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M1 M2 M3 Nm Nn Gq Gi Gq Ionotropic Ionotropic Phospholipase C IP3, DAG, Ca2+ --------------------- Agonist: Muscarine Antagonist: Atropine Inhibit Adenylyl Cyclase Reduce cAMP ----------------------------------- Agonist: Muscarine Antagonist: Atropine Phospholipase C IP3, DAG, Ca2+ --------------------- Agonist: Muscarine Antagonist: Atropine Opening of Na/K Channels ----------------------------------------- Agonist: Nicotine Antagonist: Tubocurarine Opening of Na/K Channels ----------------------------------------- Agonist: Nicotine Antagonist: Tubocurarine Reflexes: Carotid Sinus ------------------------ Increased AVERAGE BP: Vagal Reflex Slows HR ---------------- Decreased AVERAGE BP: Sympathetic Reflex Increases HR CNS Autonomic Ganglia Heart: Heart Rate (NOT BP) Smooth Muscles Decrease in Heart Rate (Negative Chorontropy) Decrease in Conduction (Negative Dromotropy) Smooth Muscles (Eye): Contraction of Sphincter Muscle (Miosis) Increased Outflow of Aqueous Humor (Reduction of Intraocular Tension) Contraction of Ciliary Muscle (Relaxes Suspensatory Ligaments --> Spasm of Accommodation for Near Vision) ----------------------------------------- Bladder: Contraction of Detrusor Muscle Relaxation of Trigone/Sphincter Muscles ----------------------------- Respiratory Tract: Constriction of Bronchus (Bronchospasm) Increases Respiratory Secretions ------------------------ GIT: Increases Tone + Peristalsis Increases Secretion of GIT Glands Causes Intestinal Contractions + Diarrhea Involuntary Defecation Increased Sweat, Lacrimal, Salivary Secretions Neuromuscular Junction (Skeletal Muscle) Ganglia (Sympathetic + Parasympathetic Pre-Ganglionic) Adrenal Medulla Drug: Drug Class: Mechanism of Action: Indications: Adverse Effects: Contraindications: Hemicholinium Indirect Cholinergic Antagonists Acetylcholine Inhibitor Blocks Transport of Choline into the Nerve Cell Blocks Acetyl + Choline --> Acetylcholine Shuts Down Entire Parasympthethic System Shuts Down Entire Pre-Ganglionic Synapses (SNS + PNS) Vesamicol Indirect Cholinergic Antagonists Acetylcholine Inhibitor Blocks Uptake and Storage of Acetylcholine into the Vesicles Botulinum Toxin Indirect Cholinergic Antagonists Acetylcholine Inhibitor Blocks the Release of Acetylcholine from the Vesicles Spider Venom Indirect Cholinergic Agonists Over-Release of Acetylcholine Causes Release of Acetylcholine Butyryl Cholinesterase Indirect Cholinergic Antagonists Acetylcholine Inhibitor Pseudocholinesterase Breaks Down Acetylcholine in the Pre-Synaptic Cleft Present in Plasma, Liver, and Intestines Acetylcholine Direct Cholinergic Agonists: Choline Ester Short Duration Poorly Absorbed Poorly Lipid Soluble Poor BBB Penetration Acts on both Muscarinic + Nicotinic Receptors Direct Administration: Ach --> Blood Vessels (M3) Causes: Arginine --> Nitric Oxide/EDRF GTP --> cGMP --> VASODILATION No Theraputic Implications: Diffuse Action (More Side Effects) Rapid Hydrolysis (Within Seconds) --------------------- Direct Administration: Tx: Hypertension Direct Administration: M2-M3 Side Effects Reflex Tachycardia (Sympathetic Reflex (M2) Decrease in Conduction of Heart (M2) Increases in Tone and Peristalsis of GIT (M3) Increases in Secretions