bond). Neostigmine inhibits acetylcholine into choline and acetic acid. this allows acetylcholine to build up at the neuromuscular junction and overcome the competitive inhibition of nondepolarizing blocking drugs. It is used to accelerate the reversal of nondepolarizing neuromuscular blockade of nicotinic receptors in the neuromuscular junction at the of surgery.
Atropine
Side effects
Side effects:
dryness of mouth, blurred vision, confusion, constipation, dizziness, tachycardia, palpitations, urinary hesitance or retention, abdominal distention, nausea, vomitting or loss of lobido
Storage conditions
Storage condition:
keep in a dry place away from sunlight and out of reach of children
Contra indication
Contraindication:
patient pre-disposed to narrow angle glaucoma
Indication
Indication:
Atropine carries FDA indications for anti-sialagogue/anti-vagal effect, organophosphate/ muscarinic poisoning, and bradycardia
Route of Administration
Route of administration:
Atropine can be administered by Intravenous (IV), subcutaneous,intramuscular, or endotracheal method; IV is preferred
Mechanism of Action
Mechanism of Action:
Atropine is an antimuscarinic that works through competitive inhibition of postganglionic acetylcholine receptors and direct vagolytic action, which leads to parasympathetic inhibition of the smooth muscle. The end effect of increased parasympathetic inhibition allows for pre-existing sympathetic stimulation to predominate, creating increased cardiac output and other associated antimuscarinic side effects