PNS PHARMACOLOGY by Philomena Akpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn CHOLINERGIC TRANSMISSION en-us 2023-04-17 17:09:14 UTC 2025-09-30 12:51:44 UTC hello@padlet.com Describe the steps of neurotransmission in the picture. oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557325707 2023-04-17 17:19:31 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557325707 oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557343988 2023-04-17 17:33:06 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557343988 Your patient oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557379558 Your patient presents with diarrhea, stooling vomiting and muscle twitching.
Describe the receptors and the signaling mechanisms associated with this symptoms?]]> 2023-04-17 17:56:44 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557379558 List examples of Muscarinic and Nicotinic agonists. oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557386547 2023-04-17 18:01:40 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557386547 If your patient complains of dry mouth what drugs would you give the patient. oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557389073 Describe the mechanism of action of the drugs including secondary messengers?]]> 2023-04-17 18:03:16 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557389073 If your patient explains he took a muscarinic agonist poison. He presents with initial muscle twitching and then flaccid muscles. oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557420868 What receptors are associated with this presentation and why did he present or develop flaccid muscles?]]> 2023-04-17 18:26:44 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557420868 Describe the effect of muscarinic activation in the eye? oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557421972 How does this differ from sympathetic activation of the eye?]]> 2023-04-17 18:27:35 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557421972 List examples of muscarinic antagonist oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557427210 2023-04-17 18:31:33 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557427210 If your patient takes night shade berry which has an antimuscarinic as active. What will be the clinical presentation. Suggest a potential management. oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557428829 2023-04-17 18:32:52 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557428829 Step of neuro transmission. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557602052 Acetylcholine will release in the terminal due to calcium influx, due to which soma get more negative and it will exite and acetylcholine release in the Clift , then it bind to muscarinic receptor and Nicotinic receptor of postsynaptic nerve , after that acetylcholine esterase  will break the acetylcholine into acetyl and choline which will be reused again in process.]]> 2023-04-17 21:47:33 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557602052 Steps of Neurotransmission https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557606055 Synthesis of Neurotansmitter

1) Acetyl Co-A joins with Choline to form Acetylcholine which is the neurotransmitter.

Pathway of Activation & Deactivation of Neurotransmitter

1) when there is a influx of calcium causes negative which helps transmissions by excitation into pre synaptic cleft, where Acetylcholine released, this acetylcholine binds to muscarnic and nicotine receptors in the post synaptic cleft which helps in activation.

2) Later Acetylcholine Esterase will helps in breakdown of acetylcholine which will be reuse.



]]> 2023-04-17 21:54:16 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557606055 Steps of neurotrasmission https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557606218 Choline is transported into the presynaptic nerve
terminal by a sodium-dependent choline transporter (CHT). This transporter can be inhibited by hemicholinium drugs. In the cytoplasm, acetylcholine is synthesized from choline and acetyl-COA(AcCOA) by the enzyme choline acetyltransferase (ChAT)Acetylcholine is then transported into the storage vesicle by a second carrier. the vesicle-associated transporter (VAT) which can be inhibited by vesamicol. Peptides(P)
adenosine triphosphate (ATP) and proteoglycan are also stored in the vesicle.
Release or transmitter occurs when voltage-sensitive calcium
channels in the terminal membrane are opened. allowing an influx of calcium.
the resultant increase in intracellular calcium causes fusion of
vesicles with the surface membrane and exocytotic expulsion of acetylcholine and cotransmitters into the junctional cleft . This step can be blocked by botulinum toxin. Acetylcholine's action is terminated by
the enzyme acetyl cholinesterase. Receptors on the
presynaptic nerve ending modulate transmitter release.
]]> 2023-04-17 21:54:33 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2557606218 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559464808 Nicotinic agonist- Varenicline,acetylcholine ,Nicotine
Muscarinic agonist-Pilocarpine,Methacholine,donipizil]]> 2023-04-19 02:12:12 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559464808 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559470367 Pilocarpine (Salagen) is a cholinergic agonist, meaning it activates cholinergic receptors in your body. This causes your saliva glands to make more saliva so that your mouth is less dry.]]> 2023-04-19 02:16:11 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559470367 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559474943 Muscarinic agonists are agents that activate the muscarinic acetylcholine receptor.]]> 2023-04-19 02:19:29 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559474943 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559479279 Muscarinic agonists act mainly via muscarinic M₃ cholinoceptors to cause contraction of the iris sphincter, ciliary muscle and trabecular meshwork as well as increase outflow facility of aqueous humour.]]> 2023-04-19 02:22:24 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559479279 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559480470 atropine, scopolamine, and ipratropium]]> 2023-04-19 02:23:04 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559480470 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559485829 It cause the anticholinergic effect ]]> 2023-04-19 02:27:09 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559485829 dry mouth https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559554019 Pilocarpine or cevimeline, a selective M3 agonist, can be used to increase salivation and lacrimal secretion in patients with dry mouth or dry eyes .When pilocarpine binds to muscarinic receptors on the salivary glands, it triggers the production of secondary messengers such as IP3 and DAG, which, as described earlier, help to increase the production of saliva.]]> 2023-04-19 03:18:21 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559554019 Muscle twitching https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559557820 In large doses, such as can occur in poisoning, anticholinesterases initially cause twitching of muscles. This is because spontaneous ACh release can give rise to endplate potentials that reach the firing threshold. Later, paralysis may occur due to depolarisation block, which is associated with the build-up of ACh.]]> 2023-04-19 03:21:33 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559557820 Nightshade berry https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559560752 Nightshade berries contain atropine, which is a potent antimuscarinic agent
clinical presentations of atropine toxicity include:

