Cholinergic Agents Flashcards Preview

Pharmacology > Cholinergic Agents > Flashcards

Flashcards in Cholinergic Agents Deck (57):
1

Nicotine (mechanism)

Nicotinic ACh receptor agonist

2

Succinylcholine (mechanism)

Nicotinic ACh receptor agonist (Nm at neuromuscular jx)

3

Bethanechol (mechanism)

Muscarinic receptor agonist (predominantly M3)

4

Bethanechol (use)

Activate bowels and bladder

5

Succinylcholine (use)

Depolarizing blockade for brief paralysis during surgical procedure

6

Succinylcholine (metabolism)

By pseudocholinesterase, so effects can't be reversed by AChE inhibitor

7

Succinylcholine (side effects)

Malignant hyperthermia
Exaggerated hyperkalemia leading to arrhythmias (life-threatening!) in pts w/ crush/burn injuries, denervating injuries (quadriplegia, Guillain-Barre), myopathies -> so use non-depolarizing one for these ppl instead

8

Carbachol (mechanism)

Nonselective cholinergic agonist (activates both nicotinic and muscarinic)

9

Carbachol (use)

Topically for eye stuff (glaucoma, pupillary constriction, relief of IOP)

10

Pilocarpine (mechanism)

Nonselective muscarinic agonist, but M3 effects predominate so it contracts ciliary m. and pupillary sphincter and is a potent stimulator of sweat, tears, saliva (you cry, drool, sweat on your PILOw)

11

Pilocarpine (use)

Topically for glaucoma (open-angle and closed-angle) - esp in emergency (very effective at opening meshwork into canal of Schlemm)

12

Methacholine (mechanism)

Nonselective muscarinic agonist

13

Methacholine (use)

Challenge for asthma dx

14

Neostigmine (mechanism)

AChE inhibitor

15

Neostigmine (3 uses/CNS penetration)

1. myasthenia gravis
2. reverse of nondepolarizing neuromuscular jx blockade OR phase II of depolarizing NMJ blockade
3. postop ileus&urinary retention
does NOT penetrate CNS

16

Pyridostigmine (mechanism)

AChE inhibitor

17

Pyridostigmine (use/CNS penetration)

Myasthenia gravis (long acting)
does NOT penetrate CNS

18

Physostigmine (mechanism)

AChE inhibitor

19

Physostigmine (use/CNS penetration)

Fixes atropine overdose (fixes anticholinergic toxicity)
DOES cross CNS

20

Donepezil (mechanism)

AChE inhibitor

21

Donepezil (use)

One of Alzheimer drugs

22

Rivastigmine (mechanism)

AChE inhibitor

23

Rivastigmine (use)

One of Alzheimer drugs

24

Galantamine (mechanism)

AChE inhibitor

25

Galantamine (use)

One of Alzheimer drugs

26

Edrophonium (mechanism)

AChE inhibitor

27

Edrophonium (use)

Dx of myasthenia gravis historically (it's now dx by anti-AChR Ab test)

28

AChE inhibitors (side effects)

Exacerbation of COPD, asthma, peptic ulcers

29

Organophosphates (mechanism/toxicity)

Irreversible AChE inhibitor
DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal m. and CNS, lacrimation, sweating, salivation)

30

Organophosphates/AChE inhibitors (antidote)

Atropine (competitive inhibitor) + pralidoxime (regenerates new AChE if given early)

31

Atropine (mechanism)

Nonselective muscarinic ANTAgonist

32

Atropine (3 uses)

Bradycardia, opthalmic (dilates pupil), fixes cholinergic crisis

33

Hematropine (mechanism)

Nonselective muscarinic ANTAgonist

34

Hematropine (use)

To produce mydriasis

35

Advantage of a-agonists over anti-muscarinic agents when concerning their use to produce mydriasis?

a-agonists don't produce cycloplegia at high doses like anti-muscarinic agents do

36

Tropicamide (mechanism)

Nonselective muscarinic ANTAgonist

37

Tropicamide (use)

To produce mydriasis

38

Benztropine (mechanism/CNS penetration/use)

Can cross BBB to block muscarinic neurons in corpus striatum
Parkinson's disease (improves tremor and rigidity, but little effect on bradykinesia -> good for drug-induced parkinson or those w/ tremor as the predominant sx)

39

Atropine (side effects)

Hot as a hare, dry as a bone, red as a beet, blind as a bat (cycloplegia & mydriasis - can cause acute angle-closure glaucoma in eldery), mad as a hatter (disorientation), constipation

40

Scopalamine (mechanism)

Nonselective muscarinic ANTAgonist

41

Scopalamine (2 uses/CNS penetration)

Motion sickness, crosses BBB
Fixes problems created by myasthenia gravis drugs (help tone down anti-muscarinic effects so they can affect only the receptor that's a problem - nicotinic receptor)

42

Ipratropium (mechanism and 2 uses)

Muscarinic ANTAgonist with predominant effects on M3 (SMC and glands)
For COPD (first line), asthma (second line) -> poorly absorbed systematically so less systemic effects

43

Tiotropium (2 uses)

COPD, asthma

44

Oxybutynin (mechanism and use)

Muscarinic ANTAgonist with predominant effects on M3 (SMC and glands)
Reduces urgency/bladder spasm

45

"-fenacin" (mechanism/use)

Solifenacin, darifenacin
Muscarinic ANTAgonist
Reduces urgency/bladder spasm

46

"-terodine" (mechanism/use)

Tolterodine, fesoterodine
Muscarinic ANTAgonist
Reduces urgency/bladder spasm

47

Trospium (mechanism/use)

Muscarinic ANTAgonist
Reduces urgency/bladder spasm

48

Glycopyrrolate (mechanism)

Nonselective muscarinic ANTAgonist

49

Glycopyrrolate (2 uses)

REDUCES SECRETIONS
- Pre-op to reduce airway secretions and salivation
- Peptic ulcers

50

Antimuscarinic/anticholinergic (antidotes)

Physostigmine salicylate (AChE inhibitor that crosses BBB)

51

Pilocarpine (side effects)

Miosis and cyclospasm (don't have this w/ B-blocker glaucoma med)

52

Carbachol (side effects)

Miosis and cyclospasm (don't have this w/ B-blocker glaucoma med)

53

Trihexyphenidyl (mechanism and use)

Antimuscarinic
For Parkinson (esp drug-induced or those w/ tremor as the prominent sx)

54

Digitalis (antidote)

Potassium (to correct hypokalemia if present)

55

Hemicholinium (mechanism)

Blocks choline uptake -> prevents ACh synthesis

56

Bromoacetylcholine (mechanism)

Blocks choline acetyltransferase -> can't make ACh

57

Vesamicol (mechanism)

Competitively blocks vesicular ACh transporter -> prevents ACh from entering secretory vesicles