Cholinergic Pharmacology

Question 1

The _____ receptor subtype is richly expressed in brain areas involved in cognition.

A. M1

B. M2

C. M3

D. Nn

E. Nm

Answer 1

A

Question 2

The _____ receptor subtype is richly expressed in brain areas involved in appetite, such as the hypothalamus.

A. M1

B. M2

C. M3

D. Nn

E. Nm

Answer 2

C

Question 3

Parasympathetic stimulation via ____________ such as acetylcholine and carbachol functions to contract the pupillary sphincter and ciliary muscles.

A. Muscarinic agonists

B. Muscarinic antagonists

C. Nicotinic agonists

D. Nicotinic antagonists

E. None of these

Answer 3

A

Question 4

What is the primary effect of M2 receptor activation on the cardiovascular system?

Answer 4

Vagal slowing of the heart rate (negative chronotropic effect)

Question 5

The atrial muscarinic effec that slows the AV node of the heart is called the:

A. negative ionotropic effect

B. negative dromotropic effect

C. negative chronotopic effect

D. None of these

Answer 5

B

Question 6

The _____ receptor subtype increases tracheobronchial secretions when stimulated.

A. M1

B. M2

C. M3

D. Nn

E. Nm

Answer 6

C

Question 7

ACh binds to what two gut receptors in order to contract muscles in the gut during peristalsis?

Answer 7

M3 - increases intracellular free calcium

M2 - inhibits cAMP production

Question 8

An initial excitatory postsynaptic potential (EPSP) is mediated by the ______ receptor in autonomic ganglia.

A. M1

B. M2

C. M3

D. Nn

E. Nm

Answer 8

D

Question 9

Which of the following is used to treat glaucoma?

A. Acetylcholine

B. Carbachol

C. Pilocarpine

D. Methacholine

Answer 9

C

Question 10

Which drug is available as ophthalmic surgical aid for slower onset and more sustained miosis?

Answer 10

Carbachol

Question 11

The _________ inhalation challenge is used by some to test for asthma or occupational airway hypersensitivity.

Answer 11

Methacholine

Question 12

Why is edrophonium a useful diagnostic agent for myasthenia gravis?

Answer 12

It is a rapid, reversible cholinesterase inhibitor.

Question 13

Treatment of organophosphate poisoning is treated with what two drugs?

Answer 13

1. 2-PAM to reactivate enzyme
2. Atropine to block muscarinic effects

Question 14

_____________ is effective in reversing effects of antimuscarinic agents used in surgery to induce tachycardia.

Answer 14

Neostigmine

Question 15

____________ is an antibody-mediated autoimmune disease targeted against the alpha subunit of nicotinic receptors at the neuromuscular junction.

Answer 15

Myasthenia gravis

Question 16

Which is NOT a naturally occurring alkaloid muscarinic receptor antagonist?

A. Atropine

B. Hycosamine

C. Scopolamine

D. Tropicamide

Answer 16

D - Tropicamide is not naturally occuring as it is a synthetic agent with a shorter duration of action than atropine.

Question 17

___________ is a muscarinic receptor antagonist that is commonly prescribed for lung obstructive disease and does not readily cross membranes or the BBB.

Answer 17

Ipratropium

Question 18

____________ is preferred by anesthesiologists to reduce secretions in preparation for, or during, surgeries.

Answer 18

Glycopyrrolate - it is charged and reduces secretions without accessing the neural receptors.

Question 19

Since Atropine can cause long term paralysis in the eye muscles, shorter acting analogs such as ___________ are used in ophthalmic diagnostics and surgeries.

Answer 19

Tropicamide (4-8 hour duration)

Question 20

Which two drugs can be limit the cardiovascular effects of neostigmine when it is used to reverse neuromuscular blockage?

Answer 20

Atropine and glycopyrrolate

Question 21

Which muscarinic antagonist is used for motion disorders?

Answer 21

Scopolamine patches (or anti-histamines!)

Question 22

Which of the following drugs is the shortest duration neuromuscular blocking agent?

A. Atracurium

B. Succinylcholine

C. Panocuronium

D. All of these are short-duration NMJ blocking agents.

Answer 22

B

Question 23

What is the affect of Pancuronium on cardiac muscarinic receptors?

Answer 23

Moderate block of M2 receptors