  1. Dry mouth
  2. Blurred vision and dilated pupils (mydriasis)
  3. Increased heart rate (tachycardia)
  4. Decreased gastrointestinal motility, which can lead to constipation
  5. Urinary retention
  6. Confusion, agitation, and hallucinations
Management of atropine toxicity involves supportive care and the administration of antidotes. The main antidote for atropine toxicity is physostigmine, a cholinesterase inhibitor 
]]> 2023-04-19 03:24:28 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2559560752 Steps of Neurotransmission https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560114955 Synthesis of Ach is due to Acetyl Co-A with choline in process of sodium influx by CHT.
When the calcium channels open there will be an influx of calcium, causing a negative.
Excitatory neurotransmission in the presynaptic cell causes Ach release into the synaptic cleft and can bind to the nicotinic receptor and muscarinic receptor of the postsynaptic cell.
Later acetylcholinesterase breaks down the Ach into the Acetyl Co-A and choline to continue the process again. ]]> 2023-04-19 12:37:55 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560114955 Examples of Muscarinic and Nicotinic agonists https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560122327 Muscarinic agonists- Bethanechol, Carbachol, Pilocarpine, Methacholine.
Nicotinic agonists- Nicotine, Succinylcholine, Varenicline, ]]> 2023-04-19 12:44:00 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560122327 If your patient complains of dry mouth what drugs would you give the patient? and describe the MOA of the drug including secondary messengers. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560134957 The patient is facing xerostomia which is the sensation of oral dryness due to no saliva production. 
To treat it I would give pilocarpine which is a cholinergic muscarinic agonist that stimulates the secretion of exocrine glands.]]> 2023-04-19 12:53:39 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560134957 If your patient explains he took a muscarinic agonist poison. He presents with initial muscle twitching and then flaccid muscles.What receptors are associated with this presentation and why did he present or develop flaccid muscles? https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560147241 Patient took a muscarinic agonist over intake can cause poisoning such the symptoms can be muscle twitching of the facial muscles and it is due to cholinesterase inhibitor as it results to increased levels of Ach in the synapses Muscarinic receptors are associated with the presentation. ]]> 2023-04-19 13:02:42 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560147241 Describe the effect of muscarinic activation in the eye? How does this differ from sympathetic activation of the eye? https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560155020 Carbachol - Stimulation of muscarinic receptors in the eye which can make constriction of the ciliary muscle and contract the iris which Increases the aqueous humor outflow and decreases the intraocular pressure for miosis of the eye. 

Pilocarpine -  Stimulation of muscarinic receptors in the eye to increase intraocular pressure. ]]> 2023-04-19 13:08:13 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560155020 List examples of muscarinic antagonist https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560159393 Atropine, Scopolamine, Ipratropium, Tiotropium bromide, Glycopyrrolate, Oxybutynin]]> 2023-04-19 13:11:19 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560159393 Muscarnic & Nicotinic agonist https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560173221 Muscarinic agonists- Bethanechol, Carbachol, Pilocarpine, Methacholine.
Nicotinic agonists- Nicotine, Succinylcholine, Varenicline.
]]> 2023-04-19 13:20:37 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560173221 If your patient takes nightshade berry which has an antimuscarinic as active. What will be the clinical presentation? Suggest potential management. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560176241 Nightshade berries contain atropine which is a potent antimuscarinic drug. it can cause Xerostomia, mydriasis with blurred vision, Constipation, Tachycardia, Fever, and Tremors.

Potential management could be the administration of physostigmine, IV fluids to maintain hydrated, Support blood pressure, and Administration of Benzodiazepines to control agitation and seizures. 







