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Flashcards in FA Cholinomimetics Deck (34):
1

Bethanechol

Direct muscarinic receptor agonist; activates bowel and bladder smooth muscle; resistant to AChE;

2

Carbachol

Carbon copy of ACh;

3

CU bethanechol

postoperative ileus, neurogenic ileus, urinary retention

4

CU carbechol

glaucoma, pupillary constriction, relief of IOP

5

CU pilocarpine

potent stimulator of sweat, tears and saliva; open and closed angle glaucoma

6

CU methacholine

challenge test for diagnosis of asthma

7

Pilocarpine

Contracts ciliary muscle of eye (open-angle glaucoma), contracts pupillary sphincter (closed-angle glaucoma);
"you cry, drool, and sweat on your pillow"

8

Methacholine

Stimulates muscarinic receptors in airway when inhaled

9

CU neostigmine

postoperative and neurogenic ileus and urinary retention, Myasthenia gravis, reversal of NMJ blockage (postoperative)

10

Neostigmine

anticholinesterase (neo CNS = no CNS)

11

CU pyridostigmine

Myasthenia gravis (long acting); does not penetrate CNS

12

Pyridostigmine

anticholinesterase --> inc ACh and strength; does not penetrate CNS

13

CU Physostigmine

anticholinergic toxicity (ie jimson weed, atropine overdose); crosses BBB --> CNS

14

physostigmine

anti cholinesterase that crosses BBB

15

Name three AChE inhibitors that work for Alzheimer's

rivastigmine, galantamine, donepezil

16

Historically, dx of myasthenia gravis (extremely short acting). MG now diagnosed by anti-ChR aAB test.

Edrophonium

17

General toxicities of all indirect and direct cholinomimetics

exacerbation of COPD, asthma, PUD

18

4 direct cholinomimetics

bethanechol, carbachol, pilocarpine, methacholine

19

7 indirect cholinomimetics

Neo-, pyrido-, physio- stigmine
rivastigmine, galantamine, donepezil

20

Cholinesterase inhibitor poisoning (often due to organophosphates (parathion) that irreversibly inhibit AChE --> too much ACh)

DUMBBELS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle and CNS
Lacrimation,
Sweating
Salivation

21

Antidote to organophosphate poisoning

atropine (competitive inhibitor) + pralidoximine (regenerates AChE if given early)

22

Atropine, homatropine, tropic amide effect on eye

mydriasis (pupil dilation) and cycloplegia (paralysis of the ciliary muscle of the eye --> loss of accommodation)

23

benztropine

muscarinic antagonist for Parkinson's disease

24

scopolamine

muscarinic antagonist for motion sickness

25

ipratropium, tiotropium

muscarinic antagonist for COPD, asthma

26

oxybutynin,
darifenacin,
solifenacin

reduce urgency in mild cystitis and reduce bladder spasms

Other agents: tolterodine, fesoterodine, trospium

27

Glycopyrrolate

Affects GI and respiratory systems.
Parenteral: postoperative use to reduce airway secretions
Oral: drooling, peptic ulcer

28

atropine effect on airway

decreases secretions

29

atropine effect on stomach

decreases acid secretion

30

atropine effect on gut motility

decreases

31

atropine effect on bladder

decreases urgency in cystitis

32

atropine effects

inc pupil dilation, cycloplegia
dec AW secretions, stomach acid, gut motility, urgency in cystitis

33

Atropine toxicity

Hot as a hare (inc temp due to dec sweating)
Dry as a bone (dry mouth + skin)
Red as a beet (flushed skin)
Blind as a bat (cycloplegia, mydriasis)
mad as a hatter (disorientation... and constipation)

34

special populations to worry about with atropine toxicity

acute angle-closure glaucoma in elderly (mydriasis),
urinary retention in men w/ BPH,
hyperthermia in infants