cholininomimetic drugs

Question 1

bethanechol: class, application, and action

Answer 1

cholinomimetic. direct agonist. used for post-operative ileus, neurogenic ileus, and urinary retention. activates bowel and bladder smooth muscle. resistant to AChE.

Question 2

carbachol: class, application, and action

Answer 2

cholinomimetic agent; direct agonist.

used for glaucoma, pupillary constriction, and relief of intraocular pressure.

Question 3

pilocarpine: class, application, and action

Answer 3

potent stimulator of sweat, tears, and saliva. used for open and closed angle glaucoma.
contracts the ciliary muscle, which is good for open angle glaucoma, and contracts the pupillary sphincter, good for closed angle glaucoma. (you cry, drool, and sweat on your PILO). resistant to AChE

Question 4

Methacholine

Answer 4

used as a challenge test for asthma. stimulates the muscarinic receptors in the airway when it is inhaled

Question 5

Neostigme: uses, class, special considerations

Answer 5

used for post op and neurogenic ileus, myasthenia gravis, and post-op reversal of the NMJ blockade. No CNS penetration

Question 6

pyridostigmine: uses, class, special considerations

Answer 6

used for myasthenia gravis, doesn’t penetrate the CNS.

itis stronger than other anticholinesterases.

Question 7

physostigmine: uses, class, special considerations

Answer 7

used for anticholinergic toxicity becasue it can cross the BBB and penetrate the CNS. it is used to treat atropine overdose. anticholinesterase

Question 8

Edrophonium: uses, class, special considerations

Answer 8

historically used to diagnoses myasthenia gravis (very short-acting). We now use anti-AChR Ab test. anticholinesterase

Question 9

Potential side effects of all cholinomimetic agents

Answer 9

COPD exacerbation, asthma, and peptic ulcers.

Question 10

What might be seen with cholinesterase inhibitor poisoning?

Answer 10

Too much cholinergic activity! see diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, and salivation

Question 11

Antidotes for cholinesterase inhibitor poisons

Answer 11

atropine (competitive inhibitor) + pralidoxime (regenerates AChE if given early enough)