Preganglionic of everything (including adrenal gland)

Postganglionic of parasympathetic and sweat glands

Located in the preganglionic synapses

not important pharmacologically

Located at postganglionic synapses of the parasympathetic system and in the sweat glands of the sympathetic system

Found on presynaptic adrenergic neurons activation interferes with norepinephrine release

Adverse affects – sweating, salivation, flushing, decreased blood pressure, nausea, abdominal pain, diarrhea and bronchospasm

 Contraindications – Physical obstruction, asthma and Peptic ulcers

   Can stimulate BOTH Muscarinic and Nicotinic receptors at PNS/SNS

More resistant to cholinesterase than pilocarpine

DOC for EMERGENCY lowering of both wide and narrow angle Glaucoma

  Adverse reactions – CNS Disturbances; miosis with decreased vision and brow aches (not related to decrease in IOP)

       Place in therapy – Historically an initial treatment of choice but newer agents have replaced it

No abnormal resistance to aqueous humor outflow

angle-closure glaucoma

medical emergency w/ acute onset

      When cilia contract it has a tendency to move forward iris towards ciliary body which allows the tendons that connect the lens to ciliary body to relax 

accommodation

(which allows lens to round and see close up)

  problem is in the trabebucular meshwork and when you give muscarinic direct agonist you cause stimulation of muscarinic receptors that pull and contract ciliary muscle with stretches and opens the trabecular meshwork and allowing better and more rapid egress of anterior fluid out of the canal of schlemm

open angle glaucoma 

Would you ever want to give a muscarinic agonist systemically to treat glaucoma? 

No because you will give muscarinic effects in the whole body not JUST the eye so most of these topically administered

give a drug that constricts iris to go towards ciiary body to open up angle

Adverse reactions  - Can enter CNS and may cause convulsions in high doses.  

Adverse reactions – salivation, flushing, decreased BP, diarrhea

Actions: miosis; muscle paralysis, respiratory arrest ; convulsions, fasiculations

    It is a newer agent similar to isoflurophate

Most used anticholinesterase agent  

Eye - Diagnostic use only -  Causes mydriasis and cycloplegia.  Increases intraocular pressure in patients with glaucoma  

 Pulseless Electrical Activity and Asystole it is used after Epinephrine

Improves sinus node and atrioventricular node conduction by inhibiting vagal activity

heat prostration- decreased sweating

diarrhea- mainly against M2

gastric ulcer- mainly against M2

May cause drowsiness and usually dry mouth

Possible blurred vision and pupil dilation

Agent most commonly used to produce anticholinergic effect in lower urinary tract, improves bladder capacity and voiding dysfunction

causes euphoria and arousal

can also cause relaxation, improves attention

Indication – Surgery to produce complete muscle relaxation

succinyl CoA

depolarizing

short duration

rapidly absorbed, reason it can only be used for diagnosis NOT treatment