If I give intravenous acetylcholine then the effects produced on cardiovascular system are hypotension , tachycardia and increased cardiac output. Now if I give intravenous acetylcholine esterase inhibitors on another patient then the effects produced on cardiovascular system are hypertension, bradycardia and decreased cardiac output. Ach esterase inhibitors also increase acetylcholine concentration then why does the effects are exactly opposite in the above mentioned two cases.
Reference for abovementioned data : Cholinergic drugs , katzung pharmacology, 14th edition.
Is it because Ach esterase inhibitors increase Ach concentration locally in the tissues which produce more direct effects while the Ach is rapidly metabolised in the plasma so can't reach into the tissues so it produces more indirect effects via baroreflex ?