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Flashcards in Drugs Mimicking Pan Deck (10)
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1
Q

How can their action be induced

A

Directly activating muscarinic receptors

Indirectly activating muscarinic receptors through inhibition of cholinesterase enzyme

2
Q

What are the direct muscarinic agonists

A

▪️Choline esters like bethanechol which is similar to ach and resistant to hydrolysis
▪️Cholinomimetic alkaloids like pilocarpine
Tertiary amine well absorbed from GIT and enters CNS easily

3
Q

Therapeutic uses of muscarinic receptor agonists

A

Postoperative paralytic ileus (bethanechol)

Pilocarpine to inc salivary secretion in treatment of xerostomia in sjögren syndrome

4
Q

What do anticholinestrases do

A

Inhibit action of both true and pseudocholinesterase enzymes
Can prolong and potentiate action of ach at:
Muscarinic receptors in PNS
Nicotinic receptors at NMJ
Nicotinic and muscarinic receptors in CNS to improve cognitive functions

5
Q

Reversible anticholinestrases

A

Neostigmine

6
Q

Irreversible anticholinestrases

A

Organophosphorus compounds

7
Q

Therapeutic uses of anticholinestrases

A

Myasthenia gravis: poor penetration: neostigmine
Pyridostigmine: longer half life
Atropine: intolerable adverse effects
Edrophonium: short half life and used for diagnosis
▪️Neostigmine can also be used to reverse effects dir to excess competitive neuromuscular blocking agents at end of surgical anesthesia
▪️paralytic ileus and postoperative urine retention: Neostigmine and pyridostigmine
▪️Alzheimer’s disease: donepezil

8
Q

Signs of opcs toxicity

A

Severe manifestations of muscarinic receptor activation (secretions)
Cns manifestations in form of confusion, convulsion and coma
Muscle fasciculations, weakness and paralysis

9
Q

What are the non specific measures to manage opc toxicity

A

Termination of further exposure
Maintain parent airway
Supportive measures
Control of convulsions by diazepam

10
Q

Specific antidotes for opc toxicity

A

Atropine competes with ach at muscarinic receptor
Oximes to reactivate cholinesterase
Should be give as early as possible
Up to 6 hours