of GIT Glands Intestinal Contractions --> Diarrhea and Involuntary Defecation (M3) Constriction of Bronchioles + Respiratory Secretions (M3) Methacholine Direct Cholinergic Agonists: Choline Ester Short Duration Poorly Absorbed Poorly Lipid Soluble Poor BBB Penetration NO NICOTINIC ACTION Constricts Bronchioles Increase in Respiratory Secretions Very Little Theraputic Implication: Very Short-Lived Used in Diagnosis of Bronchial Hyperactivity + Asthmatic Conditions (Metacholine Challenge) Carbachol Direct Cholinergic Agonists: Choline Ester Relatively Short Duration Poorly Absorbed Poorly Lipid Soluble Poor BBB Penetration Can Cause Relesae of Epinephrine from Adrenal Medulla (Nicotinic Action) Local Miotic Agent (Constricts the Pupil) Reduces Intraocular Tension Used Locally for Glaucoma Treatment (Eye Drops) No Side Effects due to Locality of the Eye Drops Bethanechol Direct Cholinergic Agonists: Choline Ester Relatively Short Duration Poorly Absorbed Poorly Lipid Soluble Poor BBB Penetration NO NICOTINIC ACTION Stimulates Atonic Bladder (Postpartum-Postoperative) NON-OBSTRUCTIVE Urinary Retention Postpartum-Postoperative Atonic Bladder Congenital Megacolon Paralytic Ileus (Post-Op, Neurogenic) Generalized Effects of Cholinergic Stimulation: Sweating, Salivation, Flushing, Decreased BP, Nausea, Abdominal Pain, Diarrhea, Bronchospasm Pilocarpine Tertiary Amine Crosses BBB Direct Cholinergic Agonists: Cholinomimetic Alkaloid Long Duration Far Less Potent Penetrates BBB Obtained from Leaves of Pilocarpus Microphyllus Applied Topically to the Cornea Produces Rapid Miosis Contraction of the Ciliary Muscle (Spasm of Accommodation) Drug of Choice: Emergency: Lowering Intraocular Tension of both Narrow Angle (Closed Angle) and Wide Angle (Open Angle) Glaucoma ------------------- Sjogren's Syndrome: Promotes Salivation in Patients with Xerostomia Can also be caused by Irradiation of the Head and Neck Diaphoresis (Profuse Sweating) Salivation Can Enter BBB --> CNS Disturbances --> Convulsions Arecholine Direct Cholinergic Agonists: Cholinomimetic Alkaloid Long Duration Drug: Drug Class: Mechanism of Action: Indications: Adverse Effects: Contraindications: Edrophonium Quaternary Does NOT Cross BBB Indirect Cholinergic Agonists: Anticholinesterase Reversible Short-Acting Agents that Inhibit Acetylcholineasterase Protects Acetylcholine from Hydrolysis ------------------------------------- Combine with ChE and Carbamylated Enzyme is Slow to Hydrolyze and Free the Enzyme (10-20 Minutes) DIAGNOSIS of Myasthenia Gravis Tensilon Test Used to Differentiate Myasthenia Gravis from Cholinergic Crisis No CNS Side Effects +Generalized Cholinergic Stimulation Physostigmine Tertiary DOES Cross BBB Indirect Cholinergic Agonists: Anticholinesterase Reversible Intermediate-Acting Agents that Inhibit Acetylcholineasterase Protects Acetylcholine from Hydrolysis ------------------------------------- Combine with ChE and Carbamylated Enzyme is Slow to Hydrolyze and Free the Enzyme (30 Minutes) Oral Absorption is Good. Uncharged, Lipid Soluble, Crosses BBB Tx: Glaucoma (Lower Intraocular Tension and Produce Miosis) Tx: Bladder/Intestinal Atony Tx: Antidote in Atropine Overdose Can Enter BBB --> CNS Disturbances --> Convulsions Atria AV Node SA Node

