Cholinergic Agonists And Antagonists - Dr. Kruse

Question 1

M1 location

Answer 1

nerves

Question 2

M2 location

Answer 2

heart, SM, nerves

Question 3

M3

Answer 3

glands, SM, Endothelium

Question 4

M4 location

Answer 4

CNS

Question 5

M5 location

Answer 5

CNS

Question 6

Nn location

Answer 6

Post-ganglionic cell body, dendrites, CNS

Question 7

Nm location

Answer 7

skeletal muscles neuromuscular junction

Question 8

eye contraction receptor

Answer 8

M3 and M2 = constriction of pupil by contracting sphincter of iris + ciliary muscle

Question 9

lung Rs

Answer 9

M2 and M3 (bronchoconstriction)

Question 10

GIGU Rs

Answer 10

M2 + M3

Question 11

Direct -acting cholinergic agonists metabolized by what

Answer 11

acytylcholinesterase

Question 12

nicotinic vs muscarinic R and absorption

Answer 12

1. Nicotinic : uncharge and highly absorbed

2. Muscarinic : charged, highly absorbed

Question 13

Direct -acting cholinergic agonists 4

Answer 13

1. Ach
2. Methacholine
3. Carbachol
4. Bethanechol

Question 14

indirect-acting cholinergic agonists do what and 3 types

Answer 14

increase Ach

1. alcohols (reversible)
2. Carbamic acid esters (reversible)
3. Organophosphates (irreversible)

Question 15

Indirect -acting cholinergic agonists and absorption

Answer 15

alcohol + carbamic acid esters = charges + poorly absorbed

Organophosphates = uncharged and absorbed

Question 16

parasympathetic affect on bladder

Answer 16

relax sphincter

contraction of detrusor

Question 17

parasympathetic effect on sweat glands

Answer 17

secretion

Question 18

parasympathetic stimulation on bronchial glands

Answer 18

stimulate

Question 19

main uses for direct -acting cholinergic agonists

EYE

Answer 19

1. glaucoma

2. esotropia (hypermetropic accomodative error)

Question 20

main uses for direct -acting cholinergic agonists

GIGU

Answer 20

1. post-ileus
2. congenital megacolon
3. urinary retention
4. esophageal reflux
5. Xerostomia , Sjögren syndrome

Question 21

muscarinic stimulatants Side effects

Answer 21

N, V, D, urinary urgency, salvation, sweating, increase in glandular secretion = SLUDGE

Question 22

muscarinic stimulants are contraindicated in

Answer 22

1. asthma
2. hyperthyroidism
3. coronary insufficiency
4. acid-peptic disease

Question 23

Nicotine stimulants side effects

Answer 23

1. nicotine poisoning : from cigs and insecticides

2. acute toxicity : CNS, skeletal muscle end plate depolarization , resp paralysis, htn, cardiac arrhythmias

Question 24

tx side effects of direct -acting cholinergic agonists

Answer 24

1. atropine

2. parenteral anticonvulsants (diazepam a benzodiazepine)

Question 25

Acetylcholine is for what

Answer 25

intraocular during surgery = miosis (constriction of pupil)

Question 26

Bethanechol is used for what

Answer 26

1. urinary retention (can cause UTI if sphincter does not relax) 2. heartburn

Question 27

Carbachol is used for

Answer 27

1. glaucoma 2. intraocular surgery for miosis 3. opthalmic examination

Question 28

Cevimeline used for

Answer 28

dry mouth in sjögrens syndrome

Question 29

Pilocarpine used for

Answer 29

1. dry mouth in sjögrens syndrome, head/neck cancer 2. miosis during surgery 3. glaucoma

Question 30

Varenicline (Chantix) MOA and for who

Answer 30

1. stimulation and moderate release of mesolimbic dopamine (bind to Nn) 2. for smoking cessation

Question 31

Varenicline (Chantix) adverse effects

Answer 31

neuropsychiatric sx, agitation, depression, dark behavior

Question 32

Indirect- acting cholinergic agonists main 6 uses

Answer 32

1. Glaucoma 2. Dementia 3. Antidote to anticholinergic poisoning 4. reversal of neuromuscular paralysis 5. myasthenia gravis 6. Ach.esterase inhibitor toxicity

Question 33

Ach.esterase inhibitor toxicity sx

Answer 33

SLUDGE SX, EFFECTS NMJ, TX WITH ATROPINE

Question 34

glaucoma and mAchR stimulation

Answer 34

aqueous humor outflow and reduces intraocular P

Question 35

anticholinergic poisoning sx and from what

Answer 35

1. vasodilation cutaneous , anhidrosis, hyperthermia, mydriasis, delirium, X urination 2. atropine, anti-histamines, TCA, sleep aids,

Question 36

most common cholinergic antagonist

Answer 36

atropine

Question 37

anticholinergic agents 7 uses

Answer 37

1. motion sickness 2. GI 3. dilation eye 4. respiration problems 5. urinary problems 6. cholinergic poisoning 7. movement disorder

Question 38

parkinsons disease drug to help

Answer 38

anti-cholinergic = reduce tremors, most effective is standard dopamine tx

Question 39

motion sickness drug

Answer 39

anticholinergic agents = scopolamine

Question 40

anesthesia

Answer 40

anticholinergic = atropine blocking vagal reflexes, from surgical manipulation of organs = given with neostigmine (AchE Inhibitor)

Question 41

when do you need anticholinergic on eye

Answer 41

prolonged eye dilation in 1. LASIK surgery, (a-adrenergic receptor agonist is shorter acting and less adverse effects) 2. uveitis and iritis prevention

Question 42

lungs and anticholinergic agents

Answer 42

1. Ipratropium and tiotropium | 2. for COPD mostly and asthma

Question 43

anticholinergic agents and GI

Answer 43

travelers D, Lomotil (atropine + diphenoxylate)

Question 44

anticholinergic agents GU

Answer 44

1. urinary urgency (minor inflammatory bladder disorder) | 2. agents acting on M3**

Question 45

4 drugs acting on M3 for the GU

Answer 45

1. oxybutynin : dry sx side effects 2. Darifenacin 3. Solifenacin 4. Tolterodine

Question 46

insectacide poisoning does what and how to tx

Answer 46

cholinesterase inhibitor =tx with anticholinergics (anti-Muscarininc = ATROPINE) = no effect is you treat with anti-nAchR (pralidoxime)

Question 47

anticholinergic agents adverse effects

Answer 47

1. dry as a bone 2. blind as a bat 3. red and beet 4. mad as a hatter 5. hot has a hare

Question 48

anticholinergic agents contraindicated in what 3 pts

Answer 48

1. glaucoma 2. prostatic hyperplasia 3. acid-peptic disease