1. Autonomics Claro M. Isidro M.D.

9. Effector Organs Receptors Action Eye sphincter m. ciliary m. M3 M3 Contraction (meiosis) Contraction (accomodation) Heart SA node AV node Contractility M 2 M 2 M 2 ↓ Heart rate ↓ conduction velocity & ↑ refractory period ↓ contraction Lung bronchial m. M 3 contraction

10. Effector Organs Receptor Action Blood Vessels most BV skeletal m. - - Small doses – vasodilatation Large doses – vasoconstriction GIT sphincter motility & tone M 3 M 3 Relaxation Increase GUT trigone & sphincter m. bladder wall & detrusor m. Penis, seminal v. M 3 M 3 M Relaxation Contraction Erection

11. Effector Organs Receptor Action Secretory glands sweat intestinal bronchial lacrimal M M 3 M M Generalized secretion ↑ secretion ↑ secretion Profuse secretion

14. Susceptibility to Cholinesterase Muscarinic Effects Nicotinic Effects Therapeutic Use Ach + +++ +++ Miotic Metacholine + ++++ + Dx of bronchial hyperactivity Carbachol - +++ ++ Miotic Betanechol - ++ - Non-obstructive urinary retention

35. Dose Effects 2.0 mg Rapid HR; palpitations marked dryness of mouth Dilated pupils; some blurring of vision 5.0 mg All of the above symptoms marked; difficulty in speaking and swallowing; Restlessness and fatigue; Headache; dry, hot skin Difficulty in micturition Reduced intestinal peristalsis

36. Dose Effects 10.0 mg and more Above symptoms more marked Pulse rapid and weak Iris practically obliterated Vision very blurred Skin flushed, hot, dry, and scarlet Ataxia, restlessness and excitement Hallucinations and delirium Coma