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Page 1: Drug: Drug Class: Mechanism of Action: Indications ... · Increases in Tone and Peristalsis of GIT (M3) Increases in Secretions of GIT Glands Intestinal Contractions --> Diarrhea

M1 M2 M3 Nm NnGq Gi Gq Ionotropic Ionotropic

PhospholipaseCIP3,DAG,Ca2+---------------------

Agonist:MuscarineAntagonist:Atropine

InhibitAdenylylCyclaseReducecAMP

-----------------------------------Agonist:MuscarineAntagonist:Atropine

PhospholipaseCIP3,DAG,Ca2+---------------------

Agonist:MuscarineAntagonist:Atropine

OpeningofNa/KChannels-----------------------------------------

Agonist:NicotineAntagonist:Tubocurarine

OpeningofNa/KChannels-----------------------------------------

Agonist:NicotineAntagonist:Tubocurarine

Reflexes:CarotidSinus

------------------------IncreasedAVERAGEBP:

VagalReflexSlowsHR

----------------DecreasedAVERAGEBP:

SympatheticReflexIncreasesHR

CNSAutonomicGanglia

Heart:HeartRate(NOTBP)SmoothMuscles

DecreaseinHeartRate(NegativeChorontropy)DecreaseinConduction(NegativeDromotropy)

SmoothMuscles(Eye):ContractionofSphincterMuscle(Miosis)IncreasedOutflowofAqueousHumor(ReductionofIntraocularTension)

ContractionofCiliaryMuscle(RelaxesSuspensatoryLigaments-->Spasmof

AccommodationforNearVision)-----------------------------------------

Bladder:ContractionofDetrusorMuscle

RelaxationofTrigone/SphincterMuscles-----------------------------RespiratoryTract:

ConstrictionofBronchus(Bronchospasm)IncreasesRespiratorySecretions

------------------------GIT:

IncreasesTone+PeristalsisIncreasesSecretionofGITGlands

CausesIntestinalContractions+DiarrheaInvoluntaryDefecation

IncreasedSweat,Lacrimal,SalivarySecretions

NeuromuscularJunction(SkeletalMuscle)

Ganglia(Sympathetic+ParasympatheticPre-Ganglionic)

AdrenalMedulla

Drug: DrugClass: MechanismofAction: Indications: AdverseEffects: Contraindications:

Hemicholinium IndirectCholinergicAntagonistsAcetylcholineInhibitor

BlocksTransportofCholineintotheNerveCellBlocksAcetyl+Choline-->Acetylcholine

ShutsDownEntireParasympthethicSystemShutsDownEntirePre-GanglionicSynapses(SNS+PNS)

Vesamicol IndirectCholinergicAntagonistsAcetylcholineInhibitor

BlocksUptakeandStorageofAcetylcholineintotheVesicles

BotulinumToxin IndirectCholinergicAntagonistsAcetylcholineInhibitor

BlockstheReleaseofAcetylcholinefromtheVesicles

SpiderVenom IndirectCholinergicAgonistsOver-ReleaseofAcetylcholine

CausesReleaseofAcetylcholine

ButyrylCholinesterase

IndirectCholinergicAntagonistsAcetylcholineInhibitor

PseudocholinesteraseBreaksDownAcetylcholineinthePre-SynapticCleft

PresentinPlasma,Liver,andIntestines

Acetylcholine

DirectCholinergicAgonists:CholineEsterShortDurationPoorlyAbsorbed

PoorlyLipidSolublePoorBBBPenetration

ActsonbothMuscarinic+NicotinicReceptorsDirectAdministration:

Ach-->BloodVessels(M3)Causes:

Arginine-->NitricOxide/EDRFGTP-->cGMP-->VASODILATION

NoTheraputicImplications:DiffuseAction(MoreSideEffects)RapidHydrolysis(WithinSeconds)

---------------------DirectAdministration:

Tx:Hypertension

DirectAdministration:M2-M3SideEffectsReflexTachycardia(SympatheticReflex(M2)

