Cholinergic Agonists And Overview: Acetylcholine, Hemicholinium, Hexamethonium, Curare, Pirenzepine, Pilocarpine, Bethanechol, Carbachol, Clostridium Botulinum mnemonic

Cholinergic Agonists and Overview

Acetylcholine [Acetylene torch with coal] is stored in vesicles in the presynaptic bouton. After release, it is cleared from the synapse by acetylcholinesterase and reabsorbed by the presynaptic neuron via Na-coupled transport
- Black Widow spider venom causes the vesicles to spill [spider pierces vesicles]
- Clostridium Botulinum toxin blocks release of vesicles [Green bottle blocks vesicles]
- Hemicholinium [Half an acetylene-coal torch] prevents re-uptake into presynaptic neuron
Acetylcholine stimulates nicotinic [cigarette] and muscarinic [musk ox] receptors.
- Nicotinic receptors are found in brain, ganglia, adrenals, and muscle [Gangster with muscle tattoo]
  - Hexamethonium blocks receptors in ganglia [6 methyl compound blocks gangster's gun]
  - Curare derivatives (e.g. tubocurarine) [curare tube arrow] penetrate into muscle and block nicotinic receptors
- Muscarinic receptors are in CNS, heart, and stomach (stomach has a sub-category "M2" receptors) [Musk ox with colored organs]
  - Muscarinic receptors act via DAG, IP3/Ca++ second messenger system [Dog leading the ox, also used by alpha-1 (A1 sauce) adrenergic receptors]
  - pirenzepine blocks stomach-specific M2 receptors [piranha and pine bite acetylcholine]
  - Pilocarpine [Peeling carp pine] stimulates muscarinic receptors [pretends to be a musk-ox by wearing horns] and is useful for both narrow and wide angle glaucoma [eye with angles and small pupil]. Side effects include sweating.
  - Bethanechol also stimulates muscarinic receptors [Bee ethane coal torch impersonates musk ox horns]
- Drugs that stimulate both nicotinic and muscarinic receptors [in the middle]:
  - Acetylcholine is used as a vasodilator. This effect is mediated by muscarinic receptors [Acetylene-coal torch dilates vase]
  - Carbachol [Carbon-coal dimer] is fast acting [stop watch], causes miosis [carbachol-shaped pupil], and release of adrenaline [Adrenal glands with lightning bolt]

Visual Mnemonic - Cholinergic Agonists And Overview: Acetylcholine, Hemicholinium, Hexamethonium, Curare, Pirenzepine, Pilocarpine, Bethanechol, Carbachol, Clostridium Botulinum
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