Muscarine cholinergic stimulants

MUSCARINIC CHOLINERGIC STIMULATION OF PHOSPHATIDYL INOSITOL TURNOVER IN THE CNS... 

Motion sickness is caused by stimulation of the vestibular system. This area contains many histaminic (Hj) and muscarinic cholinergic receptors. The higher brain (i.e., cerebral cortex) is affected by sensory input such as sights, smells, or emotions that can lead to vomiting. This area is involved in anticipatory nausea and vomiting associated with chemotherapy. 

Reverses age-related decline in choline acetyltransferase Reverses an age-related decline in muscarinic receptors Stimulates learning-related cholinergic activity Monoamine Facilitates release of norepinephrine (through o2)... 

Whitehouse PJ, Price DL, Clark AW, et al Alzheimer disease evidence for selective loss of cholinergic neurons in the nucleus basahs. Ann Neurol 10 122-126, 1981 Whitehouse PJ, Price DL, Struble RG, et al Alzheimer s disease and senile dementia—loss of neurons in the basal forebrain. Science 215 1237-1239, 1982 Whitehouse PJ, Hedreen JC, White CL, et al Basal forebrain neurons in dementia of Parkinson s disease. Ann Neurol 13 243-248, 1983 Whitehouse P, Martino A, Antuono P, et al Nicotinic acetylcholine binding sites in Alzheimer s disease. Brain Res 371 146-151, 1986 Whitehouse PJ, Martino AM, Marcus KA, et al Reductions in acetylcholine and nicotine binding in several degenerative diseases. Arch Neurol 45 722-724, 1988 Whitton PS, Sama GS, O Connell MT The effect of the novel antidepressant tianeptine on the concentration of 5-hydroxytryptamine in rat hippocampal diasylates in vivo. Neuropharmacology 39 1-4, 1991 Whitworth P, Kendall DA Lithium selectively inhibits muscarinic receptor-stimulated inositol tetrakisphosphate accumulation in mouse cerebral cortex slices. J Neurochem 51 258-265, 1988... 

Aihaara T et al Cholinergically stimulated gastric acid secretion is mediated by M3 and M5 but not Mi muscarinic acetylcholine receptors in mice. Am J Physiol 2005 288 G1199. 

When reconstituted into proteoliposomes with Ml muscarinic cholinergic receptor, PLC/11 potently stimulates the GTPase activity of Gaq, achieving a steady-state rate 1000-fold greater than that in the absence of a GAP... 

Thus, cholinergic muscarinic receptors ultimately mediate the effect on the tissue itself. Table 18-2 summarizes the primary physiologic responses when muscarinic receptors are stimulated on various tissues in the body. Note that the specific response to stimulation of a muscarinic cholinergic receptor depends on... 

Acetylcholine receptors are classified as either muscarinic cholinergic receptors or nicotinic cholinergic receptors. The alkaloid muscarine mimics the effects produced by stimulation of the parasympathetic system. These effects are postganglionic and are exerted on exocrine glands, cardiac muscle, and smooth muscle. The alkaloid nicotine mimics the actions of acetylcholine, which include stimulation of all autonomic ganglia, stimulation of the adrenal medulla, and contraction of skeletal muscle. 

Receptor-dependent vasodilation may also take place in a more indirect manner through the presynaptic modulation of the release of neurotransmitters, such as norepinephrine and acetylcholine. In addition to its effects on postsynaptic receptors, norepinephrine stimulates the presynaptic a2-receptor, thereby inhibiting further transmitter release. Moreover, the activation of other presynaptic receptors such as the muscarinic cholinergic, dopaminergic, purinergic, serotoninergic, and histaminergic receptors leads to diminished norepinephrine release and subsequent vasodilation. 

Actions Actions include generalized cholinergic stimulation, paralysis of motor function (causing breathing difficulties), and convulsions. Isoflurophate produces intense miosis and thus has found therapeutic use. Atropine in high dosage can reverse many of the muscarinic and central effects of isoflurophate. 

Thus either intravenous or intramuscular doses of atropine are indicated to antagonize the muscarinic symptoms. Physostigmine and edrophonium are cholinesterase inhibitors and would exacerbate the problem. Norepinephrine would not be effective in combatting the cholinergic stimulation. Trimethaphan being a ganglionic blocker would also worsen the condition. 

Muscarinic receptor stimulation increases gastrointestinal motility and secretory activity (see p. 29). Cholinergic antagonists, such as hyoscyamine, are used as adjuncts in the management of peptic ulcer disease and Zollinger-Ellison syndrome, particularly in patients... 

Q6 In comparison with the sympathetic transmitter norepinephrine, the inactivation of acetylcholine by cholinesterases is rapid so that normally the activity of acetylcholine at the synapse is relatively short-lived. The choline component is taken up into the presynaptic terminal and acetylcholine is resynthesized and stored in the synaptic vesicles. Anticholinesterases function as cholinergic stimulants in the parasympathetic nervous system since they greatly prolong and so increase the actions of endogenous acetylcholine at muscarinic receptors on the effector tissue. 

The parasympathetic division is the dominant portion of the pulmonary autonomic nervous system in all mammals. Airway smooth muscle is richly supplied with muscarinic receptors and stimulation of M3 receptors results in smooth muscle contraction and bronchoconstriction. Cholinergic stimulation is the primary mechanism of bronchospasm in horses with recurrent airway obstruction (Robinson et al 1996). Parasympathetic innervation can be demonstrated throughout the tracheobronchial tree of the horse but smooth muscle contraction evoked by stimulation of cholinergic nerves is more pronounced in the trachea than in the smaller bronchi. It is expected that parasympathetic blockade with a muscarinic antagonist will have the greatest effect in large, central airways. 

The alkaloid, cicutoxin, is distributed throughout the plant, though concentrated in the roots. Cicutoxin is an unsaturated aliphatic alcohol which is postulated to exert toxicity by central cholinergic stimulation. Specifically, stimulation of both nicotinic and muscarinic receptors occur. 

Pyridostigmine bromide studies have been performed in dogs, guinea pigs, monkeys, rabbits, rats, and mice. Diarrhea, salivation, tremors, and respiratory failure were seen prior to death. Side effects of the drug are related to muscarinic and nicotinic effects. Toxicity is also related to cholinergic stimulation. Effectiveness of pretreatment to reduce lethality after exposure to nerve agents (in particular, soman) is dependent on the administration of atropine and pralidoxime, postexposure. 

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