ANS pt 2 - slides 1-17

Question 1

why is there muscle weakness with myasthenia gravis

Answer 1

lower Nm receptor stimulation

Question 2

what muscarinic agonist is used to treat glaucoma and xerostomia

Answer 2

pilocarpine

Question 3

name an example of a neuronal nicotinic agonist

Answer 3

nicotine

Question 4

what are two adverse effects of irreversible AChE inhibitors

Answer 4

excessive muscarinic stimulation
inhibition of neuromuscular transmission

Question 5

what are 3 examples of nerve gases

Answer 5

sarin
tabun
VX

Question 6

name 6 adverse effects of muscarinic antagonists

Answer 6

xerostomia
anhidrosis
urinary retention
constipation
blurred vision
photophobia

Question 7

what muscarinic agonist is used to treat urinary retention and intestinal paralysis

Answer 7

bethanechol

Question 8

what branch of the ANS would a neuronal nicotinic agonist stimulate

Answer 8

both the sympathetic and parasympathetic

Question 9

name a charged AChE inhibitor

Answer 9

neostigmine

Question 10

bethanechol is an example of what kind of drug

Answer 10

muscarinic agonist

Question 11

what are the effects of muscarinic antagonists

Answer 11

tacchycardia
decreased sweat gland, bronchial, GI secretions and motility

relaxation of bronchia SM and detrusor muscle
mydriasis and cycloplegia

Question 12

what are two adverse effects of irreversible AChE inhibitors

Answer 12

excessive muscarinic stimulation
inhibition of neuromuscular transmission

Question 13

what drugs can trigger malignant hyperthemia

Answer 13

succinylcholine
general anesthetics

Question 14

what is an example of a depolarizing blocker

Answer 14

succinycholine

Question 15

what causes myasthenia gravis

Answer 15

inactivation of ACh Nm receptors by auto-antibodies

Question 16

muscarine is found in what natural source

Answer 16

poisonous mushrooms

Question 17

what is an example of irreversible AChE inhibitors

Answer 17

echothiophate

Question 18

what 3 drugs can be used to treat AChE inhibitor effects

Answer 18

atropine
oxygen
diazepam

Question 19

what targets do muscarinic agonists stimulate

Answer 19

all parasympathetic targets plus the sweat glands from the sympathetic NS

Question 20

what is an example of an insecticide

Answer 20

malathion

Question 21

what can occur at high doses of muscarinic antagonists

Answer 21

psychosis
delirium
(due ot excitation of the CNS)

Question 22

what is typically the predominant effect of neuronal nicotinic agonists

Answer 22

sympathetic effects due to the increased release of Epi/norepi by the adrenal medulla

Question 23

what is bethanechol used to treat

Answer 23

urinary retention and intestinal paralysis

Question 24

AChE inhibitors typicall lead to increased effects at what cholinergic receptors

Answer 24

muscarinic and neuromuscular

Question 25

what is an adverse effect of muscarinic agonists

Answer 25

overstimulation of parasympathetic targets

Question 26

what does SLUDGE stand for

Answer 26

salivation lacrimation urination diaphoresis GI motlility emesis

Question 27

what muscarinic antagonist can be administered via transdermal patch as an antiemetic

Answer 27

scopolamine

Question 28

why are most neuromuscular blockers administered parenterally

Answer 28

because they are permanently charged ammonium compounds

Question 29

what receptors do neuromuscular blockers affect

Answer 29

nicitinic receptors on skeletal muscle

Question 30

what are the adverse effects of AChE inhibitors

Answer 30

excessive stimulation of muscarinic and neuromuscular receptors

Question 31

what is scopolamine

Answer 31

a muscarinic antagonist can be administered via transdermal patch as an antiemetic

Question 32

what do muscarinic agonists do

Answer 32

stimulate muscarinic receptors

Question 33

name a neutral AChE inhibitor

Answer 33

physostimgine

Question 34

name 3 examples of non-depolarizing neuromuscular blockers

Answer 34

tubocurarine rocuronium cisatracurium

Question 35

nicotine is what kind of drugs

Answer 35

neuronal nicotinic agonist

Question 36

name 3 things AChE inhibitors can be used to treat

Answer 36

myasthenia gravis paralysis induced by non-depolarising neuromuscular blockers alzheimers disease

Question 37

what NS does neuromuscular blockers affect

Answer 37

the somatic NS

Question 38

what is Malignant hyperthermia

Answer 38

dangerously high temp rigid muscles/spasms rapid HR due to overactivation of muscle receptors