DecreaseinConductionofHeart(M2)IncreasesinToneandPeristalsisofGIT(M3)IncreasesinSecretionsofGITGlandsIntestinal

Contractions-->DiarrheaandInvoluntaryDefecation(M3)ConstrictionofBronchioles+RespiratorySecretions(M3)

Methacholine

DirectCholinergicAgonists:CholineEsterShortDurationPoorlyAbsorbed

PoorlyLipidSolublePoorBBBPenetration

NONICOTINICACTIONConstrictsBronchioles

IncreaseinRespiratorySecretions

VeryLittleTheraputicImplication:VeryShort-Lived

UsedinDiagnosisofBronchialHyperactivity+AsthmaticConditions

(MetacholineChallenge)

Carbachol

DirectCholinergicAgonists:CholineEster

RelativelyShortDurationPoorlyAbsorbed

PoorlyLipidSolublePoorBBBPenetration

CanCauseRelesaeofEpinephrinefromAdrenalMedulla(NicotinicAction)

LocalMioticAgent(ConstrictsthePupil)ReducesIntraocularTension

UsedLocallyforGlaucomaTreatment(EyeDrops) NoSideEffectsduetoLocalityoftheEyeDrops

Bethanechol

DirectCholinergicAgonists:CholineEster

RelativelyShortDurationPoorlyAbsorbed

PoorlyLipidSolublePoorBBBPenetration

NONICOTINICACTIONStimulatesAtonicBladder(Postpartum-Postoperative)

NON-OBSTRUCTIVEUrinaryRetention

Postpartum-PostoperativeAtonicBladder

CongenitalMegacolonParalyticIleus(Post-Op,Neurogenic)

GeneralizedEffectsofCholinergicStimulation:Sweating,Salivation,Flushing,DecreasedBP,Nausea,

AbdominalPain,Diarrhea,Bronchospasm

PilocarpineTertiaryAmineCrossesBBB

DirectCholinergicAgonists:CholinomimeticAlkaloid

LongDurationFarLessPotentPenetratesBBB

ObtainedfromLeavesofPilocarpusMicrophyllusAppliedTopicallytotheCornea

ProducesRapidMiosisContractionoftheCiliaryMuscle

(SpasmofAccommodation)

DrugofChoice:Emergency:

LoweringIntraocularTensionofbothNarrowAngle(ClosedAngle)andWide

Angle(OpenAngle)Glaucoma-------------------

Sjogren'sSyndrome:PromotesSalivationinPatientswith

XerostomiaCanalsobecausedbyIrradiationof

theHeadandNeck

Diaphoresis(ProfuseSweating)Salivation

CanEnterBBB-->CNSDisturbances-->Convulsions

ArecholineDirectCholinergicAgonists:CholinomimeticAlkaloid

LongDuration

Drug: DrugClass: MechanismofAction: Indications: AdverseEffects: Contraindications:

EdrophoniumQuaternary

DoesNOTCrossBBB

IndirectCholinergicAgonists:Anticholinesterase

ReversibleShort-Acting

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------CombinewithChEandCarbamylatedEnzymeisSlowto

HydrolyzeandFreetheEnzyme(10-20Minutes)

DIAGNOSISofMyastheniaGravisTensilonTest

UsedtoDifferentiateMyastheniaGravisfromCholinergicCrisis

NoCNSSideEffects+GeneralizedCholinergicStimulation

PhysostigmineTertiary

DOESCrossBBB

IndirectCholinergicAgonists:Anticholinesterase

ReversibleIntermediate-Acting

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------CombinewithChEandCarbamylatedEnzymeisSlowto

HydrolyzeandFreetheEnzyme(30Minutes)

