Direct and Indirect Cholinomimetics Flashcards by Aivan Onyango

[21-minute video]: Cholinesterase Inhibitors - Sketchy

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Clinical uses of direct acting cholinomimetics include the following except:
(a) Postpartum urinary retention
(b) Neurogenic bladder atony
(c) Duodenal ulcers
(d) Postoperative paralytic ileus
(e) Congenital megacolon

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Adverse effects of direct acting cholinomimetics include the following except:
(a) Constipation
(b) Excessive salivation
(c) Hyperhidrosis
(d) Bronchoconstriction
(e) Hypotension

(a) Constipation

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Which of the following direct acting cholinomimetics is NOT an alkaloid?
(a) Lobeline
(b) Nicotine
(c) Arecholine
(d) Acetylcholine
(e) Pilocarpine

(d) Acetylcholine

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Clinical uses of direct acting cholinomimetics include the following except:
(a) Nonobstructive urinary retention
(b) Gastroesophageal reflux
(c) Peptic ulcer disease
(d) Sjogren’s syndrome
(e) Postoperative paralytic ileus

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Which direct acting cholinomimetic agent is not an alkaloid?
(a) Oxotremonine
(b) Arecholine
(c) Pilocarpin
(d) Methacholine
(e) Lobeline

(d) Methacholine

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The following are direct-acting cholinominetics except
(a) Atropine
(b) Methacholine
(c) Carbachol
(d) Pilocarpine
(e) Bethanechol

(a) Atropine

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The following are indirect-acting cholinominetics except
(a) Edrophonium
(b) Neostugmine
(c) Pralidoxime
(d) Echothiophate
(e) Arbaril

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The following are pharmacological effects of acetylcholine except
(a) Negative chronotropy
(b) Bronchoconstriction
(c) Ureteral peristalsis
(d) Constipation
(e) Miosis

(d) Constipation

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Clinical uses of cholinomimetic agents include the following except:
(a) Neurogenic bladder atony
(b) Gastroesophageal reflux
(c) Management of bronchial airway hyperreactivity
(d) Postoperative paralytic ileus
(e) Congenital megacolon

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Which direct acting cholinomimetic is a choline ester?
(a) Pilocarpine
(b) Arecholine
(c) Nicotine
(d) Bethanechol
(e) Lobeline

(d) Bethanechol

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Which of the following is a direct acting cholinomimetic agent?
(a) Physostigmine
(b) Edrophonium
(c) Carbachol
(d) Atropine
(e) Isoflurophate

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The following can be used in the management of acute toxicity caused by indirect acting cholinomimetic except?
(a) Benzodiazepines
(b) Decontamination
(c) Pralidoxime
(d) Propanolol
(e) Atropine

(d) Propanolol

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Acetylcholine is not a specific neurotransmitter at:
(a) Sympathetic ganglia
(b) Sympathetic postganglionic nerve endings
(c) Parasympathetic ganglia
(d) Parasympathetic postganglionic nerve endings

(b) Sympathetic postganglionic nerve endings

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Muscarinic receptors are located in:
(a) Autonomic ganglia
(b) Skeletal muscle neuromuscular junctions
(c) Autonomic effector cells
(d) Sensory carotid sinus baroreceptor zone

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Which of the following cholinomimetics activates both muscarinic and nicotinic receptors?
(a) Lobeline
(b) Pilocarpine
(c) Nicotine
(d) Bethanechol

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Characteristics of carbachol include all of the following EXCEPT:
(a) It decreases intraocular pressure
(b) It causes mydriasis
(c) It exerts both nicotinic and muscarinic effects
(d) It is resistant to acethylcholiesterase

(b) It causes mydriasis

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Acetylcholine is not used in clinical practice because:
(a) It is very toxic
(b) The doses required are very high
(c) It is very rapidly hydrolyzed
(d) It is very costly

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Parasympathomimetic drugs cause:
(a) Bronchodilation
(b) Mydriasis
(c) Bradycardia
(d) Constipation

The symptoms of mushroom poisoning include all of the following EXCEPT:
(a) Salivation, lacrimation, nausea, vomiting
(b) Dryness of mouth, hyperpyrexia, hallucination
(c) Headache, abdominal colic
(d) Bradycardia, hypotension and shock

(b) Dryness of mouth, hyperpyrexia, hallucination

Which of the following direct-acting cholinomimetics has the shortest duration of action?
(a) Acetylcholine
(b) Methacholine
(c) Carbachol
(d) Bethanechol

(a) Acetylcholine

Bethanechol has all of the following properties EXCEPT:
(a) It is extremely resistant to hydrolysis
(b) Purely muscarinic in its action
(c) It is used for abdominal urinary bladder distention
(d) It exerts both nicotinic and muscarinic effects

(d) It exerts both nicotinic and muscarinic effects

An M-cholinomimetic agent is:
(a) Carbachol
(b) Pilocarpine
(c) Acetylcholine
(d) Bethanechol

(b) Pilocarpine

Further notes:
Acetylcholine acts on both nicotinic and muscarinic receptors.

