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