Question 39

what is myasthenia gravis

Answer 39

chronic autoimmune disease linked to defective transmission at the neuromuscular junction

Question 40

will edrophonium make a subtherapeutic myasthenic patient better or worse

Answer 40

better

Question 41

whats another word for muscarinic antagonists

Answer 41

anticholnergics

Question 42

What do cholinomimetics do

Answer 42

act like ACh

Question 43

what is a drug to treat malignant hyperthermia

Answer 43

dantrolene

Question 44

what drug can be used to differentiate between a cholinergic crisis and severe symptoms of myasthenia

Answer 44

edrophonium

Question 45

what is the mechanism of action of AChE inhibitors

Answer 45

temporarily inactivates acetylcholinesterase

Question 46

name a short-acting AChE inhibitor

Answer 46

edrophonium

Question 47

what is another name for parasympathomimetic

Answer 47

muscarinic agonists

Question 48

what is the result of a neuronal nicotinic agonist

Answer 48

increased release of noradrenaline, adrenaline and acethycholine

Question 49

what does a cholinergic crisis cause

Answer 49

repetitive overstimulation of nicotinic receptors lead to a neuromuscular block by depolarization (ie paralysis)

Question 50

when does blockage of muscle contraction occur with neuromuscular blockers

Answer 50

when 70% of Nm receptors are blocked

Question 51

what's an adverse effects of neuromuscular blockers

Answer 51

excessive paralysis can result in cessation of breathing

Question 52

how does succinylcholine work

Answer 52

overstimulates receptors until they become inactivated

Question 53

what is the result of AChE inhibitors

Answer 53

increased ACh levels

Question 54

what do cholinolytics do

Answer 54

blocks ACh-related effects

Question 55

name 6 uses of muscarinic antagonists

Answer 55

reduce urinary urgency/incontinence decrease hypermotility of gut pre-op/palliative care to dry out secretions eye exam/surgery treat muscarinic poisoning treat asthma (blocks bronchoconstriction)

Question 56

what is the mechanism of action of muscarinic antagonists

Answer 56

blocks muscarinic receptors

Question 57

what are 3 uses of neuromuscular blockrs

Answer 57

relaxation during surgery endotracheal intubation+mechanical ventilation

Question 58

name 3 reversible AChE inhibitors

Answer 58

neostigmine physostigmine edrophonium

Question 59

what is a cholinergic crisis

Answer 59

excessive ACh levels at Nm and muscarinic receptors

Question 60

how long is the duration of depolarizing neuromuscular blockers

Answer 60

5mins - metabolized by plasma cholinesterases

Question 61

what poisonous mushrooms are muscarine found in

Answer 61

amatina muscaria inocybe clitocybe

Question 62

when is improvement seen with myasthenia gravis

Answer 62

if ACh levels are increased at neuromuscular junctions

Question 63

what medication can be used to reverse effects of AChE inhibitors if used quickly enough

Answer 63

pralidoxime

Question 64

what are 3 contraindications of AChE inhibitors

Answer 64

GI obstruction urinary obstruction asthma

Question 65

rank the sensitivity of muscles to neuromuscular blockers from highest to lowest

Answer 65

fast twitch respiratory slow twitch

Question 66

what plant does atropine come from

Answer 66

atropa belladonna

Question 67

what is dantrolene used to treat

Answer 67

malignant hyperthermia

Question 68

what two muscarinic agonists are used to treat glaucoma

Answer 68

pilocarpine carbachol

Question 69

cycloplegia

Answer 69

loss of accommodation

Question 70

how does dantrolene work

Answer 70

blocks calcium release from intracellular sarcoplasmic reticulum stores in skeletal muscle

Question 71

will edrophonium make a cholinergic crisis better or worse

Answer 71

worse

Question 72

how do non-depolarizing neuromuscular blockers work

Answer 72

by competing with acetylcholine for binding to muscle nicotinic receptor

Question 73

what are 4 muscarinic antagonists

Answer 73

atropine tolterodine oxybutynin solifenacin

Question 74

insecticides and nerve gases are what type of drugs

Answer 74

irreversible AChE inhibitors

Question 75

what is another name for muscarinic agonists

Answer 75

parasympathomimetics

Question 76

what is echothiophate used to treat

Answer 76

glaucoma

Question 77

pilocarpine and carbachol are what kind of drugs

Answer 77

muscarinic agonists