ANS Cholinergic

Question 1

prototype that acts directly at both muscarinic and nicotinic receptors

Answer 1

Ach

Question 2

prototype for the indirect acting cholinesterase inhibitors

Answer 2

neostigmine

Question 3

Muscarinic mechanism of action

Answer 3

g protein and releases second messengers DAG and IP3. IP3 causes release of calcium from storage sites and causes smooth muscle contraction

Question 4

Nicotinic mechanism of action

Answer 4

Ach receptor is located on channel protein that is selective for sodium and potassium. Receptor activation causes depolarization with influx of Na+ causes EPSP

Question 5

drug that blocks synthesis of Ach

Answer 5

hemicholinium

Question 6

drug that blocks storage of Ach

Answer 6

vesamicol

Question 7

drug that blocks release of Ach

Answer 7

botulinum toxin

Question 8

drug that block NE synthesis

Answer 8

metyrosine

Question 9

drug that blocks catecholamine storage

Answer 9

reserpine

Question 10

drug that blocks catecholamine release

Answer 10

guanethidine

Question 11

drug that facilitates release of catecholamine

Answer 11

amphetamine

Question 12

drug that impairs reuptake of catecholamines

Answer 12

cocaine

Question 13

causes relaxation of skeletal muscle and systemic blood vessels

Answer 13

beta 2

Question 14

causes contraction of skeletal muscle and systemic blood vessels

Answer 14

alpha 1

Question 15

causes increase in heart rate

Answer 15

beta 1

Question 16

causes relaxation of lungs and tracheal and bronchial smooth muscle

Answer 16

beta 2

Question 17

short duration of action, quaternary structure , susceptible to pseudocholinesterase

Answer 17

direct acting cholinergic agonists

Question 18

pilocarpine, bethanachol, methacholine

Answer 18

direct acting muscarinic agonists

Question 19

Methacholine has the greatest muscarinic action on which system?

Answer 19

cardiac

Question 20

2 drugs with very high selectivity to nicotinic receptors

Answer 20

Ach and pilocarpine

Question 21

How do you reverse the effect of methacholine?

Answer 21

beta agonist

Question 22

first cause depolarization at nicotinic receptor but then become antagonist

Answer 22

nicotinic receptor agonists

Question 23

nicotine, succinylcholine varenicline

Answer 23

nicotinic receptor agonists

Question 24

Effect of large dose of nicotine on NMJ

Answer 24

depolarization and depression of transmission, receptor desensitization

Question 25

partial agonist of nicotinic receptors and receptor is mesolimbic nicotinic

Answer 25

varenicline

Question 26

what is varenicline selective for?

Answer 26

alpha4 beta 2 neuronal nicotinic receptor

Question 27

adverse effects of varenicline (4)

Answer 27

1. nausea 2. sleep disturbances 3. GI 4. nicotine withdrawal

Question 28

block acetylcholinesterase from degrading Ach

Answer 28

indirect acting cholinergic agonists

Question 29

edrophonium, neostigmine, physostigmine, and malathion examples of ?

Answer 29

reversible acetylcholinesterase inhibitors (indirect acting agonists)

Question 30

example of irreversible indirect acting agonists

Answer 30

organophosphates

Question 31

Cholinesterase regenerator; reverse organophosphates

Answer 31

pralidoxime (2 PAM) | diacetylmonoxime (DAM)

Question 32

tertiary NH and antidote for antimuscarinic CNS toxicity, tx of glaucoma, tx of MG

Answer 32

physostigmine

Question 33

antibodies to alpha 1 subunit of nicotinic receptor channel complex

Answer 33

myasthenia gravis

Question 34

Which cholinesterase inhibitor has the shortest duration of action?

Answer 34

edrophonium

Question 35

prototype of antimuscarinic drugs

Answer 35

atropine

Question 36

use for mydriasis and cycloplegia

Answer 36

antimuscarinic drugs

Question 37

muscarinic antagonists

Answer 37

glycopyrrolate atropine tolterodine ipratropium

Question 38

Which antimuscarinic has a quarternary structure and will limit distribution in the CNS?

Answer 38

trospium

Question 39

primary uses of muscarinic antagonists (5)

Answer 39

1. bronchodilation 2. treat bradyarrhythmia 3. urinary incontinence 4. decreased GI motility 5. dry secretions

Question 40

large doses of this drug make it an antagonist

Answer 40

nicotine

Question 41

Small dose of nicotine increase ___ and ___.

Answer 41

BP and HR

Question 42

Hypotension caused by larger doses of ___.

Answer 42

nicotine

Question 43

nicotinic antagonist ganglionic blocker

Answer 43

trimethaphan

Question 44

nicotinic antagonist neuromuscular blockers

Answer 44

atracurium pancuronium rocuronium

Question 45

Which nicotinic antagonist neuromuscular blocker has the longest duration of action?

Answer 45

pancuronium

Question 46

membrane depolarizes resulting in an initial which produces fasciculations then flaccid paralysis

Answer 46

phase I block of depolarizing NMB

Question 47

membrane repolarizes but receptor is desensitized to effect of acetylcholine

Answer 47

phase II block of depolarizing NMB

Question 48

compete with Ach to bind with nicotinic receptor of motor end plate; blockade inhibit Ach from binding

Answer 48

Non depolarizing, competitive NMB

Question 49

Histamine release is a direct effect of ___

Answer 49

NMB nicotinic antagonists

Question 50

Phase II can be antagonized by

Answer 50

antiChE agent

Question 51

3 effects of depolarizing agents

Answer 51

1. ) muscle fasciculation 2. ) hyperkalemia 3. ) masseter muscle rigidity

Question 52

can be reversed by acetylcholinesterase inhibitor agents

Answer 52

non depolarizing agents

Question 53

indirect acting cholinergic receptor antagonist

Answer 53

botulinum toxin

Question 54

adverse effects of nicotinic and muscarinic

Answer 54

1. anaphylaxis 2. associated with site of injection and dose (local effects, dry mouth, dysphagia, ptosis, vision effects)

Question 55

most likely cause of death from cholinesterase inhibitor toxicity

Answer 55

respiratory failure

Question 56

neostigmine and pyridostigmine causes ___

Answer 56

diarrhea; cholinesterase inhibitors increase bowl movement

Question 57

parasympathetic innervation and bethanechol will cause ___

Answer 57

increase bronchial smooth muscle tone

Question 58

what do muscarinic cholinergic agonists treat

Answer 58

miosis (tx of narrow angle glaucoma)

Question 59

drug with little to none vascular effect and CNS effect and duration of action of 2-4 hours

Answer 59

neostigmine

Question 60

both ganglion blockers and muscarinic blockers cause ____

Answer 60

mydriasis

Question 61

therapeutic indication for antimuscarinic drugs?

Answer 61

COPD

Question 62

which drug causes vasodilation and can be blocked by atropine

Answer 62

bethanechol

Question 63

beta 2 stimulants cause ___

Answer 63

tremors