Cholinomimetrics/ Cholinoreceptor Blockers Flashcards Preview

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Flashcards in Cholinomimetrics/ Cholinoreceptor Blockers Deck (12):
1

Cholinomimetic drugs (direct acting):

Nicotinic: Nicotine

Muscarinic:

  • Bethanechol
  • methacholine
  • pilocarpine

Choline Esters:

  • Acetylcholine
  • Bethanechol
  • Carbachol

Plant Alkaloids:

  • Muscarine 
  • Nicotine
  • Pilocarpine

Other drugs: 

  • Cevimeline
  • Varenicline

Mnemonic: ABC; MNoP; CV

2

Bethanechol

1. Cholinomimetic drugs (direct acting) – Muscarinic Agonists

2. Ileus and urinary retention

3

Methacholine

1. Cholinomimetic drugs (direct acting) – Muscarinic Agonists

2. Diagnostic of Bronchial hyperactivity; challenge test for asthma

4

Pilocarpine

1. Cholinomimetic drugs (direct acting) – Muscarinic Agonists

2. Glaucoma and xerostomia

5

Cholinoreceptors Blockers

Nicotinic (Nn):

  • Hexamethonium
  • Mecamylamine

Nicotinic (Nm):

  • succinylcholine
  • atracurium
  • tubocurarine

Muscarinic:

  • benzatropine
  • atropine
  • glycopyrrolate
  • scopolamine

Mnemonics: He and Me SAT by the BAGS

6

Muscarinic receptor Antagonist/ Parasympatholytics:

Belladonna Alkaloids 

  • Hyoscyamine
  • Atropine
  • Scopolamine

Mnemonics: HAS

 

Semisynthetic and synthetic muscarinic receptor antagonists:

  • Tropicamide
  • Tolterodine and Tropium
  • Tiotropium and Ipratropium
  • Pirenzepine
  • Dicyclomine
  • Oxybutynin
  • Glycopyrrolate
  • Solifenacin

 

Mnemonics: TTTTIP DOGS

 

Muscarinic receptors antagonists Toxicity:

  • Tachycardia
  • Constipation
  • Urinary retention
  • Mydriasis with cycloplegia
  • Decreased salivation, sweating and lacrimation
  • Hyperthermia
  • Bronchodilation: Rx Asthma

Muscarinic receptors antagonists Toxicity causing Meds:

  • Antihistamines 
  • Cold meds
  • Antidepressants
  • Antipsychotics

 Treatment of Toxicity: Physostigmine 

7

Nicotinic Receptor Antagonists

Ganglion Blocking Agents:

  • Trimethaphan
  • Hexamethonium and Mecamylamine (Ganglion Blockers)

Nondepolarizing Neuromuscular blocking agents: 

  • Cisatracurium
  • Pancuronium
  • Rocuronium
  • Atracurium
  • Tubocurarine
  • Vecuronium

Mnemonic: CPR AT VinnyS’

Depolarizing Neuromuscular blocking agents: 

  • Succinycholine

8

Pancuronium

Atracurium

Tubocurarine

Mivacurium

1. Non-depolarizing (Competitive) Neuromuscular (Nm) Blockers

2. Muscle relaxation in anesthesia; Endotracheal intubation

3. Block acetylcholine --> paralysis of eyes and face, then progress to the limbs and respiratory muscles. No effect on cardiac or smooth muscles or consciousness

4. Malignant hyperthermia; muscle rigidity, hypertension, acidosis, and hyperkalemia

Mivacurium: metabolized by plasma pseudocholine esterase and has a short duration of action

Antidote: Neostigmine

9

Succinylcholine

1. Depolarizing (Noncompetitive) Neuromuscular (Nm) Blockers

2.

3. Phase I: fasciculation which gets worse if neostigmine is given. Phase II: Desensitization (membrane is desensitized --> becomes unresponsive to Acetylcholine for some time


4. Malignant hyperthermia; muscle rigidity, hypertension, acidosis, and hyperkalemia


Note: Succinylcholine is metabolized by plasma pseudocholine esterase and has a short duration of action

10

Benzodiazepines (Diazepam)

1. Spasmolytic (Skeletal muscle relaxants)

2.

3. Increases GABA actions at GABAa receptors --> reduce the tone of spinal motor neurons

4. Malignant hyperthermia

11

Baclofen

1. Spasmolytic (Skeletal muscle relaxants)

2.

3. Direct agonist at GABAb receptors in the spinal cord

4. Malignant hyperthermia

Note: As good as diazepam with less sedation

12

Dantrolene

1. Spasmolytic (Skeletal muscle relaxants)

2

3. Blocks Ca++ release from the sarcoplasmic reticulum --> decrease contractility on skeletal muscle

4. Malignant hyperthermia