Cholinergic drugs act as parasympathomimetics by either directly activating cholinergic receptors or indirectly inhibiting the enzyme acetylcholinesterase. They have major uses like stimulating bladder and gastrointestinal tone, constricting pupils, and facilitating neuro-muscular transmission. Direct acting drugs act on receptors to trigger a tissue response while indirect acting drugs inhibit acetylcholinesterase. Common effects include increased salivation, lacrimation, urinary incontinence, diarrhea, gastrointestinal cramps, and emesis. Examples are choline esters like bethanechol and cholinergic alkaloids like pilocarpine and arecoline.

1. CHOLINOMETICS/
CHOLINERGIC/
PARASYMPATHOMIMETIC
NALI SOMASHEKAR SANTHOSH

2. CHOLINERGIC/CHLOINOMIMETIC/PARASYMPATHOMIMETIC
 DIRECT ACTING – ACT ON THE RECEPTORS TO ACTIVATE A TISSUE RESPONSE
 INDIRECT ACTING – INHIBIT THE ACTION OF THE ENZYME ACETYLCHOLINESTERASE
 MAJOR USES – STIMULATE BLADDER & GI TONE CONSTRICT PUPILS(MIOSIS),NEURO-
MUSCULAR TRANSMISSION

3. CHOLINERGIC(CHLOINOMIMETIC/PARASYMPATHOMIMETIC)
DRUGS

4. Muscarinicactionsofcholinergicagonists(ach)

5. Muscarinicactionsofcholinergicagonists(ach)

6. Muscarinicactionsofcholinergicagonists(ach)

7. nicotinicactionsofcholinergicagonists(ach)

8. Drugeffectsofcholinergicagents
 SLUDGE
 SALIVATION
 LACRIMATION
 URINARY INCONTINENCE
 DIARRHEA
 GASTROINTESTINAL CRAMPS
 EMESIS

9. CHOLIHNEESTERS
 USES: RARELY USED (EVANESCENT AND NON SELECTIVE ACTION)
 BETHANECHOL: MORE SELECTIVE ON MUSCARINIC RECEPTOR
 NON OBSTRUCTIVE URINARY RETENTION,NEUROGENIC BLADDER.PARALYTIC ILEUS
SIDE EFFECTS
 BLEEDING COLIC
 INVOLUNTARY URINATION/DEFECATION
 SWEATING
 FALL IN BP
 BRONCHOSPASM

10. CHOLINOMIMETICALKALOIDS
1.PILOCARPINE
 SOURCE:PILOCARPUS MICROPHYLLUS
PROMINENT MUSCARINIC ACTIONS:
 GANGLIONIC ACTIUON VIA M1 RECEOTORS
 CVS EFFECT
 SMALL DOSE – FALL IN BP(MUSCATINIC M2)
 HIGHER DOSE - RISE IN BP AND TACHYCARDIA(GANGLION MEDIATED M1)
 EYES-LOCAL APPLICATION-PENETRATES CORNEA,MIOSIS,CILIARY MUSCLE CONTRACTION
USES
 AS MIOTICS( COUNTERACT MYDRIATICS USED FPOR REFRACTION,ALONG WITH
MYDRIATICS TO PREVENT/BREAK ADHESIONS) IN OPEN ANGKE GLAUCOMA

11. 2.ARECHOLIN
SOURCE : FROM BETEL NUT ARECA
MUSCARINIC AS WELL AS NICOTINIC ACTIONS
NO TERAPEUTIC USE
3.MUSCARINE
SOURCE : MUSHROOMS AMANITA MUSCARIA
ONLY MUSCARINIC ACTIONS
NOT USED THERAPEUTICALLY
HAS TOXICOLOGICAL IMPORTANCE CHOLINOMIMETIC ALKALOIDS

12. REFFERENCE
 https://pubmed.ncbi.nlm.nih.gov/30844190/#:~:text=Cholinergic%20medications%20are%
20a%20category,-acting%20and%20indirect-acting
 https://www.ncbi.nlm.nih.gov/books/NBK538163/
 https://www.britannica.com/science/cholinergic-drug