Drug Acting on G.I. System – Cholinergic, Anticholinergics

Drug Acting on G.I. System

Cholinergic

Anticholinergics

Proton pump  inhibitors

Antiemetics

Emetics

Purgatives

Antacids

Fluid and Electrolyte therapy 

Antidiarrheals

Histamines

Cholinergic Drug

Parasympathomimetic or cholinomimetics

Stimulate parasympathetic nervous system in same manner as
does acetylcholine

May stimulate cholinergic receptors directly or slow
acetylcholine metabolism at synapses (Affect the enzyme acetylcholinesterase)

Useful in treating Alzheimer’s disease, Myasthenia gravis and
to treatment atony of the smooth muscle of the GI system or urinary system.

GI effects

Acetylcholine stimulates cholinergic receptors in the gut to
promote normal secretory and motor activity

Cholinergic activity in the gut will increase peristalsis
and facilitates movement of flatus and feces.

The secretory functions of the salivary and gastric glands
also stimulated.

Increased tone and contractility in GI smooth muscle,
relaxation of sphincters, increased salivary gland and GI secretions.

Anticholinergics

Also called cholinergic blocking agents or parasympatholytics
Again, focus is on the parasympathetic nervous system

Parasympathetic system acts as a resting and reparative
function Functions include digestion, excretion, cardiac decelertion, and
anabolism and near vision.

Most anticholinergic drugs interact with the muscarinic
receptors in the brain, secretory glands, heart, and smooth muscle.

A few can also affect the nicotinic receptors. 

Glycopyrrolate (Robinul) is an example

Mechanism of action:

Act by occupying receptor sites at parasympathetic nerve endings,
thereby leaving fewer receptor sites free to respond to acetylcholine.

Distribution of receptors is broad so effect of anticholinergics
will be diffuse.

Helpful in treating irritable colon or colitis.

Useful in gastritis, pylorospasm and ulcerative colitis as
they slow motility.

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