Parasympathetic / Cholinergic Flashcards
(83 cards)
1
Q
Cholinergic transmission steps
A
Synthesis Storage in vesicles Release Binding to receptor Degradation of acetylcholine Recycling of choline
2
Q
Carries choline from extracellular to pre-synaptic region
A
Na-dependent transporter
3
Q
Process in synthesis
Enzyme
Product
A
Acetylation
Choline acetyltransferase
Acetylcholine
4
Q
Inhibits transporter, uptake of acetylcholine
A
Vesamicol
5
Q
Inhibits transport of choline to the pre-synaptic region
A
Hemicholinum
6
Q
Blocks release of acetylcholine
Decreased neurotransmitter
Decreased muscle contraction
Paralysis
A
Botulinum toxin
7
Q
Cholinoceptors
A
Muscarinic
Nicotinic
8
Q
M1
A
E - exocrine glands
A - autonomic glands
C - CNS
9
Q
M2
A
HCSP Heart CNS Smooth muscle Peripheral nerve
10
Q
M3
A
ESEBC Exocrine glands Smooth muscle Eye Blood vessel CNS
11
Q
M4
A
CNS
Enhanced locomotion
12
Q
M5
A
CSI
CNS
Salivary glands
Iris
13
Q
NN
A
Ganglion - stimulation
CNS - neurotransmisson
14
Q
NM
A
Skeletal muscle - contraction
15
Q
Subtypes of cholinergic agonists
A
DIRECT
Indirect
16
Q
DIRECT acting cholinergic agonists
A
Choline esters
Alkaloids
17
Q
Choline esters
A
Acetylcholine
Bethanechol
Carbachol
Methacholine / provocholine
18
Q
Most potent cholinergic agonist
Cause 10-Min miosis during cataract surgery
Lack of selectivity
A
Acetylcholine
19
Q
Strong muscarinic activity
Increase intestinal motility after surgery
A
Bethanechol
20
Q
Ester of carbamic acid
A
Carbachol
21
Q
For open angle glaucoma that is resistant to pilocarpine
A
Carbachol
22
Q
Weak nicotinic activity
Diagnosis of asthma
A
Methacholine
23
Q
What should be given after the methacholine test
A
Rapid-acting bronchodilator
24
Q
DOC for glaucoma
Can Cross blood brain barrier
A
Pilocarpine
25
No therapeutic use
Muscarine
26
Has muscarinic and nicotinic activity
| Potential for Alzheimer’s
Arecholine
27
Indirect-acting cholinergic agonists /
| Cholinesterase inhibitors
Organophosphates
Carbamates
Quaternary amines
28
DFP Keana
Diisopropylfluorophosphate
29
Organophosphates
Isofluorophate
Echothiophate
Malathion, parathion
Tabon, sarin, soman
30
Chronic treatment of open-angle glaucoma
| Duration 1 week
Isofluorophate
31
Open angle glaucoma
| 3-7 days
Echothiophate
32
Insecticides / Pesticides
No clinical use
Active metabolites: malaoxon, paraoxon
Malathion, parathion
33
Phospholine Iodide
Echothiophate
34
Placed on soldiers to combat the spread of life threatening diseases on the Front lines typhus and Malaria
DDT
| dichlrorodiphenyltrichloroethane
35
Nerve gases
Tabun
Sarin
Soman
36
Organophosphate toxicity
Cholinergic Crisis
37
Antidote for cholinergic Crisis
Pralidoxine chloride 2 PAM
| Atropine
38
Carbamates
Physostigmine eserine
Neostigmine prostigmin
Pyridostigmine mestinon
39
Intestinal and bladder atony
Miotic agent for open angle glaucoma
6-12 hrs
Physostigmine
40
Treats MYASTHENIA GRAVIS
Paralytic ileus or atony of the urinary bladder
Antidote for TUBOCURARINE POISONING
3-6 hrs
Neostigmine
41
Carbamate insecticides
Carbaryl
Propoxur
Aldicarb
42
For tensilon test - diagnosis of myasthenia gravis
Edrophonium
43
Cholinergic antagonists
Muscarinic blockers
Ganglion blockers
Neuromuscular blockers
44
Prevents motion sickness
| Blocks short-term memory
Scopolamine
45
Scopolamine, when given with atropine produces
Twilight sleep
