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Related Concept Videos

Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

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Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
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Direct-Acting Cholinergic Agonists: Pharmacokinetics01:31

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Direct-acting cholinergic agonists, such as synthetic choline esters and naturally occurring alkaloids, exert their effects by enhancing the actions of acetylcholine and stimulating the parasympathetic nervous system. Synthetic choline esters share structural similarities with acetylcholine. For example, they have a positively charged quaternary ammonium or onium group, contributing to their hydrophilic characteristics. As a result, they are poorly absorbed in the body through oral...
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Cholinergic Antagonists: Pharmacological Actions01:28

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Antimuscarinic drugs block muscarinic receptors in multiple systems, including the gut, eye, smooth muscles, respiratory tract, cardiovascular, and central nervous systems. They produce similar effects with varying selectivity depending on the specific agent and tissue. Here are the key pharmacological actions of antimuscarinics:
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Indirect-Acting Cholinergic Agonists: Pharmacokinetics01:22

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Indirect-acting cholinergic agonists, or anticholinesterases, enhance the body's cholinergic activity by inhibiting acetylcholine's breakdown. They are categorized as reversible or irreversible agents based on their mechanism of action. They are further classified into short-acting, intermediate-acting, and long-acting agents based on their duration of action.
Reversible agents containing quaternary amines, such as neostigmine and edrophonium, are not easily absorbed orally because they...
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Cholinergic Antagonists: Therapeutic Uses01:26

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Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:    
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
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Direct-Acting Cholinergic Agonists: Therapeutic Uses01:11

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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors
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Cyclosporine in Cholinergic Itch.

Sumit Sehgal1, Vanshika Arora1, Lalit Gupta1

  • 1Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India.

Indian Dermatology Online Journal
|March 15, 2022
PubMed
Summary

Oral cyclosporine effectively treats severe cholinergic itch in young adults, even when antihistamines fail. This study shows significant symptom reduction and good tolerability in patients with this difficult-to-manage condition.

Keywords:
Anti-histamine therapyCholinergic itchCyclosporine

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Area of Science:

  • Dermatology
  • Clinical Medicine

Background:

  • Cholinergic itch is a severe condition often poorly responsive to antihistamines.
  • It presents as intense itching and burning, particularly in young adults during winter.
  • Symptoms are triggered by heat, sunlight, or spicy foods.

Purpose of the Study:

  • To evaluate the efficacy of oral cyclosporine in treating antihistamine-refractory cholinergic itch.
  • To assess the safety and tolerability of cyclosporine for this condition.

Main Methods:

  • A prospective, open-label clinical study was conducted.
  • Twenty patients with cholinergic itch refractory to antihistamines were enrolled.
  • Oral cyclosporine was administered, and treatment response was measured using a Numerical Rating Scale (NRS).

Main Results:

  • Cholinergic itch severity significantly decreased from a mean NRS of 7.8 to 0.3 within two weeks of cyclosporine treatment (P < 0.0001).
  • All patients experienced effective control of their symptoms.
  • The trunk was the most commonly affected area in all participants.

Conclusions:

  • Oral cyclosporine is an effective treatment for cholinergic itch.
  • The medication was well-tolerated by all patients in the study.