Cholinergic Agonists and Antagonists (M1)

Question 1

How do cholinergic agonists achieve vasodilation of blood vessels?

Answer 1

activation of nitric oxide synthetase and fromation of nitric oxide and cGMP

Question 2

What are the four choline esters? 1-4. What do all of them have in common structurally? 2

Answer 2

1. acetylcholine
2. methacholine
3. carbachol
4. bethanechol
5. positively charged quaternary ammonium compounds

Question 3

What are the clinical limitations of acetylcholine?

Answer 3

1. limited absorption
2. short duration
3. lack of specificity

Question 4

What are the steps in the management of organophosphate poisoning?

Answer 4

1. decontamination
2. support cardio and resp
3. Acetylcholine receptor antagonist (atropine) to block Ach
4. Pralidoxime to regenerate cholinesterase

Question 5

What are the plants that are muscarinic receptor antagonists?

Answer 5

Belladonna alkaloids

Question 6

What are the first signs of muscarinic antagonist toxicity?

Answer 6

dry mouth and suppression of salivation

Question 7

What was the main side effect of scopolamine that limited its use?

Answer 7

confusional psychosis

Question 8

What cardiovascular disorders are muscarinic antagonists used to treat?

Answer 8

sinus bradycardia

Question 9

What CNS disorders are muscarinic antagonists used to treat?

Answer 9

Parkinson’s

Question 10

What ophthalmic uses are muscarinic antagonists used to treat?

Answer 10

1. refraction
2. treat uveitis
3. treat myopia (not anymore)
4. treat amblyopia

Question 11

How do you treat anticholinergic toxicity?

Answer 11

treat symptomatically, don’t use cholinesterase inhibitors