pharm p 250 - 254

Question 1

DOC for both open/closed angle glaucoma?

Answer 1

pilocarpine

Question 2

explain how pilocarpine works in open angle and closed angle glaucoma

Answer 2

1. contracts ciliary muscle of eye in open angle glaucoma

2. contracts pupillary sphincter in closed angle glaucoma

Question 3

T or F: pilocarpine is degraded by AChE

Answer 3

F: pilocarpine is resistant to AChE

Question 4

Name 4 direct cholinomimetic agonists

Answer 4

1. bethanechol
2. carbachol
3. methacholine
4. pilocarpine

Question 5

among the 4 direct cholinomimetics, which ones are resistant to AChE?

Answer 5

bethanechol, pilocarpine

Question 6

3 clinical applications for bethanechol?

Answer 6

posoperative ileus, neurogenic ileus, urinary retention

Question 7

what is the mech of bethanechol for its usage for urinary retention?

Answer 7

stimulates M3 to inc bladder constriction to urinate

Question 8

what is a DOC for Sojgern?

Answer 8

pilocarpine (stimulates sweat, tears, and saliva)

Question 9

DOC for atropine overdose?

Answer 9

physostigmine

Question 10

DOC for myasthenia gravis?

Answer 10

pyridostigmine

Question 11

Does pyridostigmine go into CNS?

Answer 11

no

Question 12

Does physostigmine get into CNS?

Answer 12

yes

Question 13

what are the 2 drugs for myasthenia gravis?

Answer 13

neostigmine, pyridostigmine

Question 14

what 3 pathologies are contraindicated to all cholinomimetic agents?

Answer 14

1. COPD
2. asthma
3. peptic ulcers

Question 15

cholinesterase inhibitors (neostigmine, edrophonium, pyridostigmine) are also used for reversal of blockade of what types of drugs?

Answer 15

reversal of blockade of non-depolarizing neuromuscular blocking agent (Tubocurarine, atracurium, mivacurium)

Question 16

what is the clinical application of non-depolarizing neuromuscular blocking agents?

Answer 16

induce muscle paralysis in surgery or mechanical ventilation

Question 17

name the 3 anticholinesterases (cholinesterase inhibitor) used for Alzheimer?

Answer 17

donepezil, galantamine, rivastigmine

Question 18

historically, what was used to diagnose myasthenia gravis?

Answer 18

edrophonium

Question 19

nowadays, what is used to diagnose myasthenia gravis?

Answer 19

anti-acetylcholine receptor antibody test

Question 20

which drug regenerates AChE for organophosphate toxicity?

Answer 20

pralidoxime

Question 21

name 3 drugs that can be used for urinary incontinence (overactive bladder)

Answer 21

oxybutynin, solifenacin, tolterodine

Question 22

2 drugs for COPD, asthma?

Answer 22

ipratropium, tiotropium

Question 23

what is a muscarinic antagonist for Parkinson dz?

Answer 23

benztropine

Question 24

what drug can be used for acute dystonia?

Answer 24

benztropine

Question 25

what drug can be used to dec urgency in cystitis?

Answer 25

atropine

Question 26

what toxin binds to fast voltage gated Na+ channel in cardiac and nerve tissue preventing depolarization?

Answer 26

tetrodotoxin

Question 27

what toxin is from fugu?

Answer 27

fugu is pufferfish, tetrodotoxin

Question 28

what toxin leads to temperature related dysesthesia?

Answer 28

ciguatoxin

Question 29

what is the mech of ciguatoxin?

Answer 29

opens Na+ channels causing depolarization (opposite to tetrodotoxin)

Question 30

what is the main source of ciguatoxin?

Answer 30

reef fish such as barracuda, snapper, moray eel

Question 31

what toxin cause acute onset burning sensation of the mouth flushing of face, erythema, urticaria, pruritus, headache and may cause anaphylaxis like presentation (bronchospasm, angiodedema, hypotension)?

Answer 31

scombroid poisoning

Question 32

treatment for scombroid poisoning?

Answer 32

antihistamines and if needed antianaphylactics such as bronchodilators, epinephrine

Question 33

name 3 indirect sympathomimetics

Answer 33

1. amphetamines 2. cocaine 3. ephedrine

Question 34

name 2 alpha2 agonists

Answer 34

clonidine, guanfacine

Question 35

3 clinical applications for clonidine and guanfacine?

Answer 35

hypertensive urgency, ADHD, Tourette syndrome

Question 36

what drug is used for hypertension in pregnancy?

Answer 36

alpha methyldopa

Question 37

2 side effects of alpha methyldopa?

Answer 37

direct coombs + hemolysis, SLE like syndrome

Question 38

at high does of epinephrine what effect is dominant?

Answer 38

alpha

Question 39

norepinephrine is used for hypotension due to what property compared to epinephrine?

Answer 39

no beta 2 effect for norepinephrine