Cholinergics

Question 1

Prototype muscarinic agonist

Answer 1

Acetylcholine

Question 2

Acetylcholine is __ charged, so it can/can’t cross the BBB

Answer 2

Positively; can’t

Question 3

Acetylcholine must be administered _____

Answer 3

Intravenously

Question 4

Vascular effects of acetylcholine

Answer 4

Vasodilation due to stimulation of M3 receptors on vascular endothelium, causing release of nitric oxide
Decreased heart rate and contractility (M2 receptors)

Question 5

Ophthalmic acetylcholine use

Answer 5

Complete miosis (pupil constriction/ciliary muscle contraction)

Question 6

Prototype choline ester

Answer 6

Bethanechol

Question 7

Bethanechol uses

Answer 7

Urinary retention

Question 8

Synthetic choline ester function

Answer 8

More M-selective with prolonged action

Question 9

Prototype alkaloid

Answer 9

Pilocarpine

Question 10

Pilocarpine MOA

Answer 10

Agonist of all muscarinic receptors

Question 11

Pilocarpine uses

Answer 11

Xerostomia/sjogrens
Glaucoma

Question 12

Cevimeline MOA

Answer 12

Selective M1/M3 agonist alkaloid in lacrimal and salivary glands

Question 13

Cevimeline uses

Answer 13

Sjogrens/xerostomia

Question 14

Side effects of muscarinic agonists

Answer 14

Sweating, hypotension, cramping, diarrhea

Question 15

Muscarinic agonist contraindications

Answer 15

Hyperthyroidism
Asthma
Peptic ulcer

Question 16

Muscarinic agonist antidotes

Answer 16

Atropine
Epinephrine

Question 17

Prototype muscarinic antagonist

Answer 17

Atropine

Question 18

Atropine isa competitive antagonist of ____ receptors

Answer 18

All M receptors

Question 19

Atropine does/does not cross BBB

Answer 19

Does

Question 20

Atropine response is ___dependent

Answer 20

Dose

Question 21

Atropine effects

Answer 21

Decrease saliva
Mydriasis
Tachycardia
Decrease gastric secreteions

Question 22

Clinical uses of atropine

Answer 22

Reverse bradycardia
Induce Mydriasis
Antidote for insecticide and nerve gas poisoning
Relieve muscarinic side effects of other drugs

Question 23

Adverse effects of atropine

Answer 23

Hot as a hare
Dry as a bone
Blind as a bat
Red as a beet
Mad as a hatter

Question 24

Atropine drug interactions

Answer 24

Antihistamines
Antidepressants
Antipsychotics

Question 25

Scopolamine MOA

Answer 25

Anti muscarinic Blocks M3 receptors in vestibular apparatus of inner ear

Question 26

Scopolamine use

Answer 26

Anti-emetic Prevent motion sickness

Question 27

Ipratropium bromide use

Answer 27

Bronchodilator

Question 28

Ipratropium bromide is administered by ___

Answer 28

Inhalation

Question 29

Ipratropium bromide has minimal side effects because ___

Answer 29

It is always ionized so it can’t cross membranes well It is inhaled so systemic effects are minimal

Question 30

Tropicamide use

Answer 30

Dilate eyes for eye exams

Question 31

Tropicamide is shorter/longer acting than atropine

Answer 31

Shorter (6 hrs vs 4-6 days)

Question 32

Tolterodine use

Answer 32

Overactive bladder disorder

Question 33

Major concern of tolterodine

Answer 33

Cognitive decline of elderly patients