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Cholinergic agonists
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Describe the effects of cholinergic receptors, correlating these effects with the clinical effects of cholinergic
agonists.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions and important drug–drug interactions associated with the direct- and
indirect-acting cholinergic agonists.
3.
Discuss the use of cholinergic agonists across the lifespan.
4.
Compare and contrast the prototype drugs bethanechol, donepezil and pyridostigmine with other cholinergic
agonists.
5.
Outline the care considerations, including important teaching points, for people receiving a cholinergic
agonist.
Glossary of key terms
acetylcholinesterase:
enzyme responsible for the immediate breakdown of acetylcholine when released from the nerve ending;
prevents overstimulation of cholinergic receptor sites
Alzheimer’s disease:
degenerative disease of the cortex with loss of acetylcholine-producing cells and cholinergic receptors;
characterised by progressive dementia
cholinergic agonists:
responding to acetylcholine; refers to receptor sites stimulated by acetylcholine, as well as neurons that release
acetylcholine
miosis:
constriction of the pupil; relieves intraocular pressure in some types of glaucoma
myasthenia gravis:
autoimmune disease characterised by antibodies to cholinergic receptor sites, leading to destruction of the
receptor sites and decreased response at the neuromuscular junction; it is progressive and debilitating, leading to paralysis
nerve gas:
irreversible acetylcholinesterase inhibitor used in warfare to cause paralysis and death by prolonged muscle contraction
and parasympathetic crisis
parasympathomimetic:
mimicking the effects of the parasympathetic nervous system, leading to bradycardia, hypotension, pupil
constriction, increased GI secretions and activity, increased bladder tone, relaxation of sphincters and bronchoconstriction
Test your current knowledge of cholinergic agonists with a PrepU Practice Quiz!
DIRECT-ACTING CHOLINERGIC
AGONISTS
bethanechol
carbachol
pilocarpine
INDIRECT-ACTING
CHOLINERGIC AGONISTS
Agents for myasthenia gravis
edrophonium
neostigmine
pyridostigmine
Agents for Alzheimer’s disease
donepezil
galantamine
rivastigmine
