Cholinergic Drugs II Flashcards Preview

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Flashcards in Cholinergic Drugs II Deck (24):
1

inhalation drugs for tx of COPD (and asthma)

ipratropium and tiotropium (muscarinic antagonist)

2

used to produce mydriasis with cycloplegia (paralysis of the ciliary muscle of the eye leading to loss of accommodation so can't see near)

homatropine, cyclopentolate, tropicamide
(muscarinic antagonist)

3

muscarinic antagonist that is used to treat parkinsonism and the extrapyrimidal effects of antipsychotic drugs

benztropine and trihexphenidyl

4

muscarinic antagonist used orally to inhibit GI motility

glycopyrrolate

5

muscarinic antagonist used to treat overactive bladder

tolterodine

6

what happens to the heart when antimuscarinic drugs are used at different levels

at low to medium levels can cause bradycardia and sedation
at high levels can cause tachycardia

7

who are most at risk for anticholinergic drugs

elderly especially those with cognitive impairment because they already do not produce enough acetylcholine and hence blocking the little they have can cause some serious damage

8

what are the nicotine receptor antagonists

mecamylamine, trimethaphan, and hexamethonium

ganglion blockers

9

what were the ganglion blockers used to treat (name them again)

mecamylamine, trimethaphan, hexamethonium
used to tx hypertension but have been replaced

10

effects of ganglion blockers on the following: arterioles, veins, heart, iris, ciliary muscle, GI tract, urinary bladder, salivary glands, sweat glands

helps to know what system dominates in each

arterioles - vasodilation so low BP
veins - dilation so decreased cardiac output
heart - increase HR aka tachycardia
iris - mydriasis
ciliary muscle - cycloplegia (focus for far vision)
urinary bladder - urinary retention
salivary glands - xerostomia (dry mouth)
sweat gland - anhydrosis

11

non depolarizing (competitive) neuromuscular blocker drug

tubocurarine
nondepolarizing in that it binds to the nicotinic receptor inhibiting acetylcholine from binding hence stopping depolarization

12

use of tubocurarine

anesthetic during surgery to relax skeletal muscle

13

how can you overcome effect of tubocurarine

give acetylcholinesterase inhibitor neostigmine or edrophonium

14

adverse effect of tubocurarine

some (so basically not tubocurarine) are moderate blockers of muscarine receptors

histamine release (for tubocurarine)

15

depolarizing neuromuscular junction blocker

succinylcholine

16

how does succinylcholine work

it binds to nicotinic receptor causing depolarization but it does not get metabolized so membrane remains depolarized and unresponsive to additional impulses leading to flaccid paralysis

17

when is succinylcholine used

rapid endotracheal intubation (rapid onset and brief duration so effective for this)
ECT (electroconvulsive therapy)

18

adverse effect of succinylcholine

malignant hyperthermia

19

what do you treat malignant hyperthermia with

dantrolene

20

drugs that act presynaptically

hemicholium 3, vesamicol, botulinum toxin

21

how does hemicholium work

it inhibits the synthesis of acetylcholine by blocking the high affinity transporter for choline hence preventing uptake of choline

for research only

22

how does vesamicol work

inhibits acetycholine storage
blocks ACh-H transporter that is used to store ACh in the vesicle

23

how does botulinum toxin work

it inhibits acetylcholine release

24

what is botulinum used for

diseases associated with increased muscle tone like achalasia, strabismus, blepharospasm, focal dystonia

also used to facial wrinkles

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