46
Produce mydriasis and cycloplegia for ophthalmoscopic examination
Homatropine
Cyclopentolate
Tropicamide
47
For ASTHMA and COPD chronic obstructive pulmonary disease
| More peripheral effects less CNS effects
Ipratropium bromide
48
Treatment for COPD
Tiotropium
49
For peptic ulcer
| Selective for muscarinic receptor in the stomach
Pirenzepine
50
Pirenzepine decreases secretion of
Acid and pepsin
51
Parkinson’s disease
| Extrapyramidal disorders
Benztropine
Trihexyphenidyl
Oxybutynin
52
Hypermotility of the bowel
Dicyclomine
53
Reduces GI smooth muscle spasms
| Adjunct for peptic ulcer
Propantheline
54
Other drugs that have anticholinergic effects
Antihistamines
Antipsychotics
TCAs
Opioids
55
Block nicotinic receptors causing paralysis
Neuromuscular blockers /
| Skeletal muscle relaxants
56
Subtypes of neuromuscular blockers
Competitive non-depolarizing
| Competitive depolarizing
57
Compete with acetylcholine at nicotinic receptors
Prevent depolarization
Inhibit muscular contraction
Nondepolarizing blockers
58
Adjunct to anesthesia
For short surgical operations
Very little histamine release
Vecuronium
59
Mechanical ventilation for critically ill patients
| Ideal for patients with kidney and liver failure
Atracurium
| Cisatracurium
60
No histamine release
Cisatracurium
61
Has vagolytic actions
| Used when elevated heart rate is desired
Pancuronium
62
Increase heart rate
| No histamine release
Pancuronium
63
Prevents fasciculation associated with succinyl choline
Tubocurarine
64
Tubocurarine adverse effects
Hypotension:________
Bronchospasm:_________
Histamine
| Ganglionic blockade
65
For short surgical procedures
Mivacurium
66
Mivacurium is hydrolyzed by
Plasma cholinesterase
67
Useful for tracheal intubation in patients with gastric contents
Rocuronium
68
Adjunct to anesthesia in long surgery cases
| Long duration in patients with renal dysfunction
Pipecuronium
| Doxacurium
69
DRUG INTERACTIONS of Nondepolarizing neuromuscular blockers
Cholinesterase inhibitors
Halogenated hydrocarbon anesthetics
Aminoglycoside antibiotics
Calcium channel blockers
70
Can overcome the action of nondepolarizing blockers
Cholinesterase inhibitors
| Neostigmine, physostigmine, edrophonium
71
Enhance neuromuscular blockade by exerting a stabilizing action of nondepolarizing blockers
Halogenated hydrocarbon anesthetics
72
Inhibit ACh release from cholinergic nerves by competing with calcium ions
Aminoglycoside antibiotics
73
May increase the neuromuscular block of nondepolarizing and dep blockers
Calcium channel blockers
74
Muscle regidity and hyperpyrexia
Malignant hyperthermia
75
Treatment for malignant hyperthermia
DANTROLENE
- blocks release of calcium from the sarcoplasmic reticulum of muscle cells
Rapidly cooling the patient
76
Pre-reversal
Atropine
| Glycopyrrolate
77
Reversal
Cholinesterase inhibitors
78
Block nicotinic receptors in both sympathetic and parasympathetic ganglia
Ganglionic blockers
79
Ganglionic blockers
Hexamethonium
Trimethaphan
Mecamylamine
Nicotine
80
First drug effective for hypertension
Hexamethonium
81
Treatment of hypertensive emergencies caused by pulmonary edema or dissecting aortic aneurysm
Trimethaphan
82
Treats moderately severe to severe hypertension
Mecamylamine
83
Nicotine
Low dose: _______
High dose: _______
Ganglionic stimulation
| Ganglionic blockade
