5.1 Cholinergic Flashcards Preview

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Flashcards in 5.1 Cholinergic Deck (23)
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1
Q

What receptor type is found only in nerves?

A

M1

2
Q

What receptor is found in nerves, the hearts, and smooth muscle?

A

M2

3
Q

What receptor type is found in glands, endothelium, and smooth muscle?

A

M3

4
Q

What receptor is found only at the neuromuscular junctions?

A

Nm

5
Q

What receptor is found in the CNS, Post-ganglionic cell body/dendrites?

A

Nn

6
Q

How do muscarinic receptors get the signal into the cell?

A

G-membrane linked

7
Q

How do nicotinic receptors get the signal into the cell?

A

Voltage-gated

8
Q

In the CNS, what is the mechanism A2 receptors use for their effect?

A

Control Ca++ release

9
Q

What catalyzes hydrolysis of ACh?

A

AChE

Butyryl-ChE (in plasma)

10
Q

What are the cardiac effects of ACh?

A

Vasodilation
↓ HR (negative chronotropic effect)
↓ conduction velocity (negative dromotropic effect)
↓ force of cardiac contraction (negative inotropic effect)

11
Q

What are the respiratory effects of ACh?

A

Regulating bronchomotor tone
Bronchoconstriction
↑ tracheobronchial secretion

12
Q

What are the urinary effects of ACh?

A

Detrusor muscle contraction
↑ increase voiding pressure
Ureteral peristalsis

13
Q

What are the GI effects of ACh?

A

↑ GI motility, tone
↑ amplitude of contractions
↑ secretory activity of stomach and intestine

14
Q

What are the HEENT effects of ACh?

A

↑ lacrimation, nasopharyngeal, and sweat glands secretion
↑ salivary secretion
Contraction of pupillary sphincter muscle miosis
Contraction of ciliary muscle

15
Q

What is a cholinomimetic?

A

Drug that mimics the actions of ACh

16
Q

What is the mechanism of a direct agonist cholinomimetic?

A

Directly binds to ACh receptor

17
Q

What is the mechanism of an indirect cholinomimetic agonist?

A

Affect metabolism of breakdown of ACh

= affects AChE

18
Q

What type of cholinomimetic are Esters of choline and Alkaloids?

A

Direct cholinomimetic

19
Q

What is the mechanism of Esters of choline?

A

Structure has charged quaternary ammonium group
Poor lipid soluble poorly absorbed  poorly distributed into CNS
All hydrolyzed in GI – Less active
Differ in susceptibility to hydrolysis

20
Q

What is Miochol-E used for?

A

Ester of choline

Cataract surgery– intraop only – induce miosis – intraoccular inj. Or topical

21
Q

What is Methacholine (Provocholine) used for? Contraindications?

A

Mix powder w/ NS and inhale via neb
Diagnostic test – bronchial hyperresponsiveness
Asthma vs. COPD asthmatic pts produce intense bronchoconstriction
Contraindications: limited airflow; MI, stroke, uncontrolled HTN, and pregnancy
Emergency resuscitation, O2, Beta-2 agonist should be available during testing

22
Q

What is Carbachol used for?

A

Catarac surgery – intraoccular inj or topical – induce miosis or prevent elevated IOP (intraoccular pressure)
Eye drop – no longer available in US – Open angle glaucoma

23
Q

What is Bethanechol (Urecholine) used for? Contraindications?

A

Urinary tract – Increase detrusor muscle tone
Indications: urinary retention, inadequate emptying w/o obstruction, neurogenic bladder
Dose: 10-50mg PO TID – QID empty stomach to avoid vomiting
GI tract – stimulates peristalsis; motility; increase resting LES (lower esophageal sphincter) pressure
Indications: GERD, post-op abd distention, gastroparesis…
Caution: bradycardia, hypotension, seizure
Contraindications: Asthma, COPD, urinary or GI obstruction, CVD
Hyperthyroidism + muscarinic agonists a. Fib