Characteristics of pilocarpine include all of the following EXCEPT:
(a) It is a tertiary amine alkaloid
(b) It causes miosis and a decrease in intraocular pressure
(c) Causes a decrease in secretory and motor activity of gut
(d) It is useful in the treatment of glaucoma

Which of the following cholinomimetics is a plant derivative with lower potency than nicotine but with a similar spectrum of action? (a) Lobeline (b) Pilocarpine (c) Carbochol (d) Acetylcholine

(a) Lobeline

Which of the following cholinomimetics is indirect-acting? (a) Lobeline (b) Edrophonium (c) Pilocarpine (d) Carbachol

(b) Edrophonium

The mechanism of action of indirect-acting cholinomimetic agents is: (a) Binding to and activation of muscarinic or nicotinic receptors (b) Inhibition of the hydrolysis of endogenous acetylcholine (c) Stimulation of the action of acetylcholinesterase (d) Releasing acetylcholine from storage sites

(b) Inhibition of the hydrolysis of endogenous acetylcholine

Indicate a reversible cholinesterase inhibitor: (a) Isoflurophate (b) Carbochol (c) Physostigmine (d) Parathion

Which of the following cholinesterase inhibitors is irreversible? (a) Physostigmine (b) Edrophonium (c) Neostigmine (d) Isoflurophate

(d) Isoflurophate

Indicate cholinesterase activator: (a) Pralidoxime (b) Edrophonium (c) Pilocarpine (d) Isoflurophate

(a) Pralidoxime

Isofluorophate increases all of the following effects except: (a) Lacrimation (b) Bronchodilation (c) Muscle twitching (d) Salivation

(b) Bronchodilation

Indicate a cholinesterase inhibitor, which has an additional direct nicotinic agonist effect: (a) Edrophonium (b) Carbochol (c) Neostigmine (d) Lobeline

Сholinesterase inhibitors do not produce: (a) Bradycardia, no change or modest fall in blood pressure (b) Increased strength of muscle contraction, especially in muscles weakened by myasthenia gravis (c) Miosis and reduction of intraocular pressure (d) Dramatic hypertension and tachycardia

(d) Dramatic hypertension and tachycardia

Which of the following cholinomimetics is commonly used in the treatment of glaucoma? (a) Pilocarpine (b) Lobeline (c) Acethylcholine (d) Neostigmine

(a) Pilocarpine

Indicate the organophosphate cholinesterase inhibitor, which can be made up in an aqueous solution for ophthalmic use and retains its activity within a week: (a) Physoctigmine (b) Edrophonium (c) Echothiophate (d) Neostigmine

Which of the following cholinomimetics is most widely used for paralytic ileus and atony of the urinary bladder? (a) Lobeline (b) Neostigmine (c) Pilocarpine (d) Echothiophate

(b) Neostigmine

Chronic long-term therapy of myasthenia is usually accomplished with: (a) Edrophonium (b) Neostigmine (c) Echothiophate (d) Carbachol

(b) Neostigmine

Which of the following cholinomimetics is a drug of choice for reversing the effects of nondepolarizing neuromuscular relaxants? (a) Echothiophate (b) Physostigmine (c) Edrophonium (d) Pilocarpine

Indicate the reversible cholinesterase inhibitor, which penetrates the blood-brain barrier: (a) Physostigmine (b) Edrophonium (c) Neostigmine )d) Piridostigmine

(a) Physostigmine

Which of the following cholinomimetics is used in the treatment of atropine intoxication? (a) Neostigmine (b) Carbochol (c) Physostigmine (d) Lobeline

The symptoms of excessive stimulation of muscarinic receptors include all of the following EXCEPT: (a) Abdominal cramps, diarrhea (b) Increased salivation, excessive bronchial secretion (c) Miosis, bradycardia (d) Weakness of all skeletal muscles

(d) Weakness of all skeletal muscles

The excessive stimulation of muscarinic receptors by pilocarpine and choline esters is blocked competitively by: (a) Edrophonium (b) Atropine (c) Pralidoxime (d) Echothiophate

(b) Atropine

The toxic effects of a large dose of nicotine include all of the following EXCEPT: (a) Hypotension and bradycardia (b) Convulsions, coma and respiratory arrest (c) Skeletal muscle depolarization blockade and respiratory paralysis (d) Hypertension and cardiac arrhythmias

(a) Hypotension and bradycardia

The dominant initial sights of acute cholinesterase inhibitors intoxication include all of the following except: (a) Salivation, sweating (b) Mydriasis (c) Bronchial constriction (d) Vomiting and diarrhea

(b) Mydriasis

# l Which of the following drugs is used for acute toxic effects of organophosphate cholinesterase inhibitors? (a) Atropine (b) Pilocarpine (c) Pralidoxime (d) Edrophonium

(a) Atropine [to counteract the muscarininc effects of organophosphate poisoning] (c) Pralidoxime [to reactivate acetylcholinesterase that has been inhibited by organophosphates]