Drugs

Question 1

Hemicholinium function

Answer 1

Blocks choline uptake (the rate limiting step in ACh synthesis) and depletes ACh

Question 2

Vesamicol function

Answer 2

Affects VAT transporter to prevent ACh from being moved into storage vesicles

Question 3

Botulinum toxin

Answer 3

Interferes with ACh release by interacting with axonal proteins involved in this process

Question 4

Substrate of AChE

Answer 4

Methacholine and ACh

Question 5

Location of AChE

Answer 5

CSF, RBC, Gray matter, Cholinergic synapses

Question 6

Location of BuChE

Answer 6

Plasma, Liver, Skin, White Matter, Smooth Muscle of GIT

Question 7

Function of BuChE

Answer 7

Hydrolysis of drugs, ingested esters from plants, butyrylcholine, cetylcholine, etc

Question 8

Substrates of BuChE

Answer 8

Butyrylcholine, Cetylcholine, Procaine, Suxamethoniun

Question 9

Examples of reversible cholinesterases

Answer 9

Edrophonium
Physostigmine
Neostigmine
Pyridostigmine

Question 10

Examples of irreversible cholinesterases

Answer 10

Parathion
Dyflos
Malathion
Propuxur
Exhothiophate

Question 11

Example of cholinesterase reactivators

Answer 11

Pralidoxime

Question 12

Effects of AChE poisoning

Answer 12

• Regular PNS symptoms
• Death due to respiratory failure

Question 13

Treatment of AChE poisoning

Answer 13

• Termination of further exposure
• Maintain free airway
• Control convulsion
• Use atropine

Question 14

Drug used to diagnose MG

Answer 14

Edrophonium

Question 15

Treatment of MG

Answer 15

Physostigmine
Neostigmine
Thymectomy

Question 16

When is atropine used to treat MG?

Answer 16

When unwanted muscarinic side effects are produced from AChE agonists

Question 17

Types of glaucoma

Answer 17

Primary
Secondary
Congenital

Question 18

Treatment of glaucoma

Answer 18

Miotics, like pilocarpine, to induce miosis (pupillary construction)

Physostigmine

Question 19

Side effects of pilocarpine

Answer 19

Muscarinic effects like blocked accommodation, myopia, loss of vision at margin

Question 20

Long-acting NMB blockers

Answer 20

D-turbocurarine
Metocurine
Pancuronium
Doxacurium

Question 21

Short-acting NMB blockers

Answer 21

Mivacurium

Question 22

Intermediate-acting NMB blockers

Answer 22

Vecuronium
Rocuronium
Atracurium

Question 23

NMB agents based on chemistry

Answer 23

Natural alkaloids
Ammonia-steroids
Benzylisoquinolines

Question 24

Examples of alkaloids

Answer 24

D-tubocurarine
Alcuronium (synthetic)

Question 25

Ammonia-steroids example

Answer 25

Pancuronium Vecuronium Rocuronium

Question 26

Difference between Pancuronium and other ammonio-steroids

Answer 26

Pancuronium blocks muscarinic receptors, triggering vagal blockade and causing tachycardia. New agents have less frequency of this side effect.

Question 27

Examples of benzylisoquinolines

Answer 27

Atracurium Mivacurium

Question 28

Peculiarities of Ammonia-steroids

Answer 28

Block vagolytic activity, permit histamine release, and allow ganglionic release

Question 29

Peculiarities of benzylisoquinolines

Answer 29

They show slight propensity for histamine release and have unusual metabolism

Question 30

Competitive non-depolarizing NMJ blockers

Answer 30

D-tubocurarine

Question 31

Depolarizing NMJ blockers

Answer 31

Succinylcholine

Question 32

Examples of non-depolarizing NMJ blockers

Answer 32

D-tubocurarine Pancuronium Vecuronium Atracurium Mivacurium

Question 33

Pharmacokinetics of non-depolarizing blockers

Answer 33

They are quarternary ammonium compounds, hence, they are poorly absorbed, but rapidly excreted.

Question 34

Examples of depolarizing blockers

Answer 34

Succinylcholine

Question 35

Which NMB’s adverse effects is tachycardia?

Answer 35

Tubocurarine

Question 36

Which NMB’s adverse effects is bradycardia?

Answer 36

Succinylcholine

Question 37

Adverse effects of succinylcholine

Answer 37

Bradycardia Increased intraocular pressure Prolonged paralysis Malignant hyperthermia

Question 38

NMBs influence both sympathetic and parasympathetic control of the CVS. True or false? Why?

Answer 38

True. Because there are also nicotinic receptors in the autonomic ganglia

Question 39

Clinical application of NMBs

Answer 39

- Skeletal muscle relaxation during surgery - Tracheal intubation - Control of ventilation - Treatment of convulsion

Question 40

Examples of ganglion blockers

Answer 40

Tetra ethyl ammonium (TEA) Mecamylamine Hexamethonium Trimetaphan