OralAbsorptionisGood.Uncharged,LipidSoluble,CrossesBBB

Tx:Glaucoma(LowerIntraocularTensionand

ProduceMiosis)Tx:Bladder/IntestinalAtony

Tx:AntidoteinAtropineOverdose

CanEnterBBB-->CNSDisturbances-->Convulsions

Atria AV Node SA Node

Page 2: Drug: Drug Class: Mechanism of Action: Indications ... · Increases in Tone and Peristalsis of GIT (M3) Increases in Secretions of GIT Glands Intestinal Contractions --> Diarrhea

NeostigmineQuaternary

DoesNOTCrossBBB

IndirectCholinergicAgonists:Anticholinesterase

ReversibleIntermediate-Acting

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------CombinewithChEandCarbamylatedEnzymeisSlowto

HydrolyzeandFreetheEnzyme(30Minutes-2Hours)

PoorOralAbsorptionTx:

ProminentActiononSkeletalMusclesTx:

ParlyticIleus/CongenitalMegacolonTx:UrinaryRetention

Tx:AntidoteinTubocurarineOverdose

Tx:MyastheniaGravis

NoCNSSideEffectsTubocurarine:RelaxesSkeletalMuscles

(DuringSurgeries)

DemecariumQuaternary

DoesNOTCrossBBB

IndirectCholinergicAgonists:Anticholinesterase

ReversibleIntermediate-Acting

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------CombinewithChEandCarbamylatedEnzymeisSlowto

HydrolyzeandFreetheEnzyme(30Minutes-2Hours)

Tx:OpenAngleandClosed-Angle

GlaucomaNoCNSSideEffects

PyridostigmineAmbenoniumQuaternary

DoesNOTCrossBBB

IndirectCholinergicAgonists:Anticholinesterase

ReversibleLong-Acting

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------Pyridostigmine:3-6HoursAmbenonium:4-8Hours

Tx:ChronicManagementofMyastheniaGravis

Tx:ParlyticIleus/CongenitalMegacolon

Tx:UrinaryRetention

NoCNSSideEffects

TacrineDonepezil

RivastigmineGalantamineTertiary

DoesCrossBBB

IndirectCholinergicAgonists:Anticholinesterase

ReversibleLong-Acting

Anti-ChE Tx:Alzheimer'sDisease CanEnterBBB-->CNSDisturbances-->Convulsions

Organophosphates:Echothiophate

THIOLS

IndirectCholinergicAgonists:Anticholinesterase

IrreversibleInsectisides/NerveGasPoisons

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------ParalysisofMotorFunction(BreathingDifficulty)ConvulsionsProduceIntenseMiosis(Therapeutic)

Aging:ThePhosphorylatedEnzymeslowlyreleasesoneofitsethylgroups.Thismakesitimpossibleforenzymereactivator(Pralidoxime)tobreakthebondbetweenthedrugandenzyme

=Irreversible.------------------------

Tx:Open-AngleGlaucoma

CataractsDUMBBELSS:D:DiarrheaU:UrinationM:Miosis

B:Bradycardia+BronchoconstrictionE:Excitation(CNS+Muscle)

L:LacrimationS:Salivation+Sweating

Organophosphates:ParathionMalathion

(Insecticides)THIOLS

IndirectCholinergicAgonists:Anticholinesterase

IrreversibleInsectisides/NerveGasPoisons

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------CompoundsreactwithEsteraticSite,whichishydrolyzed

extremelyslowlywithwaterornotatall.

