PPT-A Cholinergic Challenge…

Written by Dr Amy Armstrong Nov 2023 Emergency Medicine Teaching Programme Clinical Case A 45yearold farmer is brought in as a standby to resus having been found unwell in an agricultural store on his farm by another worker . A Selective Overview. Carl Rosow, M.D., Ph.D.. Disclosures. Consultant – Salix Pharmaceuticals. Topics for Today. Pharmacodynamics. Receptors, potency, efficacy. Agonists, antagonists. The dose response curve. A:- Precursor -. Choline. B :- Enzyme- . . Synthesizing - Choline . Acetylase. . Degrading - . A. cetycholine. Esterase . (TRUE). . - . SYSTEM. . . TWO MAJOR DIVISIONS. PARASYMPATHETIC. -ganglia close to organ innervated. -. preganglionic. fibers are . myelinated. and long. -postganglionic fibers short and . unmyelinated. SYMPATHETIC. Cholinergic Agonists Direct-Acting Cholinomimetics Direct-Acting Cholinergic Agonists (N & M) Cholinergic agonists (parasympathomimetics) mimic the effects of ACh on cholinoceptors. These agents broadly classified into A:- Precursor -. Choline. B :- Enzyme- . . Synthesizing - Choline . Acetylase. . Degrading - . A. cetycholine. Esterase . (TRUE). . - . 11/10/17 . Case 1: . 18 month old girl brought the ER by ambulance after grandmother was unable to wake her up from a long nap. . No concurrent illness. On exam: Shallow breathing, moans and withdraws in response to pain, does not open her eyes. Rest of physical exam is normal. . Cholinergic antagonist is a general term for agents that bind . to . cholinoceptors. (muscarinic . or nicotinic) and prevent the . effects . Abd. Al- Kader. PhD Pharmacology. THE CHOLINERGIC . NEURON. 1. The . preganglionic. fibers terminating in the . adrenal medulla. 2. The autonomic ganglia . (both parasympathetic and sympathetic. ). Dr.. . Nirbhay. Kumar. Asstt. . Professor & Head. Deptt. . of Veterinary Pharmacology & Toxicology. Bihar Veterinary College, Bihar Animal Sciences University, Patna. Cholinergic Transmission. that bind . to . cholinoceptors. (. muscarinic. . or nicotinic) . and prevent . the effects of . acetylcholine (. ACh. ) and . other . cholinergic agonists. The most clinically. useful of these agents are selective . . Dr.. Rashmi . Rekha. Kumari. Asstt. . Prof, . Deptt. . Of Pharmacology & Toxicology,BVC,Patna-14. Cholinergic transmission. Neurohumoral. transmission . either at synapse or neuroeffector junction in which acetylcholine act as a humoral agent(neurotransmitter) for transmission of action potential across the junction. Direct-Acting Cholinergic Agonists (N & M). Cholinergic agonists (parasympathomimetics) mimic the effects of ACh on cholinoceptors.. These agents broadly classified into. :. Endogenous choline esters, Ach. on. . intestine and % of antagonism. .. PHL 313 (Lab. . 2). 2. 3. The . “Muscarinic Actions” . -- Similar to those of. . parasympathetic . stimulation. • . (M1): CNS, PNS, gastric parietal cells . muscarinic. antagonist / . muscarinic. blocker.. OBJECTIVES. Classify & describe cholinergic antagonists. Explain actions, therapeutic uses & adverse reactions of cholinergic antagonists. Cholinergic antagonist / Cholinergic blockers.