Parasympathetic Activation / Cholinomimetic Agents Flashcards Preview

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Flashcards in Parasympathetic Activation / Cholinomimetic Agents Deck (42):
1

4 CNs involved in parasympathetic NS

1. CN III
2. CN VII
3. CN IX
4. CN X

2

All preganglionic neurons use what NT and act on what receptor

ACh; act on nicotinic receptors

3

What is unique about parasympathetic preganglonics?

Ae very long and synapse in ganglia near target organs; this makes their actions more localized

4

Parasympathetic postganglionic neurons use what NT and what receptor

ACh--> on muscarinic receptors

5

What is the difference in nicotinic and muscarinic receptors in terms of how they produce their effects

Nicotinic--> open ligand gated Na/K channels

Muscarinic--> activate GPCRs and effect 2nd messenger systems

6

Other than autonomic ganglia, where else in the body are nicotinic receptors found?

1. at the NMJ; part of somatic nervous system
2. adrenal medulla (sympathetic NS)

7

Other than CNs, where else are parasympathetic nerves found?

2nd and 3rd SACRAL spinal nerves (hence name craniosacral system)

8

parasympathetic action in GI

increased motility and tone--> increased digestion

9

parasympathetic action in bladder

relaxes sphincter, increases muscle tone of bladder wall

10

Parasym NS action in eye

1. miosis
2. ciliary muscle contraction (accomodation)

11

Parasym NS action on lung

Contraction--> increased bronchial tone

12

Parasymp NS action on heart

decreased HR; some decrease in contractility

13

parasymp activity in lacrimal glands

stimulate tears

14

parasymp activity in salivary gland

watery secretion

15

parasymp effect on g.u.

erection (of penis or clitoris)

16

mnemonic for orhanophosphate poisoning/ cholinergic excess

DUMBELSS

Not specific for only parasympathetic action; nicotinic and muscarinic receptors are found elsewhere too

17

what does DUMBELSS stand for

1. diarrhea
2. urination
3. miosis
4. bronchospasm
5. excitation of muscle/CNS (nicotinic @ NMJ)
6. lacrimation
7. salivation
8. sweating

18

other than parasympathetic post ganglionic nerve targets, where else in body are muscarinic receptors found

Sweat glands

19

organophosphate mechanism of injury

inactivates acetylcholineesterase--> ACh excess--> excess cholinergic stimulation

20

What two drugs are given for cholinergic excess/ organophosphate toxicity

1. Atropine--> (blocks muscarinic rceptors)
2. Pralidoxime--> (regenerates acetylcholinesterase

21

ptosis and diplopia that worsens throughout the day

Myasthenia gravis

22

what drug is used to test for myasthenia gravis

edrophonium (Tensilon test)

23

50% M.G. asociated with thymic ______

hyperplasia

24

20% M.G. associated with thymic _____

atrophy

25

15% M.G. associated with thymic ________

tumor (thymoma)

26

What causes a Myasthenia crisis (symptom)

Rapidly progressing weakness in respiratory muscles

27

4 treatments for myasthenia gravis

1. immunotherapy (cyclosporine, immunotherapy)
2. Plasmapheresis
3. Indirect cholinergic agent
4. thymectomy

28

3 anticholinesterases useful for tx of Alzheimer's

1. Donepezil
2. Galantamine
3. Rivastigmine

29

who gets poisoned by organophosphates

farmers

30

4 direct cholinomimetic agonists

1. Bethanecol
2. Carbachol
3. Pilocarpine
4. Methacholine

31

direct ACh agonist given for postoperative ileus, neurogenic ileus or urinary retention

Bethanecol

32

direct ACh agonist given for glaucoma

Carbachol

33

agonist that is an analoque of ACh

Carbachol

34

agonist that is potent stimulator of sweat, tears, and saliva; given for glaucoma (both open and closed)

Pilocarpine

*cry, drool, sweat on your PILOw"

35

direct agonist given as challenge test for asthma

Methacholine

*stimulates muscarinic receptor in lung to induce bronchspasm

36

5 indirect agents (anticholinesterases)

1. Neostigmine
2. Pyridostigmine
3. Edrophomium
4. Physostigmine
5. Donepezil

37

indirect agent for short term tx of myasthenia gravis

Neostigmine

38

indirect agent that reverses non-depolarizing NMJ blockers

Neostigmine

39

indirect agent used for long term tx of myasthenia gravis

Pyridostigmine

40

which indirect agent can cross the BBB

Physostigmine

41

With all chlinomimetic agents, exacerbation of what three conditions can occur

1. COPD
2. Asthma
3. Peptic Ulcer Disease

42

indirect agent used for atropine overdose

Physostigmine

* "Phyxes" atropin OD

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