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【正文】 rugs Chlinomimetic drugs Directacting Indirectacting (Cholinesterase Inhibitors) Muscarinic Nicotinic Reversible Irreversible Pilocarpine is a muscarinic agonist applied topically to cause pupillay constriction (miosis) in the treatment of glaua Direct Cholinergic Agonists The side effects of these drugs are directly related to their interaction with muscarinic receptors Indirectacting Drugs Cholinesterase Inhibitors These drugs have all the same actions (and side effects) as the directacting drugs (muscarinic). In addition, because they increase the concentration of acetylcholine, they have effects at the neuromuscular junction (nicotinic). NEOSTIGMINE is used in the treatment of myasthenia gravis. Other uses of the reversible cholinesterase inhibitors are in the treatment of openangle glaua and the reversal of nondepolarizing neuromuscular blockade after surgery. reversible cholinesterase inhibitors irreversible cholinesterase inhibitors There are no therapeutic uses for the irreversible cholinesterase inhibitors PRALIDOXIME and ATROPINE are uses to treat poisoning with anophosphates The anophosphates phosphorylate the cholinesterase enzyme, thus inactivating it Atropine (muscarinic antagonist) can be used in anophosphate poisoning because it will block the effects of the excess acetylcholine, but only at the muscarinic receptors. It has no effect at the neuromuscular junction (nicotinic)
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