Unit 4: Cholinergic Agonists

Question 1

2 targets of drug action for cholinergic agonists

Answer 1

1. Postsynaptic receptor

2. Acetylcholinesterase enzyme

Question 2

Acetylcholinesterase does what?

Answer 2

Breaks down acetylcholine

Question 3

Where are nicotinic and muscarunic receptors found?

Answer 3

1. All autonomic ganglia have nicotinic receptors
2. All neuromuscular junction receptors are nicotinic
3. All parasympathetic target organs have muscarunic receptors

Question 4

Cholinergic agonists are divided into the following 2 groups

Answer 4

1. Choline esters

2. Alkaloids

Question 5

The alkaloids are ______ derivatives. What is important to note regarding alkaloids and cholinesterases?

Answer 5

Plant

Cholinesterases do not metabolize alkaloids

Question 6

BETHANECHOL indication

Answer 6

Urinary retention

Question 7

Nicotine does what to nicotinic receptors?

Answer 7

It is a direct agonist

Question 8

Nicotine indications

Answer 8

Used therapeutically to help patients stop smoking

Question 9

Cholinergic agonists generally have what effects?

Answer 9

Muscarinic

Question 10

Cholinesterase inhibitors are broken into what 2 groups? How are these groups related to solubility?

Answer 10

Reversible (water soluble)

Irreversible (lipid soluble)

Question 11

The REVERSIBLE INHIBITORS are used to treat what diseases?

Answer 11

1. Myasthenia gravis

2. Alzheimer’s dementia

Question 12

The reversible cholinesterase inhibitors tend to end with what?

Answer 12

• STIGMINE

- NIUM

Question 13

The irreversible cholinesterase inhibitors are referred to as

Answer 13

Nerve gases

Question 14

What effect do cholinesterase inhibitors have on acetylcholine?

Answer 14

They increase acetylcholine

Question 15

Activation of MUSCARINIC RECEPTORS:

Effect on the EYE

Answer 15

Miosis (constriction of pupil)

Question 16

Activation of MUSCARINIC RECEPTORS:

Effect on the CV SYSTEM

Answer 16

Decrease heart rate

Question 17

Activation of MUSCARINIC RECEPTORS:

Effect on the RESPIRATORY SYSTEM

Answer 17

Bronchial constriction, increased secretions

Question 18

Activation of MUSCARINIC RECEPTORS:

Effect on the GI SYSTEM

Answer 18

Increased motility

Sphincter relaxation

Question 19

Activation of MUSCARINIC RECEPTORS:

Effect on the GU SYSTEM

Answer 19

Relaxation of sphincters

Bladder wall contraction

Question 20

Activation of MUSCARINIC RECEPTORS:

Effect on the GLANDS

Answer 20

Increased secretions

Question 21

Cholinergic agonists act on:

Answer 21

Postsynaptic receptor—some on the muscarinic one, some on the nicotinic one

Question 22

Cholinesterase inhibitors act on:

Answer 22

Breaking down cholinesterase and therefore increasing acetylcholine

Question 23

Choline esters have what in their name?

Answer 23

-CHOL-

Question 24

What is important to note about the lipid soluble cholinesterase inhibitors?

Answer 24

They rapidly cross all membranes, including the blood brain barrier

Question 25

What is Myasthenia Gravis?

Answer 25

An immune disease causing a loss of acetylcholine receptors, resulting in muscle weakness

Question 26

How does Alzheimer’s relate to acetylcholine?

Answer 26

There is a deficiency of cholinergic neurons

Question 27

EDROPHONIUM is used to …

Answer 27

Diagnose myasthenia gravis

Question 28

How does EDROPHONIUM work?

Answer 28

For patients with myasthenia gravis, the drug dramatically improves muscle strength

For patients without myasthenia gravis, it causes increased secretions and GI cramping from increased GI motility

Question 29

What is NEOSTIGMINE used to treat?

Answer 29

Myasthenia gravis

Question 30

What is PYRIDOSTIGMINE used to treat?

Answer 30

Myasthenia gravis

Question 31

Why is EDROPHONIUM—and not NEOSTIGMINE OR PYRIDOSTIGMINE—used to diagnose (vs treat) myasthenia gravis?

Answer 31

It is short acting. NEOSTIGMINE and PYRIDOSTIGMINE are both longer acting than ERDOPHONIUM.

Question 32

What drugs treat nerve gas poisoning?

Answer 32

PRALIDOXIME and ATROPINE

Question 33

SLUDGE…

Answer 33

Salivation
Lacrimation
Urination
Diaphoresis
GI Upset
Emesis