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Flashcards in Neuro Pharm (Kruse) Deck (31)
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1

Methacholine

cholinergic agonist (used to diagnose bronchial airway hyperreactivity)

2

Carbachol

cholinergic agonist (used to treat glaucoma or produce miosis)

3

Bethanechol

cholinergic agonist (used to treat urinary retention and heartburn)f

4

Cevimeline

cholinergic agonist (used to treat xerostomia)
metabolized via P450 >> excreted in urine

5

Pilocarpine

cholinergic agonist (used to treat head/neck cancer, glaucoma and produces miosis and salivation)

6

Varenicline

cholinergic partial agonist (used for smoking cessation and binds nicotinic receptors)

7

What are the 3 groups of AChE inhibitors and which ones can be used therapeutically (reversible)?

1) alcohols *
2) carbamic acid esters *
3) organophosphates

8

What is commonly used in a drug overdose and what is it combined with?

atropine (cholinergic antagonist) in conjunction with pralidoxime because it pulls organophosphates that are covalent/irreversible away from atropine

9

What are some CNS disorders that anticholinergics can treat?

1) Parkinson (benztropine, trihexyphenidyl and procyclidine)
2) motion sickness (scopolamine)
3) anesthesia (atropine, glycopyrrolate are paired with neostigmine)

10

Benztropine

anticholinergic (to treat Parkinson Disease)

11

Trihexyphenidyl

anticholinergic (to treat Parkinson Disease)

12

Procyclidine

anticholinergic (to treat Parkinson Disease)

13

Scopolamine

anticholinergic (to treat motion sickness)

14

What 2 drugs can treat uveitis and iritis?
(ophthamologic disorders)

homatropine and atropine (anticholinergics)

15

Homatropine

anticholinergic (to prevent synechia formation in uveitis and iritis)

16

What 2 drugs can be used to treat COPD?

ipratropium and tiotropium

17

What anticholinergic is used to treat common traveler's diarrhea and what is it combined with?

diphenoxylate and atropine (added to reduce risk of abuse since diphenoxylate is an opiate)

18

What anticholinergic is used for GU disorders but has profound side effects?

oxybutynin

19

What anticholinergics are preferred for GU disorders because of their minimal side effects?

darifenacin, solifenacin, tolterodine

20

What are 3 contraindications for anticholinergics?

glaucoma, prostatic hyperplasia, acid peptic disease

21

What is glycopyrrolate and how does it work?

antimuscarinic in GI disorders and after anesthesia as it stimulate skeletal muscle by increasing the levels of ACh in the body

22

What are some charged AChE inhibitors?

neostigmine, edrophonium, pyridostigmine, echothiophate, ambenonium

23

What are some neutral AChE inhibitors and what can they do that charged ones cannot?

physostigmine, donepezil, galantamine, rivastigmine, tacrine --> they can cross the BBB

24

Major NT of sympathetic nervous system

norepinephrine

25

Contraindication for varenicline use

suicidal ideation or changes in mood

26

What are 3 big uses of direct-acting cholinergic agonists?

glaucoma, accommodative esotropia, GI/GU disorders

27

Contraindications for muscarinic stimulants?

asthma, hyperthyroidism, coronary insufficiency, acid peptic disease

28

Compare alpha adrenergic receptor agonists with mAChR antagonists in treatment of ophthalmologic disorders

alpha adrenergic agonists are shorter acting and produce less adverse effects, while mAChR antagonists are used when cycloplegia or prolonged mydriasis is required (LASIK)

29

What can cause cholinergic poisoning?

cholinesterase inhibitor insecticides, wild mushrooms, chemical warfare nerve gases

30

What are some acute symptoms of nicotinic agonist toxicity?

CNS stimulation, respiratory paralysis, HTN, cardiac arrhythmias