PNS

Question 1

Which is longer in the PNS the post or preganglionic fibers

Answer 1

The preganglionic fibers are longer than the post ganglionic fibers as the parasympathetic ganglia is close to the effector organ

Question 2

What type of receptors does the PNS HAVE

Answer 2

Muscarinic and Nicotinic

Question 3

What are nicotinic receptors coupled with

Answer 3

Na+ /K+ ion channels

Question 4

What are muscarinic receptors coupled with

Answer 4

G proteins

Question 5

What are the effects of activation of muscarinic or nicotinic receptors

Answer 5

DUMB HAVES 
DEFECATION 
URINATION 
MUSCLE EXCITATION
BRONCHOSPASM 
HEART BRADYCARDIA 
AUTONOMIC GANGLIA STIMULATION
VASODILATION 
EYE MIOSIS AND ACCOMMODATION
SECRETIONS

Question 6

how does the vasodilation occur after muscarinic activity

Answer 6

M3 receptor activation increases Ca2+ release which aids in NO formation, leading to CGMP formation ——> relaxation

Question 7

How do direct cholinomimitics work

Answer 7

Mimic ACH

Question 8

What is bethanchol

Answer 8

An ester

Question 9

bethanechol receptors

Answer 9

Only muscarinic receptors

Question 10

bethanechol indications

Answer 10

ileus and urinary retention

Question 11

bethanechol contraindications

Answer 11

Kidney and gallstones

Question 12

What is pilocarpine

Answer 12

Alkaloid

Question 13

Pilocarpine receptors

Answer 13

Primarily acts on muscarinic receptors

Question 14

Pilocarpine indications

Answer 14

Glaucoma by decreasing IOP which is 
done by:- 
Increase out flow if AH 
Decreased production of AH 
Other indications: sjorgen/xerostomia by increasing secreations of lacrimal and salivary glands

Question 15

What is carbachol

Answer 15

Ester

Question 16

Carbachol receptors

Answer 16

Muscarinic and nicotinic

More potent and more side effects so not used

Question 17

What is methancholine

Answer 17

An ester

Question 18

Methacholine receptors

Answer 18

Acts on muscarinic receptors

Question 19

Methacholine uses and why is it used this way

Answer 19

Screening tool for bronchial asthma, methacholine challenge test.
It is short acting susceptible to ACHE degradation

Question 20

Methacholine contraindications

Answer 20

COPD, peptic ulcer, urinary retention, GI obstruction and IHD

Question 21

How to treat muscarinic poisoning exacerbated DUMB HAVES

Answer 21

reversed by atropine 1-2 mg every 30 mins

Question 22

How do indirect cholinomimitics work

Answer 22

Inhibition of ACHE

Question 23

What could indirect cholinomimitics be

Answer 23

Organophosphates - used as pesticides
Carbamates - tertiary or quartenary amines
Tertiary amines can cross BBB

Question 24

What are the quaternaryamines

Answer 24

Edrophonium, neosrigmine and pyridostigmine

Question 25

Edrophonium indication and why is it used this way

Answer 25

Diagnosis of myasthenia gravies Differential diagnosis between cholinergic crisis and myasthenia graves Since it’s a short acting competitive inhibitor of ACHE

Question 26

What’s the treatment of myasthenia graves

Answer 26

Pyridostigmine

Question 27

Neosrigmine indication

Answer 27

Myasthenia gravis , postoperative ileus and urinary retention and to reverse paralysis after Anastasia

Question 28

What are the tertiary amines

Answer 28

Donepezil, galantamine, rivastigmine and physostigmine

Question 29

Physostigmine indication

Answer 29

Antidote for over does on anti cholinergic drugs like Atropine- treat side effects like - constipation, urinary retention and tremor and confusion

Question 30

Galantamine and rivastigmine indication

Answer 30

Alzheimer’s disease

Question 31

Side effects of indirect cholinomimitics

Answer 31

MIOSIS, diarrhea, urination, bronchospasm and increase secreations also convulsions, coma and CVS depression

Question 32

Pralidoxime indication

Answer 32

Promotes regeneration of ACHE enzymes but it’s slow acting and doesn’t cross BBB

Question 33

Atropine indications

Answer 33

Used for bradycardia, decrease bladder contraction, dilates pupils for ophthalmology and cycloplagia Antidote for ACHE inhibitors

Question 34

Atropine side effects

Answer 34

Tachycardia, constipation and urinary retention, dry mouth and eyes as well as blurry vision

Question 35

Atropine contraindication

Answer 35

Narrow angle glaucoma

Question 36

Oxybutinin and tolterodie indication

Answer 36

Decrease muscle contraction to prevent urge incontinence and involuntary urination

Question 37

Ipratropium and tiotropium indication

Answer 37

Bronchodilators as they cause smooth muscle relaxation to relive COPD and asthma

Question 38

Scopolamine indications

Answer 38

Prevents motion sickness and block short term memory(anaesthetic procedures)

Question 39

Benztropine and trihexyphenadyl indications

Answer 39

Used in Parkinson’s disease as they’re active in the striatum to restore balance between ACH and Dopamine

Question 40

Acetylcholine esterase where is it found

Answer 40

Found in many types of conducting tissue in RBC membrane but not in plasma

Question 41

What is pseudocholinesterase

Answer 41

Also known as plasma cholinesterase | Present in plasma and works on the hydrolisis of succinylcholine

Question 42

Topicamide and cyclopentolate indication

Answer 42

Ophthalmology - mydriasis and cycloplegia

Question 43

Antidote for neuromuscular blocking drugs

Answer 43

Edrophonium, pyridostigmine and neostigmine

Question 44

Example of non depolarising neuromuscular blocker

Answer 44

Tubocurarine | -curare

Question 45

Example of depolarising neuromuscular blocker

Answer 45

Succinylcholine

Question 46

Succinylcholine adverse effects and when does it happen

Answer 46

Malignant hyperthermia, prolonged apnea mostly seen in people with a genetic defect deficiency of plasma pseudocholinesterase

Question 47

Trospium indications

Answer 47

Treatment of overactive bladder with Alzheimer’s disease

Question 48

How to treat sinus bradycardia

Answer 48

Atropine