Cholinergic Agonists

Question 1

other name for sympathetic divisioin

Answer 1

adrenergic - fight or flight

Question 2

neurotransmitter - preganglionic

Answer 2

acetylcholine

Question 3

neurotransmitter - end organs (sympathetic)

Answer 3

norepinephrine

Question 4

receptors that receive norepinephrine (sympathetic)

Answer 4

alpha and beta

Question 5

other name for parasympathetic division

Answer 5

cholinergic - rest and digest

Question 6

what stops (metabolizes) relationship with norepinephrine

Answer 6

MAO and COMT

Question 7

neurotransmitter (parasympathetic)

Answer 7

acetylcholine

Question 8

receptors for acetylcholine (parasympathetic)

Answer 8

nicotinic or muscarinic

Question 9

what stops (catabolizes) relationship (parasympathetic)

Answer 9

acetylcholinesterase or pseudocholinesterase

Question 10

if a medication is an agonist what does it do

Answer 10

makes it more - promote cholinergic response

Question 11

if medication is an antagonist what does it do

Answer 11

decreases it - stop it

Question 12

cholinergic agonist aka

Answer 12

parasympathoneumetic - mimics parasympathetic nervous system

Question 13

cholinergic agonists (parasympathoneumetics) do this

Answer 13

increase the action of acetycholine - promote rest and digest

Question 14

direct acting agonist acts just like

Answer 14

acetylcholine - protype is bethanecol

Question 15

**what does bethanecol do

Answer 15

**used for urinary retention

Question 16

one class of drugs direct acting on nicotinic

Answer 16

nicotine

Question 17

indirect acting cholinergic agonists - acts on nicotinic and muscarinic

Answer 17

binding to acetylcholinesterase - promote action of acetylcholine - binds for a short time - reversible drugs

Question 18

what disease process would indirect acting cholinergic agonists help

Answer 18

myasthenia gravis - immune system is destroying receptors for acetylcholine

Question 19

prototype for indirect acting cholinergic agonists

Answer 19

neostigmine - lasts 2-4 hours

Question 20

what binds irreversibly to acetylcholine

Answer 20

nerve gas and insecticides

Question 21

to reverse cholinergic agonist (toxic effect)

Answer 21

cholinergic antagonist - atropine

Question 22

if we block acetylcholine what system is going to dominate

Answer 22

sympathetic

Question 23

antagonizing in cholinergic system acting on muscarinic receptors prototype

Answer 23

atropine - blocks acetylcholine - making sympathetic nervous system dominate

Question 24

what acts on nicotinic receptors

Answer 24

neuromuscular blockers - acting on nicotinic receptors

Question 25

2 ways neuromuscular blockers (nicotinic receptors) work

Answer 25

depolarizing or non-depolarizing - acting on skeletal muscles blocking the impulses with a result a paralysis of that muscle

Question 26

cholinergic agonists have 2 actions what are they

Answer 26

directly (act like acteylcholine) | indirectly (binding to acetylcholinesterase)

Question 27

prototype for DIRECT acting cholinergic/muscarinic agonist (

Answer 27

bethanecol chloride

Question 28

bethanecol chloride is given for

Answer 28

post-op/postpartum urinary retention

Question 29

how does bethanecol work

Answer 29

relaxes sphincter muscles - increases voiding pressure - increasing peristalsis in urinary system

Question 30

when wouldn't you want to give bethanecol

Answer 30

a blockage causing rupture (will still cause peristalsis)

Question 31

what is bethanecol contraindicated for

Answer 31

asthma/copd patients (parasympathetic nervous system constricts bronchioles)

Question 32

cholinergic adverse effects

Answer 32

reflect system they are stimulating

Question 33

if you take too much of a cholinergic agonist what will it cause, whether direct or indirect

Answer 33

cholinergic crises

Question 34

prototype for myasthenia gravis (INDIRECT cholinergic agonist - ache inhibitor)

Answer 34

neostigmine

Question 35

if pt is in cholinergic crisis what can you give to reverse it

Answer 35

atropine (not long lasting) and supportive therapy

Question 36

are indirect cholinergic agonists reversible

Answer 36

yes

Question 37

most common 1st symptom of myasthenia gravis

Answer 37

eye droop/lid lag

Question 38

what does neostigmine do

Answer 38

makes more acetylcholine, receptors are being destroyed to keep make muscles stronger

Question 39

what time of day are the muscles exhausted in myasthenia gravis

Answer 39

night-time

Question 40

what should a pt. on neostigmine do

Answer 40

keep diary - how was muscle strength/when it was time for the next dose

Question 41

if muscle strength is good at time of next dose what do we do with the dosage

Answer 41

keep the dose the same - if weak muscle, increase dose

Question 42

what is important for a pt to wear if they are dx with myasthenia gravis

Answer 42

medic alert bracelet

Question 43

if pt is in ER and we need to determine whether they are in a myasthenia vs a cholinergic crises what can we do

Answer 43

***tensillon or edrophonium test

Question 44

what happens in a tesnillon/edrophonium test

Answer 44

give smallest dose of indirect acting cholinergic agonist (neostigmine)

Question 45

if pt is in a myasthenic crises when given a tensillon/edrophonium test will they get better or worse

Answer 45

better

Question 46

if tensillon is given and pt gets worse what type of crises are they in

Answer 46

cholinergic crises - give atropine

Question 47

drugs that have a positive charge cant

Answer 47

cross the blood-brain barrier