1. Created by: Laura Runstrom and Kim Tran

2. Muscarinic Receptor Location M1M1 M2M2 M3M3 Salivary glands Uterus Heart Eyes Lungs Stomach Pancreas Lungs Salivary glands Stomach Eyes Pancreas Bladder

3. The parasympathetic nervous system (PNS) exerts cholinergic effects on the body. A helpful pneumonic device to help you remember these effects is DUMBELLS. Throughout the slide show, you will see the highlighted letter accompanying each effect.

4. Eyes Constricts pupils for near vision DU M BE L LS Miosis & Lacrimation M 2 M 3 Contraction of sphincter muscle (miosis), contraction of ciliary muscle, lacrimal gland secretion

5. Heart Slows down heart to conserve energy DUM B ELLS Bradycardia M 2 >> M 3 Heart rate, contractility (atria and ventricle), conduction of AV node Decrease

6. Salivary Glands Increased salivation to aid digestion DUMBELL S Salivation M3M3 Dilation of arterioles, K + and water secretion

7. Lungs Body does not need extra help to breathe when at rest M 2 = M 3 Tracheal and bronchial smooth muscle contraction

8. Stomach & Intestines Helps you digest, utilize, and eliminate your food D UMBELLS Defecation M 2,M 3 Increase motility and tone, sphincter relaxation, stimulation of secretion

9. Urinary Bladder & Ureter Facilitates voiding D U MBELLS Urination M 3 > M 2 Contraction of detrusor muscle, relaxation of trigone and sphincter M1M1 Possible increase (?) motility and tone of ureter

10. Uterus Male Reproductive Organ M1M1 Variable relaxation M3M3 Erection

11. Pancreas Increases pancreatic juices to aid in digestion M 2,M 3 Increase secretion from acini

12. To review........ The PNS is all about resting, digesting, and conserving energy to fight another day. Anticholinergics can counteract these effects. To remember anticholingeric side effects, just think “anti-DUMBELLS”.

13. Anticholinergics can disrupt these functions: D efecation U rination M iosis B radycardia E mesis L acrimation L ethargy S alivation Constipation Urinary Retention Mydriasis Tachycardia No Emesis Dry Eyes Can be Activating Dry Mouth