Parasympathetic stimulation causes detrusor muscle contraction, increased voiding pressure, and ureteral peristalsis (see Tables 5-1, 6-2, and 6-3). TABLE 6-1 Characteristics of Subtypes of Nicotinic Acetylcholine Receptors (nAChRs)Ī 65-year-old man with urinary retention and inadequate emptying of the bladder is being treated with bethanechol.īethanechol is a muscarinic receptor agonist. MECHANISM OF ACTION MUSCARINIC AGONISTS AND ANTAGONISTS Trihexyphenidyl hydrochloride (ARTANE, others) see Chapter 13 Pyridostigmine bromide (MESTINON-oral REGINOL, MESTINON-parenteral) Pilocarpine hydrochloride (SALAGEN, others) Oxybutynin (DITROPAN, others OXYTROL-transdermal GELNIQUE-gel) Nicotine transdermal patch (HABITROL, others) Nicotine nasal spray or vapor inhaler (NICOTROL) Nicotine gum or lozenge (NICOTINE POLACRILEX, NICORETTE, COMMIT, THRIVE, others) Neostigmine methylsulfate (PROSTIGMIN-parenteral) Mivacurium (Not available in the United States) Malathion (CHEMATHION, MALA-SPRAY)-Insecticide Homatropine hydrobromide (ISOPTO HOMATROPRINE) Know the uses and toxicities of drugs and agents that inhibit AChE.ĭescribe the uses and toxicities of drugs that block neuromuscular transmission.īenztropine mesylate (COGENTIN, others) see Chapter 13Ĭhlorpyrifos (DURSBAN, LORSBAN)-InsecticideĬyclopentolate hydrochloride (CYCLOGYL, others)ĭiazinon (SPECTRICIDE, others)-Insecticideĭicyclomine hydrochloride (BENTYL, others) Know the uses and toxicities of muscarinic receptor agonists and antagonists. Know the mechanisms of synthesis, storage, release, and destruction of ACh in the CNS, parasympathetic and sympathetic ganglia, parasympathetic nerve fibers, and the neuromuscular junction. Understand cholinergic pharmacology, including the different types and subtypes of cholinergic receptors expressed in the central nervous system (CNS), autonomic nervous system (ANS), and neuromuscular junction. A description of the pharmacological actions of nicotine.A discussion of ganglionic transmission.A discussion of the pathophysiology and treatment of malignant hyperthermia.A description of the actions of neuromuscular blocking agents on various organ systems.A description of the nicotinic acetylcholine receptor.A review of the structure of acetylcholinesterase (AChE).A discussion of the toxicology of drugs with antimuscarinic properties.A detailed discussion of the pharmacological effects of atropine, a muscarinic receptor antagonist.The pharmacological effects of acetylcholine (ACh).A complete discussion of the properties and subtypes of muscarinic receptors.In addition to the material presented here the above chapters in the 12th Edition include: An understanding of the material in these chapters will be helpful in following the material presented in this chapter. Chapter 6 Cholinergic Pharmacology is a combination of Chapter 9 Muscarinic Receptor Agonists and Antagonists Chapter 10 Anticholinesterase Agents, and Chapter 11 Agents Acting at the Neuromuscular Junction and Autonomic Ganglia in Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition.
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