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Choligernic drugs - Coggle Diagram
Choligernic drugs
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Mechanism of action
Acetylcholine is a major neurotransmitter in the body. Depending on the type of receptors through which it undergoes mediation, the peripheral actions of acetylcholine classify as working on muscarinic or nicotinic receptors.
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M2 receptors are present on the heart, visceral smooth muscle
M3 receptors on the smooth muscle, exocrine glands, and receptors of the bladder.
Nicotinic receptors are present in the central nervous system, adrenal medulla, autonomic ganglia, and neuromuscular junction
Routes of administration
miotic agent, the administration is via ophthalmic eye drops
myasthenia gravis, pyridostigmine dosing is oral
Rivastigmine, donepezil, and galantamine are administered orally
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Indications
Myasthenia gravis: The initial first-line therapy for most patients is anticholinesterase medication, usually pyridostigmine. Neostigmine is also available but not commonly used.
Dementia: Cholinesterase inhibitors like rivastigmine, donepezil, galantamine are the available medications for cognition and global functioning in patients with dementia of all causes. Their primary use is in mild to moderate Alzheimer disease
Ophthalmology: Pilocarpine and carbachol work by increasing the aqueous outflow and hence decrease the intra-ocular tension in open-angle glaucoma. Miotics are used as an add on therapy and are now third-choice drugs. Carbachol has utility with intraocular use as a miotic in surgery.
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