cholinergics

Question 1

direct agonists

Answer 1

act on nicotonic/muscarinic receptors

Question 2

ACh

Answer 2

nicotinic
muscarinic

rapidly hydrolyzed

use: miosis induction

Question 3

Methacholine

Answer 3

muscarinic

slowly hydrolyzed

use: inhalation test for bronchial hyperactivity

Question 4

Bethanechol

Answer 4

muscarinic

hydrolysis resistant

use: urinary retention

SE: palpitations

Question 5

Carbachol

Answer 5

nicotinic
muscarinic

hydrolysis resistant

use: topical opthalmic surgery, glaucoma

Question 6

pilocarpine

Answer 6

muscarinic

hydrolysis resistant

use:
dry mouth
glaucoma

SE: palpitations

Question 7

vecimeline

Answer 7

muscarinic

hydrolysis resistant

use:
dry mouth
Sjogren’s syndrome

Question 8

nicotine

Answer 8

nicotinic

low dose: stimulate
high dose: inhibit

SE: increase HR, BP, GI tone, tremors, seizures

toxic!

Question 9

AChE inhibitors

Answer 9

form irreveresible bond w/Ser

use:
myasthenia gravis
glaucoma
Alzheimer's
reverse NMJ blockers
antimuscarinic drug toxicity

SE:
DUMBBELLS
NMJ blockade (paralysis)

Question 10

alcohols: edrophonium

Answer 10

short-acting AChE inhibitor

competitive inhibitor (reversible)

use: Dx myasthenia gravis

doesn’t cross BBB

Question 11

carbamates

Answer 11

intermediate-acting AChE inhibitor

slowly reversible

Question 12

donepezil

Answer 12

carbamate

use: Alzheimer’s

SE: GI problems

Question 13

rivastigmine

Answer 13

carbamate

use: Alzheimer’s

SE: GI problems

Question 14

galantamine

Answer 14

carbamate

use: Alzheimer’s

SE: GI problems

Question 15

neostigmine

Answer 15

carbamate

use: reverse NM block in surgery

Question 16

pyridostigmine

Answer 16

carbamate

use: myasthenia gravis

Question 17

ambenonium

Answer 17

carbamate

use: myasthenia gravis

Question 18

guanidine

Answer 18

carbamate

use: Lambert-Eaton syndrome

Question 19

organophosphates

Answer 19

long-acting AChE inhibitor
irreversible

aging: lose alkyl group
antidote: 2PAM before aging

Question 20

echothiophate

Answer 20

organophosphate

use: glaucoma

Question 21

malathion

Answer 21

organophosphate

Question 22

soman

Answer 22

organophosphate

nerve gas

Question 23

sarin

Answer 23

organophosphate

nerve gas

Question 24

dizinon

Answer 24

organophosphate

insectiside

Question 25

pralidoxime (2PAM)

Answer 25

organophosphate antidote give before aging occurs

Question 26

atropine

Answer 26

organophosphate antidote muscarinic antagonist blocks muscarinic effects of ACh given to troops prophylactically

Question 27

muscarinic antagonist

Answer 27

DUMBBELLS ``` use: preanesthetic - dry secretions asthma/COPD - bronchodilate motion sickness GI hypermotility antipsychotic SE ``` risk: glaucoma - can't see prostatic hypertrophy - can't pee memory problems

Question 28

scopolamine

Answer 28

muscarinic antagonist use: motion sickness pre-op sedation SE: drowsiness amnesia psychosis

Question 29

ipratropium

Answer 29

muscarinic antagonist poor CNS penetration use: COPD asthma