Parasympathetics

Question 1

bethanechol

Answer 1

cholinomimetic

Question 2

pilocarpine

Answer 2

cholinomimetic

Question 3

pilocarpine uses: 2

Answer 3

• glaucoma (via contracting ciliary muscle and pupil)

- dry mouth

Question 4

pilocarpine MOA for glaucoma

Answer 4

• contracts ciliary muscle, so radius of eye/fibers decreases
• lens goes from stretched to rounded
• facilitates outflow of fluid

Question 5

carbachol

Answer 5

cholinomimetic (muscarinic AND nicotinic)

Question 6

carbachol fx compared to pilocarpine in glaucoma

Answer 6

• carbachol only pupillary constriction

- pilocarpine = pupil + ciliary constriction

Question 7

methacholine

Answer 7

cholinomimetic

Question 8

varenicline

Answer 8

cholinomimetic (nicotinic partial agonist)

Question 9

common GI side effect of cholinomimetics

Answer 9

peptic ulcer

Question 10

-stigmine

Answer 10

AchE inhibitor

Question 11

long-term myasthenia gravis tx

Answer 11

pyridostigmine > neostigmine

Question 12

myasthenia gravis test drug

Answer 12

edrophonium (tensilon test) (an AchE inhibitor)

Question 13

use for curare (-curonium, -curium, -curarine)

Answer 13

non-depolarizing NMJ blockade paralysis (overcome by neostigmine) (nicotinic antagonists)

Question 14

succinylcholine and AchE inhibitor contraindicated why?

Answer 14

-it’s a nicotinic agonist, depolarizing blockade

Question 15

neostigmine uses

Answer 15

• overcome non-depolarizing NMJ blockade

- urinary retention

Question 16

AchE inhibitor with CNS effects

Answer 16

physostigmine

Question 17

physostigmine use

Answer 17

-atropine, belladonna, nightshade, Jimson weed, alkaloids, etc. overdose

Question 18

organophosphates (-thio-)

Answer 18

central and peripheral AchE inhibitors (leads to DUMBBELS, including flaccid paralysis from Ach Rc over-activation at NMJ)

Question 19

organophosphate poisoning tx

Answer 19

• NMJ and peripheral: pralidoxime (releases AchE)

- central and peripheral: atropine (musc. antagonist)

Question 20

AchE inhibitor used for which neuro disease

Answer 20

Alzheimer’s

Question 21

galantamine

Answer 21

AchE inhibitor for Alzheimer’s

Question 22

rivastigmine

Answer 22

AchE inhibitor for Alzheimer’s

Question 23

donepizil

Answer 23

AchE inhibitor for Alzheimer’s

Question 24

cycloplegia

Answer 24

weakened ability to contract ciliary muscle and accommodate (to round) the lens for near-vision

Question 25

scopolamine

Answer 25

muscarinic antagonist with CNS effects, for motion sickness

Question 26

-tropium

Answer 26

M3 antagonist for pulmonary disease (COPD, asthma)

Question 27

ipratropium

Answer 27

M3 antagonist

Question 28

tiotropium

Answer 28

M3 antagonist

Question 29

oxybutynin

Answer 29

M3 antagonist for overactive bladder/uterus

Question 30

tolterodine

Answer 30

M3 antagonist for overactive bladder

Question 31

muscarinic antagonists for which neuro disease

Answer 31

• Parkinson’s (too much Ach, too little dopamine)

- extrapyramidal symptoms from anti-psychotics that block dopamine

Question 32

benztropine

Answer 32

M1 antagonist for Parkinson’s

Question 33

trihexyphenidyl

Answer 33

M1 antagonist for Parkinson’s

Question 34

muscarinic antagonist eye side-effect

Answer 34

-acute angle closure glaucoma (mydriasis leads to less outflow of humor)