Effects of Agent on Body Systems

Cholinergic

Parasympathomimetic

Anticholinergic

Parasympatholytic

Adrenergic

Sympathomimetic

Adrenergic Blockers

Sympatholytic

“olol” ending on generic

Central Nervous System

Depending on dose, stimulation or depression can occur.  Atropine, scopolamine, Pro-Banthine, Robinul

Increases alertness, anxiety, anorexia

Exocrine Glands

Increase of saliva

Reduce secretions including saliva

Smooth Muscle

Increase in GI motility

Relax smooth muscles in respiratory and GI tract.  Bronchial dilation

a-1 vasoconstriction of skin and mucosal blood vessels.

b-1 stimulates the heart increasing heart rate and conduction velocity.

b-2 Bronchodilation, relaxes smooth muscles, vasodilation of skeletal muscle blood vessels.

Ocular

Miosis (constriction)

Cycloplegia

Decreases intraocular pressure

Mydriasis (dilation) and Cycloplegia (paralysis of accommodation cannot read up close)

Mydriasis (dilation)

Reduced intraocular pressure

Blocks myadriasis

Cardiovascular System

Decreases heart rate

Bradycardia

Hypotension

High dose - Vagal blockade resulting in tachycardia

Small dose - bradycardia

Positive chronotropic  and inotropic effect (increases HR and strength of contraction.

Blocks beta receptor producing bradycardia

Adverse Reactions

SLUD( salivation, lacrimation, urination and defecation increases)

Diarrhea may result

Xerostomia

Blurred vision,

Photophobia,

Tachycardia,

Fever,

Urinary Retention

Reduced GI motility (constipation)

Lower BP

Inhibition of sweating

Reduces milk flow in nursing mothers

Anxiety

Tremors

Serious arrhythmias may result

Alpha adrenergic action can increase blood pressure

Contraindications

Peptic ulcer

Asthma

Obstruction of GI Tract or Urinary tract (because of an increase in secretions)

Glaucoma

Prostatic Hypertrophy (urinary retention)

GI Obstruction

Urinary Obstruction

Prostrate problems

Cardiovascular Disease

Uses

Glaucoma

Xerostomia (Pilocarpine)

Urinary retention after surgery

Myasthenia gravis

Inhibit saliva pre-op

Inhibit mucus pre-op

GI disorders

Eye Exams

Parkinsons Disease

Motion Sickness

Dentistry

Useful during general anesthesia when the heart rate may fall too low.

Anaphylaxis

Cardiac Arrest

Nasal congestion (decongestant)

Asthma (B-2 agonist)

ADD

Glaucoma

Local anesthetic additive (vasoconstrictor)

Hemostatic to reduce bleeding

Shock (elevates blood pressure)

Emphysema

Hypertension

Angina

Arrhythmias

Congestive Heart Failure

Anxiety

Glaucoma

Migraine

Myocardial infarction

Drug Interactions

Additive anticholinergic effect.  Phenothiazines, antihistamines, and tricyclic antidepressants can be additive with parasympatholytics

Treatment of Overdose

Pralidoxime – regenerates acetylcholinesterase.

Atropine – blocks the muscarinic effects of acetylcholine excess.