Indirect acting cholinomimetic drugs

Question 1

What is the difference between Carbamoylating anti-ChEs and Phosphorylating anti-ChEs?

Answer 1

Carbamoylating: reversible after 15min
Phosphorylating: reversible after couple hours
irreversible if aged

Question 2

What is the MOA for Cholinesterase inhibitors (anti-ChEs)?

Answer 2

Blockade of AChE –> ACh increase

Question 3

What are the clinical uses for MOA for Cholinesterase inhibitors (anti-ChEs)?

Answer 3

Glaucoma
Alzheimer’s Disease
Treatment of mAChR antagonist toxicity
Myasthenia gravis

Question 4

What are the adverse effects for MOA for Cholinesterase inhibitors (anti-ChEs)?

Answer 4

increased cholinomimetic effects

• GIT: diarrhea, abdominal cramps, nausea/vomiting
• Urinary urgency
• Vision problems
• Musculoskeletal effects: muscle cramps, myalgia

Question 5

What are the contraindications for MOA for Cholinesterase inhibitors (anti-ChEs)?

Answer 5

– Asthma/ COPD
– Urinary or GI tract obstruction

Question 6

What is the clinical presentation of anti-ChE intoxication?

Answer 6

DUMMBBELLSS –> Parasympathetic effects
Diarrhea
Urination
Miosis
Muscle weakness/paralysis
Bradycardia
Bronchoconstriction
Excess Bronchial Secretion
Lacrimation
Lousy for vision
Salivation
Sweating

Question 7

What type of treatment is used to treat anti-ChE intoxication?

Answer 7

mAChR antagonist
AChE reactivator