Cholinergic Agonist (nicotinic)

Question 1

Acts directly on NMJ receptors and cause continuous stimulation of nicotinic NMJ
**fasciculations followed by paralysis is a hallmark

Depolarizing NMJ blocker

**reversed by atropine

Answer 1

Succinylcholine

Question 2

ACE inhibitor
Act indirectly on nicotinic receptors. Inhibition of ACE leads to increasing acetylcholine that can stimulate NMJ receptors

**short acting and reversible

For diagnosis of myasthenia gravis

**reversal of NMJ block by nondepolarizing agent

Answer 2

Quaternary ammonium compounds

Endrophonium

Question 3

ACE inhibitor
Act indirectly on nicotinic receptors. Inhibition of ACE leads to increasing acetylcholine that can stimulate NMJ receptors

**moderately reversible

**Used to reverse nondepolarizing NMJ blockers and treatment of myasthenia gravis

Answer 3

Carbamates, neostigmine, physostigmine

*physostigmine used for treatment of atropine poisoning

Question 4

ACE inhibitor
Act indirectly on nicotinic receptors. Inhibition of ACE leads to increasing acetylcholine that can stimulate NMJ receptors

**irreversible

Used as insecticides. Poisoning is treated by anticholinergic drugs like atropine

Answer 4

Organophosphate