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Flashcards in Cholinergic Drugs Deck (38):
1

what are esters of choline

direct acting choline agonists that are quaternary ammonium compounds that differ by their susceptibility to hydrolysis by cholinesterases

2

name the choline esters

acetycholine, carbachol, bethanechol, methacholine

3

which of the choline esters are more resistant to hydrolysis by cholinesterases

carbachol, bethanechol, methacholine

4

uses of acetycholine

for rapid miosis after delivery of lens in cataract surgery, in penetrating keratoplasy, iridectomy, and other anterior segment surgery

5

what receptor does bethanechol work on

it has strong muscarinic activity and little to no nicotinic activity

6

uses of bethanechol

acute post op and postpartum urinary retention and neurogenic atony of the urinary bladder for retention

7

adverse effects of bethanechol

generalized cholinergic stimulation: sweating, salivation, flushing, low BP, nausea, abdominal pain, diarrhea, bronchospasm

8

receptors that carbachol works on

both muscarinic and nicotinic

9

uses of carbachol

-miosis during surgery
-reduces intra-ocular pressure after cataract surgery (glaucoma)

10

receptor that methacholine works on

primarily muscarinic agonist with slight nicotonic action

11

uses of methacholine

diagnosis of bronchial airway hyper-reactivity in those who are not apparent asthmatics

12

classify all the choline esters in term of agonists to what receptors

methacholine, bethanechol, acetylcholine, and carbachol are all muscarinic agonists

exception of carbachol which is also a nicotinic agonist

13

what are the natural alkaloids and what receptors they work on

muscarine, arecoline, pilocarpine --> all muscarinic agonist with exception to arecoline which is also a nicotinic agonist

14

of all the natural alkaloids which is the only used clinically and what is its use

pilocarpine - second line agent for open angle glaucoma and for management of acute angle-closure glaucoma

15

adverse effects of pilocarpine

-enter brain and cause CNS disturbance
-sweating and salivation

16

use of nicotine

used for the cessation of smoking

17

what is the biggest difference between the indirect cholinergic agonists edrophonium, carbamates, and organophosphates

how long their effect last
in order of increasing effect time
edrophonium, carbamates, then organophosphates

they are all cholinesterase inhibitors hence prolonging the effect of acetylcholine

18

use of edrophonium

diagnosis of myasthenia gravis; used to reverse the neuromuscular block produced by non depolarizing blockers

19

what isn't edrophonium used for tx of said disease and rather just for diagnosis

it is very short acting

20

what are the carbamates

neostigmine, physostigmine, pyridostigmine

21

what is the use of physostigmine

tx for overdose on anti cholinergic drugs

22

what is so special about physostigmine and what type of pt do you not give this drug to

it can cross the BBB
do not give to those who overdose on TCA because it can aggravate depression of cardiac conduction

23

adverse effects of physostigmine

-crosses CNS and can lead to convulsion if high doses are used
-bradycardia
-at NMJ, huge collection of acetycholine can lead to paralysis of skeletal muscle

24

uses of neostigmine

-could be used for myasthenia gravis
-reversal of effects of non depolarizing neuromuscular blockers after surgery (most common use)
-prevention and tx of post op distention and urinary retention

25

adverse effects of neostigmine

salivation, flushing, low BP, nausea, vomiting, diarrhea, bronchospasm

26

uses of pyridostigmine

treatment of myasthenia gravis (most common use)

27

what is echothiophate used for

chronic open angle glaucoma, subacute or chronic angle closure glaucoma, or where surgery is contraindicated

basically used for glaucoma

28

what are malathion and parathion

they are insecticides and are dangerous

acetylcholinesterase inhibitors

29

what are tabun, sarin, and soman

potent synthetic toxic agent

acetylcholinesterase inhibitors

30

acetylcholinesterases approved for treatment of alzheimers

donepezil, rivastigmine, and galantamine

31

drug used for organophosphate insecticide poisoning because it is a cholinesterase regenerator

pralidoxime

32

muscarinic receptor antagonist

atropine, scopolamine

33

actions of atropine

eyes - mydriasis, increase intraocular pressure dangerously in those with glaucoma
GI - reduces motility
Urinary - decreases hypermotility of bladder
cardiovascular - blockade of M2 receptors and tachycardia
salivary, sweat, and lacrimal glands blocked
increase in body temp since sweat glands are blocked

34

what is atropine used for

-antisialogogue (reduce saliva production)
-increase heart rate or decrease AV block
-antidote for amanita muscaria
-antidote for overdose on cholinergic drugs
-alleviate side effects of muscarinic side effects of anticholinesterase drugs

35

adverse effects of atropine

dry mouth, blurred vision, sandy eyes (dry eyes), tachycardia, restlessness, confusion, hallucinations, delirium, depression, exacerbate an attack of glaucoma

36

difference between atropine and scopolamine

scopolamine has greater action in CNS and longer duration of effects

37

uses of scopolamine

mydriasis and cycloplegia (for diagnostic procedures)
prevent nausea and vomiting in motion sickness
iridocyclitis

38

adverse effect of scopolamine

blocks short term memory
sedation

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