]]> 2023-04-19 13:22:13 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560176241 Muscarnic antagonists https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560182578 Atropine- Dicyclomine
Cyclopentolate- Tropicamide
Ipratropium- Tiotropium
Tolterodine- Oxybutinin
Hyoscine
]]> 2023-04-19 13:26:03 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560182578 Nightshade berries contain atropine, antimuscarinic agent clinical presentations of atropine toxicity include:Dry mouth, Blurred, Dilated pupils, Increased heart rate, Decreased gastrointestinal motility and other anticholinergic effects. Management of atropine toxicity involves supportive care and the administration of antidotes.(Physostigmine) https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560201038 2023-04-19 13:37:48 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560201038 Drug used for dry mouth https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560215999 pilocarpine and cevimelin

Mechanism of action 
muscarinic cholinergic M3 receptor agonist, increases salivation.

Secondary messenger 

The inhibition of adenylyl cyclase results in a decreased level of intramolecular cAMP. Reduced levels of cAMP as a second messenger decreases an activity of cAMP-dependent protein kinase

]]> 2023-04-19 13:47:38 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560215999 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560219148 Patient took a muscarinic agonist can cause poisoning such the symptoms can be muscle twitching of the facial muscles and it is due to cholinesterase inhibitor as it results to increased levels of Ach in the synapses and Muscarinic receptors is involved in it.]]> 2023-04-19 13:49:32 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560219148 https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560222085 Carbachol - Stimulation of muscarinic receptors in the eye which can make constriction of the ciliary muscle and contract the iris which Increases the aqueous humor outflow and decreases the intraocular pressure for miosis of the eye.

Pilocarpine - Stimulation of muscarinic receptors in the eve to increase intraocular pressure.
]]> 2023-04-19 13:51:33 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2560222085 Your patient is undergoing surgery and is given a medication to relax his muscle before the surgery commences. He immediately develops bronchoconstriction and hypotension. State the reason for this presentation and mention at least 3 drugs that can cause this effect and describe their mechanism of action? oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566174336 2023-04-24 19:01:49 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566174336 What is the difference in mechanism of action between Suxamethomium and pancuronium? oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566179741 2023-04-24 19:07:12 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566179741 Identify the neuromuscular blockers that would be dependent on appropriate liver function. oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566183860 2023-04-24 19:10:51 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566183860 If your patient is having malignant hyperthermia what symptoms will he show and how will you manage it? oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566194955 2023-04-24 19:21:14 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566194955 What are the clinical features of Organophosphate poisoning? oakpoveso https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566195994 2023-04-24 19:22:22 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566195994 Sux vs pan https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566489029 suxamethonium is a depolarizing NMBA that mimics the action of acetylcholine at the neuromuscular junction, causing sustained muscle depolarization and relaxation. Pancuronium is a non-depolarizing NMBA that competes with acetylcholine for binding to the receptor, but does not activate it, leading to muscle relaxation.]]> 2023-04-25 01:37:52 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2566489029 The patient may be presenting with signs of adverse reaction to non-depolarizing blockade works a the neuromuscular junction. Three such drugs are 1. Mivacurium- It is inactivated by plasma cholinesterase and cause excessive hypotension. The histamine effect causes broncho-constriction 2. Atracurium- Has a slightly histamine effect and causes hypotension. 3. Tubocurarine- causes histamine effect. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567966694 2023-04-26 00:35:57 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567966694 Suxamethonium (Succinylcholine) is a depolarizing blockaded that acts a acetylcholine receptor agonist causing depolarization initially causing muscle twitching, preventing muscle contraction and causes hypotension. as oppose to Pancuronium- which is a non-depolarizing blockade that has an antimuscarinc effect which causes tachycardia and hypertension. It can be overcome by increase Acetylcholine concentration. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567977040 2023-04-26 00:44:18 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567977040 Suxamethonium is a neuromuscular blockade that is dependent on liver function because the liver cannot break down Suxamethonium. Suxamethonium is cleared from the blood with plasma cholinesterase which is synthesize in the liver and reduces its activity. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567987285 2023-04-26 00:53:41 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567987285 Patient with malignant hyperthermia would present with muscle rigidity or spams, tachycardia, brachypnea, threatening high body temperature, excess sweating. It can be succinylcholine induces. Treatment with Dantrolene (Dantrium) which is a ryanodine receptor antagonists is most effective. https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567996176 2023-04-26 01:01:46 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2567996176 The clinical feature of Organophosphate poisoning include those of nicotinic and muscarinic effect/parasympathetic activity such as muscle twitching and muscle paralysis, tachycardia, hypertension, sweating, nausea, vomiting, increase salivation, lacrimation, diarrhea, blurred vision and mitosis. An effective antidote is Atropine and pralidoxime (reactivation of cholinesterase) https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2568002558 2023-04-26 01:07:02 UTC https://padlet.com/oakpoveso/zxv2rc64izyg6mjn/wish/2568002558