Aging:ThePhosphorylatedEnzymeslowlyreleasesoneofitsalkylgroups.Thismakesitimpossibleforenzymereactivator(Pralidoxime)tobreakthebondbetweenthedrugandenzyme

=Irreversible.Tx:NOTHING

DUMBBELSS:D:DiarrheaU:UrinationM:Miosis

B:Bradycardia+BronchoconstrictionE:Excitation(CNS+Muscle)

L:LacrimationS:Salivation+Sweating

Organophosphates:ParathionMalathion

Diazinon(TIK-20)Echothiophate

SomanSarinTabun

IndirectCholinergicAgonists:Anticholinesterase

IrreversibleInsectisides/NerveGasPoisons

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------B

Aging:ThePhosphorylatedEnzymeslowlyreleasesoneofitsalkylgroups.Thismakesitimpossibleforenzymereactivator(Pralidoxime)tobreakthebondbetweenthedrugandenzyme

=Irreversible.Tx:NOTHING

DUMBBELSS:D:DiarrheaU:UrinationM:Miosis

B:Bradycardia+BronchoconstrictionE:Excitation(CNS+Muscle)

L:LacrimationS:Salivation+Sweating

Carbamates:CarbarylPropoxur

IndirectCholinergicAgonists:Anticholinesterase

IrreversibleInsectisides/NerveGasPoisons

AgentsthatInhibitAcetylcholineasteraseProtectsAcetylcholinefromHydrolysis

-------------------------------------

CholinesteraseReactivators:Pralixdoxime

CholinesteraseReactivators

BindswithAnionicSiteofChEandundergoesreactiontocauseHydrolysisofPhosphoserineBond,resultinginfree

enzyme.ButyouNEEDTOGIVEATROPINEorPatientwillnot

survivethesymptoms

OPPoisoning:Shouldbeadministeredasearlyaspossible

(24hoursismaximum).BeforeAgingTakesPlace(LossofAlkylGroup)

TreatmentisineffectiveinthecaseofPhysostigmineorNeostigmine

(Carbamates)CanAlsoGiveAtropine:Counteract

MuscarinicEffects

Drug: DrugClass: MechanismofAction: Indications: AdverseEffects: Contraindications:

AtropineHyoscine

GlycopyrrolateTertiaryAmineDoesCrossBBB

CholenergicAntagonist:NaturalAlkaloid

ObtainedfromAtropaBelladonaTachycardia(BlocksM2)

NOCHANGEinBPMydriasis(PupilDilation)(M3)

Cycloplegia(ParalysisofAccommodation)(M3)Constipation(M3)Bronchodilation(M3)UrinaryRetention(M3)

DecreasedSecretions(M3)BodyTemperatureIncreases:AtropineFever

Compensatory:DilatesBloodVesselsonFace(AtropineFlush)(M3)

Parkinson'sDisease:TremorsPreanestheticMedication

ReduceSecretionsBradycardiainAcuteMI

HighDoses:CNS:MinimalRestlessness,Excitement,Hallucinations

Toxicity:GiveAtropineChildrendonotcompensateforBodyTemperature

IncreasesbyVasodilation-->Fever-->DeathBlurredVision(Mydriasis+Cycloplegia)

DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

GlaucomaUrinaryRetention(BPHPatients)

ScopolamineTertiaryAmineDoesCrossBBB(BetterthanAtropine)

CholenergicAntagonist:NaturalAlkaloid

3-7DaysBlocksMuscarinicReceptorsinVestibulocochlearNerve

PreventsorReversesVestibularDisturbances(MotionSickness)

45Hours-1HourBefore:Preference

BlurredVision(Mydriasis+Cycloplegia)DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

HyoscineGlycopyrrolateDicyclomine

CholenergicAntagonist:SyntheticAlkaloid

Tachycardia(BlocksM2)NOCHANGEinBP

Mydriasis(PupilDilation)(M3)Cycloplegia(ParalysisofAccommodation)(M3)Constipation(M3)

Bronchodilation(M3)UrinaryRetention(M3)

DecreasedSecretions(M3)BodyTemperatureIncreases:AtropineFever

Compensatory:DilatesBloodVesselsonFace(AtropineFlush)(M3)

Antispasmodic

BlurredVision(Mydriasis+Cycloplegia)DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

IpratropiumTiotropium

CholenergicAntagonist:SyntheticAlkaloid

Tachycardia(BlocksM2)NOCHANGEinBP

Mydriasis(PupilDilation)(M3)Cycloplegia(ParalysisofAccommodation)(M3)Constipation(M3)

