Test #1: Ch. 14

Question 1

cholinergic drugs block actions of _________

Answer 1

acetcholine

Question 2

muscarinic agonists represented by

Answer 2

bethanechol

Question 3

muscarinic antagonist represented by

Answer 3

atropine

Question 4

ganglionic stimulating agent represented by

Answer 4

nicotine

Question 5

ganglionic blocking agents are represented by

Answer 5

mecamylamine

Question 6

neuromuscular blocking agents represented by

Answer 6

d-tubocurarine and succinylcholine

Question 7

cholinesterase inhibitors represented by

Answer 7

neostigmine and physostigmine.

Question 8

bethanechol (p116)

Answer 8

embodies the properties that typify all muscarinic agonists and will serve as our prototype for the group.

Question 9

principle structures affected by muscarinic activation are (4)

Answer 9

1) heart
2) exocrine glands
3) smooth muscles
4) eyes

Question 10

muscarinic agonist act on the heart to cause

Answer 10

bradycardia

Question 11

muscarinic agonist act on the exocrine glands to

Answer 11

increase sweating, salivation, bronichial secretions, and secretion of gastric acid.

Question 12

bethanechol is approved only for _________

Answer 12

urinary retention, by relaxing the trigone and sphincter muscles and increasing voiding pressure.

Question 13

bethanechol has been used on an investigational basis to treat _________

Answer 13

gastroesophogeal reflux

Question 14

why is bethanechol contraindicated for patients with low bp or low CO?

Answer 14

because it can cause hypotension (secondary to vasodilation) and bradycardia.

Question 15

adverse effects of bethanechol

Answer 15

1) hypotension and bradycardia
2) excessive salivation and increased gastric acid
3) increase pressure within the urinary tract
4) exacerbation of asthma by bronchoconstriction
5) dysrhythmias in hyperthyroid pts (increasing HR–which is an opposite effect p117)

Question 16

Cevimeline [Evoxac]

Answer 16

derivative of acetylcholine witha ctions much like those of bethanechol. Indicated for xerostomia (dry mouth).

Question 17

Pilocarpine

Answer 17

muscarinic agonist used mainly for topical therapy of glaucoma. Also used to treat dry mouth resulting from Sjogren’s syndrome

Question 18

What is the clinical use of Acetylcholine?

Answer 18

used to produce rapid miosis (pupil constriction) following lens delivery in cataract sx.

Question 19

What is found in certain poisonous mushrooms?

Answer 19

Muscarine

Question 20

What is a selective muscarinic blocking agent?

Answer 20

atropine

Question 21

best-known muscarinic antagonist

Answer 21

atropine

Question 22

atropine _____ the heart

Answer 22

increases

Question 23

atropine ______ secretion from salivary glands, bronchial glands, sweat glands and the acid secreting cells of the stomach.

Answer 23

decrease

Question 24

atropine causes ______ of the bronchi

Answer 24

relaxation

Question 25

atropine causes blockade of muscarinic receptors on the iris spincter causing __________

Answer 25

mydriasis (dilation of the pupil)

Question 26

at therapeutic doses, atropine can cause mild central nervous system _________

Answer 26

excitation

Question 27

at toxic doses, atropine can cause __________ & ________

Answer 27

hallucinations and delirium.

Question 28

Adverse effects of atropine

Answer 28

1) xerostomia (dry mouth) 2) blurred vision & photophobia 3) elevation of intraocular pressure 4) urinary retention 5) constipation 6) anhidrosis (absence of sweat) 7) tachycardia 8) asthma

Question 29

two drugs mostly used for overactive bladder (OAB)

Answer 29

oxybutynin & tolterodine. these drugs block muscarinic receptors elsewhere and cause the typical anticholinergic SE.

Question 30

anticholinergic agent that acts primarily at M3 muscarinic receptors. approved only for OAB.

Answer 30

oxybutynin [ditropan XL, gelnique, oxytrol]

Question 31

anticholinergic agent used for OAB, and displays the greatest degree of M3 selectivitiy. Has no affect on M1 (brain) or M2 (heart).

Answer 31

darifenancin [Embalex]

Question 32

anticholinergic agent used for OAB and very similar to darifenancin but not as M3 selective.

Answer 32

solifenacin [VESIcare]

Question 33

nonselective muscarinic antagonist approved only for OAB. Available in short and long acting formulations. Can produce serious cardiac dysrhythmias.

Answer 33

tolterodine [detrol, detrol LA]

Question 34

nonselective muscarinic antagonist similar to tolterodine. both agents are used only for OAB. has not been associated with QT prolongation and does not pose a risk for dysrhythmias.

Answer 34

fesoterodine [toviaz]

Question 35

anticholinergic drug with actions much like those of atropine, with two exceptions... 1. causes CNS sedation and 2. suppresses emesis

Answer 35

Scopolamine

Question 36

anticholinergic drug used to treat asthma, COPD, and rhinitis caused by allergies and common cold.

Answer 36

Ipratropium Bromide [atrovent]

Question 37

this drug is indicated for irritable bowel syndrome by IM injection

Answer 37

Dicyclomine [Bentyl]

Question 38

centrally acting anticholinergics used to treat Parkinson's disease and drug-induced Parkinsonism.

Answer 38

Cogentin and trihexyphenidyl.

Question 39

what is the best antidote for muscarinic antagonist poisoning?

Answer 39

physostigmine, a cholinesterase inhibitor