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Pharmacology > Cholinergic > Flashcards

Cholinergic Flashcards

1
Q

ACH synthesized from

A

Choline

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2
Q

Inactivates ACH

A

Acetylcholinesterase

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3
Q

Inhibits choline transporter

A

Hemicholinium

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4
Q

Inhibits release of ACh

A

Botulinum toxin

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5
Q

Direct action agonists

A

Bind to and stimulate muscarinic and nicotinic receptors directly

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6
Q

Indirect action agonists

A

Decrease breakdown of ACH by AchE increasing its duration of action in the synaptic cleft

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7
Q

Most GI and bladder effect

A

Bethanechol

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8
Q

Most effect on sweat gland secretions (increased)

A

Pilocarpine

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9
Q

Therapeutic for glaucoma; may cause blurred vision

A

Pilocarpine

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10
Q

Used to diagnose asthma

A

Methacholine

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11
Q

Therapeutic for increasing GI motility or post op abdominal distention, gastric atony

A

Bethanechol (Urecholine)

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12
Q

Therapeutic for post op urinary retention, chronic myogenic/hypotonic bladder. May increase detrusor contraction in its w/ spinal cord injury

A

Bethanechol

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13
Q

Therapeutic for xerostomia (dry mouth) due to Sjorgens

A

Pilocarpine (side effect = sweating)

Cevimeline (Specific to M3 receptors)

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14
Q

Sxs of muscarinic toxicity

A

Salivation, tears, nausea, vomiting, diarrhea, HA, visual disturbances, bronchospasms, bradycardia, shock

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15
Q

Partial agonist on nicotinic receptor in the brain

A

Varenicline (Chantix)

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16
Q

Side effects of Chantix

A

nausea, vomiting, constipation, flatulence sleep, psychiatric disturbance

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17
Q

MOA cholinesterase inhibitors

A

Increase duration of time ACH avail to activate receptors in synaptic cleft

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18
Q

Prevents enzyme aging if applied within 3-4hrs

A

Pralidoxime (2-PAM)

19
Q

Therapeutic for Myasthenia gravis, reversal of post op NM blockade and increase bladder motility

A

Neostigmine

20
Q

Used of diagnosis of Myasthenia Gravis (muscle strength improves for 5min if disease is present)

A

Edrophonium

21
Q

Used to decide if AChE inhibitor tx right (decrease muscle strength if too high a dose and vice versa)

A

Edrophonium

22
Q

Used as eye drops, long acting, not absorbed systemically, Tx of narrow angle gluacoma

A

Echothiophate

23
Q

Nerve gases

A

Soman, Sarin, Tabun

24
Q

Thiophospate pesticides, lipid soluble

A

Parathion, Malathion

25
Q

Autoimmune disease that attacks nicotinic ACh receptors causing muscle weakness, fatigue that is worse w/ exercise

A

Myasthenia Gravis

26
Q

MOA for Tx of myasthenia gravis w/ AChE

A

Increase length of time ACh present in cleft which increases probability of activation of receptors

27
Q

Cholinesterase inhibitors used in the tx of Myasthenia Gravis

A
  • Neostigmine
  • Pyridostigmine
  • Abenonium
28
Q

Sxs of AChE inhibitor toxicity

A

SLUDGE (Salivation, Lacrimation, Urination, Defecation, Gastric distress, Emesis)
Bradycardia, hypotension, confusion, ataxia, slurring, mitosis, bronchoconstriction

29
Q

Tx of organophosphate AChE poisoning

A
  • Atropine until pupils dilate

* 2-PAM if

30
Q

Carbamate AChE poisons

A

Carbaryl
Propuxur
Aldicarb

31
Q

Effects of Atropine

A

Block parasymp effects (reduced secretions, tachycardia, palpitations, urinary retention etc)

32
Q

Duration of effect of anti-muscarinics

A

Atropine>Scopolamine>Homatropine>Cyclopentolate>Tropicamide

33
Q

Ophthalmologically used for dilating eyes for exam

A

Tropicamide

34
Q

Used to decrease bradycardia sure to excessive vagal stim./reverse heart block, used after MI

A

Atropine

35
Q

Therapeutic muscarinic antagonist that improves breathing

A

Ipratropium (Atrovent)

Tiotropium (Spiriva)

36
Q

Contraindications for use of Scopolamine

A
  • Narrow angle glaucoma

* BPH

37
Q

Dry as a bone, blind as a bat, red as a beet, mad as a hatter

A

Signs of atropine overdose

38
Q

Substances that can cause anti muscarinic poisoning

A 
Antihistamines
Tricyclic antidepressants
Antipsychotics
Plants
Eyedrops
Anti-diarrhea prep
39
Q

Tx of AChE inhibitor toxicity

A

Pesticide/Nerve gas poisoning

Atropine

40
Q

Contraindications for Succinylcholine

A
  • Extensive soft tissue damage
  • Severe burns
  • non-traumatic rhabdomyalisis
  • Quadraplegia, paraplegia
  • Muscular dystrophy
  • Chn
41
Q

NMJ blocker activity enhanced by / drug interactions

A
  • Inhaled/local anesthetics
  • Aminoglycosides (depress ACh release)
  • Tetracyclines (Chelate Ca)
  • Ca channel blockers
42
Q

Factors that affect NMJ blocker activity

A
  • Myasthenia gravis
  • Aging
  • Severe burns, upper motor neuron disease
43
Q

Ganglion blockers

A

Hexamethonium

Mecamylamine

Pharmacology (6 decks)

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