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Related Concept Videos

Cholinergic Receptors: Muscarinic01:25

Cholinergic Receptors: Muscarinic

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The pharmacological actions of acetylcholine are elicited via its binding to two families of cholinergic receptors or cholinoceptors, namely, muscarinic and nicotinic receptors. Muscarinic receptors are G protein-coupled receptors and have five subtypes, M1–M5. All mAChR subtypes are activated by acetylcholine and blocked by the antagonist, atropine. 
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Cholinergic Antagonists: Chemistry and Structure-Activity Relationship01:29

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Cholinergic antagonists bind to cholinergic receptors and limit the effects of acetylcholine and other cholinergic agonists. Based on the specific cholinergic receptor affinity, these antagonists are classified as muscarinic or nicotinic. Anticholinergics interrupt parasympathetic innervations while sympathetic innervations remain uninterrupted. Muscarinic antagonists are also called 'muscarinic antagonists', 'antimuscarinics', or 'parasympatholytics'. Nicotinic...
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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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Cholinergic Antagonists: Pharmacokinetics01:24

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Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations,  while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and...
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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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Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
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Cholinergic Urticaria: Subtype Classification and Clinical Approach.

Atsushi Fukunaga1,2, Yoshiko Oda3, Shinya Imamura3

  • 1Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan. atsushi.fukunaga@ompu.ac.jp.

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Cholinergic urticaria (CholU) involves itchy wheals triggered by sweating. Subtyping CholU based on cause and symptoms, particularly sweating abnormalities, is crucial for effective treatment.

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Area of Science:

  • Dermatology
  • Immunology
  • Allergy

Background:

  • Cholinergic urticaria (CholU) is a chronic inducible urticaria characterized by itching and wheals during sweating.
  • Sweating abnormalities, including anhidrosis, are increasingly recognized in CholU.
  • Understanding CholU subtypes is vital for managing treatment resistance.

Purpose of the Study:

  • To review and update evidence on CholU, focusing on its subtypes and relationship with anhidrosis.
  • To present a new schematic of CholU pathophysiology.
  • To emphasize the importance of subtype classification for treatment.

Main Methods:

  • Comprehensive review of recent publications on CholU.
  • Analysis of epidemiological, clinical, and pathophysiological data.
  • Summarization of diagnostic and therapeutic approaches, including provocation tests.

Main Results:

  • CholU pathogenesis involves multiple factors: histamine, sweat allergy, cholinergic substances, poral occlusion, and hypohidrosis/anhidrosis.
  • A new schematic illustrating CholU pathological conditions has been developed.
  • Diagnostic and disease severity evaluation methods are summarized.

Conclusions:

  • Cholinergic urticaria is not a uniform condition; subtype classification is essential for optimal management.
  • Attention to sweating abnormalities is critical in diagnosing and treating CholU.
  • Further research into the pathophysiology of CholU subtypes is needed.