Cholinergic Pharmacology

 

Clinical Applications of Cholinergic Receptor Blockers

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P Wave PR Interval QRS (sec.) Characteristics
Before each QRS (identical) > 0.20 < 0.12 Regular

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P Wave

PR Interval

QRS (sec.)

Characteristics

Conduction Intermittent

Increasingly Prolonged

< 0.12

QRS dropped in a repeating pattern

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P Wave PR Interval QRS (sec.) Characteristics
Normal but not related to QRS none N/A No relationship between P & QRS complex

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Stoelting, R.K., "Anticholinesterase Drugs and Cholinergic Agonists", in Pharmacology and Physiology in Anesthetic Practice, Lippincott-Raven Publishers, 1999, 241-244

Brown, J.H and Taylor, P. Muscarinic Receptor Agonists and Antagonists In, Goodman and Gillman's The Pharmacologial Basis of Therapeutics,(Hardman, J.G, Limbird, L.E, Molinoff, P.B., Ruddon, R.W, and Gilman, A.G.,eds) The McGraw-Hill Companies, Inc.,1996, pp.149-159.

Muscarinic Type M3
Agonists Antagonists Tissue Responses Molecular Aspects
acetylcholine,

methacholine

atropine

Smooth muscle Contraction

Phospholipase C (PLC) stimulation through Gq/11

formation: (IP3 ) + diacylglycerol (DAG): increased cytosolic Ca2+

Secretory glands

Increased Secretion

Predominary Sympathetic or Parasympathetic Tone

Antatomical Site

Predominant Autonomic Tone

Effect of Ganglionic Blockade

Arterioles

Sympathetic-adrenergic

vasodilatation; increased peripheral blood flow; hypotension

Veins

Sympathetic-adrenergic

dilatation; blood pooling; decreased venous return; decreased cardiac output

Heart

Parasympathetic-cholinergic

tachycardia

Ciliary Muscle

Parasympathetic-cholinergic

cycloplegia (loss of accommodation)

Gastrointestinal Tract

Parasympathetic-cholinergic

reduced tone and motility; constipation; decreased secretions

Salivary Glands

Parasympathetic-cholinergic

Xerostomia (dry mouth)

Sweat Glands

Sympathetic-cholinergic

Anhidrosis (lack of sweating)

Taylor, P. Agents Acting at the Neuromuscular Junction and Autonomic Ganglia In, Goodman and Gillman's The Pharmacologial Basis of Therapeutics,(Hardman, J.G, Limbird, L.E, Molinoff, P.B., Ruddon, R.W, and Gilman, A.G.,eds) The McGraw-Hill Companies, Inc.,1996, pp.193-195. Adapted from Table 9-3.

 

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