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cholinergic drug classes
muscarinic agonist, muscarinic antagonist, cholinesterase inhibitor
muscarinic agonist
parasympoathicmimetics, bind to muscarinic receptor and mimic parasympathetic NS
muscarinic agonist drug protypes
bethanechol and pilocarpine
bethanechol MOA
stimulates muscarinic receptor to allow bladder to empty
bethanechol indication
treats urinary retention and conditions
bethanechol pharmacokinetics
PO, not absorbed well, given 3-4 x daily
bethanechol adverse effects
hypotension and bradycardia (M2), excessive GI effects and bronchoconstriction (M3)
pilocarpine MOA
binds to smooth muscle and makes it contract
pilocarpine indication
glaucoma or xerostomia
pilocarpine pharmacokinetics
glaucoma: gel on eye/eyedrops
xerstomia: orally
pilocarpine adverse effects
increased GI motility, effects worse when PO
teaching point for pilocarpine
it should not be taken with fatty foods orally, limited research for use in pregnant/lactating women and children