AChE is the enzyme responsible for hydrolysis of acetylcholine to choline and acetic acid

효과가 있는것은 acetylcholine , choline으로 분해되면 효과없음

Cholinergics

acute cholinergic toxicity(농약파트에서 참조함)

작용하는 곳 autonomic nervous system, neuromuscular junction, and central nervous system (CNS)

muscarinic signs

SLUDGE/BBB - Salivation, Lacrimation, Urination, Defecation, Gastric Emesis, Bronchorrhea, Bronchospasm, Bradycardia

DUMBELS - Defecation, Urination, Miosis(축동), Bronchorrhea/Bronchospasm/Bradycardia, Emesis, Lacrimation, Salivation

nicotinic effects(atrophine으로 해독안됨)

fasciculations, muscle weakness, and paralysis

brain

depression, lethargy, excitability, seizures, and coma

fatality : depression of the CNS respiratory center, neuromuscular weakness, excessive respiratory secretions, and bronchoconstriction

Intermediate syndrome

Delayed neurotoxicity — Organophosphorous agent induced delayed neuropathy (OPIDN)

1. Acetylcholinesterase inhibitor

농약 organophosphate : AChE에 붙어서 NE junction에 acetylcholine을 overabundance하게 함

특징 : 시간이 지나면 irriversible하게 inhibition을 함(영구)

parathion, fenthion, malathion, diazinon, and dursban

carbamate

특징 48시간 작용함, 그러나 mortality는 organophosphate와 비슷

methomyl , aldicarb

신경가스

organophosphorous nerve agents (eg, tabun [GA], sarin [GB], soman [GD]

의약품(역시 organophosphate의 종류임)

neostigmine

pyridostigmine

edrophonium

어디에 쓰나 ? glucoma

myasthenia gravis

Alzheimer(echothiophate, pyridostigmine, tacrine, and donepezil)

2.succinylcholine(neuromuscular blockade)

NM juction에서 Acetylcholine처럼 작용

농약중독시에는 intubation할때 쓰지(원래 IV, IM) 마라

anticholinergics

Atrophine

muscarinic 에서만 작용

Pralidoxime

muscarinic , nicotinic 모두에서 작용

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