Bronchodilation(M3)UrinaryRetention(M3)

DecreasedSecretions(M3)BodyTemperatureIncreases:AtropineFever

Compensatory:DilatesBloodVesselsonFace(AtropineFlush)(M3)

BronchialAsthmaCOPD

BlurredVision(Mydriasis+Cycloplegia)DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

Page 3: Drug: Drug Class: Mechanism of Action: Indications ... · Increases in Tone and Peristalsis of GIT (M3) Increases in Secretions of GIT Glands Intestinal Contractions --> Diarrhea

TropicamideHomatropineCyclopentolate

CholenergicAntagonist:SyntheticAlkaloid

Lasts.25DaysTachycardia(BlocksM2)

NOCHANGEinBPMydriasis(PupilDilation)(M3)

Cycloplegia(ParalysisofAccommodation)(M3)Constipation(M3)Bronchodilation(M3)UrinaryRetention(M3)

DecreasedSecretions(M3)BodyTemperatureIncreases:AtropineFever

Compensatory:DilatesBloodVesselsonFace(AtropineFlush)(M3)

Mydritic+CycloplegicAgent(OpthalmoscopicExams)

BlurredVision(Mydriasis+Cycloplegia)DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

TrihexyphenydylBenztropine

CholenergicAntagonist:SyntheticAlkaloid

Tachycardia(BlocksM2)NOCHANGEinBP

Mydriasis(PupilDilation)(M3)Cycloplegia(ParalysisofAccommodation)(M3)Constipation(M3)

Bronchodilation(M3)UrinaryRetention(M3)

DecreasedSecretions(M3)BodyTemperatureIncreases:AtropineFever

Compensatory:DilatesBloodVesselsonFace(AtropineFlush)(M3)

Parkinson'sDisease:Tremors

BlurredVision(Mydriasis+Cycloplegia)DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

OxybutyninTolterodineTrospiumSolifenacinDarifenacin

CholenergicAntagonist:SyntheticAlkaloid

Tachycardia(BlocksM2)NOCHANGEinBP

Mydriasis(PupilDilation)(M3)Cycloplegia(ParalysisofAccommodation)(M3)Constipation(M3)

Bronchodilation(M3)UrinaryRetention(M3)

DecreasedSecretions(M3)BodyTemperatureIncreases:AtropineFever

Compensatory:DilatesBloodVesselsonFace(AtropineFlush)(M3)

OveractiveBladder(UrinaryUrgency)BPH

BlurredVision(Mydriasis+Cycloplegia)DryMouthFever

ConstipationUrinaryRetention

TachycardiaAgitationsHallucinationsDelirium

Drug: DrugClass: MechanismofAction: Indications: AdverseEffects: Contraindications:Succinylcholine DepolarizingNMJBlockerTubocurarinePancuroniumRocuroniumMivacurium

Non-DepolarizingNMJBlockers(NmBlocker)

HexamethoniumTrimethaphanMecamylamine

Nicotine

GanglionicBlockers(NnBlockers)


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Git Tricks — git utilities that make life git easier

Git, smart git & gitflow

Git avanzado - Mario González, formador y desarrollador web · 2019-10-01 · git fetch + git rebase = git pull --rebase Subir tags: git push --tags Git avanzado. Repositorios remotos

Git LFS - acailly.github.io · $ git config --list [...] filter.lfs.clean=git-lfs clean -- %f filter.lfs.smudge=git-lfs smudge -- %f filter.lfs.process=git-lfs filter-process filter.lfs.required=true

2013 GIT Sinhala @ apepanthiya GIT Sinhala... · 2013 GIT Sinhala @ apepanthiya.lk Subject: G.C.E A/L GIT Past Papers Keywords: git, al git, git papers, git past papers, git exam,