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Cholinergic Neuro
| Question | Answer |
|---|---|
| What are cholinomimetics? | Drugs that stimulate cholinergic receptors. |
| What is the mechanism of action for cholinomimetrics? | Direct acting agonists and indirect acting agonists. |
| What are examples of direct acting agonists? | Muscarinic and Nicotinic |
| What do indirect agonists do to acetylcholinesterase? | The inhibit it. |
| Do indirect acting agonists bind directly to receptors? | No |
| Do cholinomimetics stimulate the Parasymathetic nervous system or the sympathetic nervous system? | PNS |
| What are examples of direct acting MUSCARINIC receptor agonists? | Choline esters and Naturally occurring alkaloids |
| What are examples of Choline Esters? | Bethanechol, Acetylcholine, Ceveimeline, Carbachol |
| What are examples of Naturally occuring alkaloids? | Muscarine, Arecoline, Pilocarpine |
| Which of the choline esters have less cardiac effects? | Carbachol and Bethanecol |
| What type of direct acting muscarinic drugs are used to treat open angle glaucoma? | Pilocarpine and carbachol |
| What are adverse effects of direct acting muscarinic receptor agonists on the lungs? | Bronchoconstriction and increased mucous discharge |
| What are the effects of direct acting Muscarinic receptor agonists on the GI tract? | Increase salivation, gastric/intestinal smooth muscle motility, gastric acid secretion. Relaxation of sphincters. |
| What direct acting muscarinic agonist is used in postoperative hypoactive bowels and postpartum bladder hypoactivity? | Bethanacol |
| What direct acting muscarinic agonist is used in Sjogrens syndrome? | Cevimeline |
| What direct acting muscarinic agonist is used in Radiation induced xerostomia? | Pilocarpine |
| What are the GU effects of direct acting muscarinic receptor agonists? | Contraction of detrusor muscle and relaxation of sphincter muscles. |
| What are the three types of Indirect Acting Cholinesterase Inhibitors? | Short duration, intermediate duration, and long duration |
| Name a short duration Indirect Acting Cholinesterase Inhibitor. | Edrophonium |
| Is edrophonium used for therapeutic reasons? | No it is solely for diagnostic purposes. |
| Name the Intermediate duration Indirect Acting Cholinesterase Inhibitors. | Neostigmine, Ambenonium, Physostigimine, Pyridostigmine |
| Name the long duration Indirect Acting Cholinesterase Inhibitors. | Echothiophate, organic pesticides, and nerve gases |
| What is the mechanism of action for Indirect Acting Cholinesterase Inhibitors? | They prolong Acetylcholine's effects on muscarinic sites, neuromuscular nicotinic sites, autonomic ganglia nicotinic sites, and the brain. |
| What are some therapeutic uses for Cholinesterase Inhibitors? | Myasthenia Gravis, Glaucoma, and Alzheimer's. |
| What Indirect Acting Cholinesterase Inhibitors are used to treat Myashtenia Gravis? | Neostigmine, ambenonium, pyridostigmine |
| What needs to be done in a Myasthenic crisis? | Cholinesterase inhibition needs to be increased. |
| What causes a Myasthenic crisis? | Increased antibodies for skeletal muscle nicotinic receptors. |
| What causes a Cholinergic crisis? | Nicotinic receptor desensitization. |
| How do you respond to a Cholinergic crisis? | Decrease cholinesterase inhibition. |
| How can you tell if a pt is having a Myasthenic crisis vs. a Cholinergic crisis? | In a Myasthenic crisis the pt has trouble swallowing and in a Cholinergic crisis a pt has excessive salivation. |
| What Indirecting Acting Cholinesterase Inhibitor drugs can be used in chronic open angle glaucoma? | Neostigmine and echothiopate |
| What Indirecting Acting Cholinesterase Inhibitors are used to treat Alzheimers? | Donepezil, Rivastigmine, and Galantamine |
| What are unique adverse effects for Cholinesterase inhibitors? | tremors, muscle fascicultation, desensitization, flaccid paralysis |
| What is the antidote to a an overdose of cholinesterase inhibitors? | Atropine or pralidoxime |
| What is another name of Muscarinic Receptor Antagonists? | Anti Muscarinics |
| Name some Anti Muscarinics. | Atropine, tiotropium, dicyclomine, totlerodine, scopolamine |
| What are anti muscarinics made from? | Jimson weed |
| How do Antimuscarinics work? | They compete with muscarinic receptors. |
| What type of nerve signals do Anti Muscarinics block, PNS or SNS? | PNS |
| What are Anti Muscarinics more sensitive towards? In descending order. | Glands, heart, eyes, GU, GI, lungs, stomach |
| What Anti Muscarinic is used for pupillary dilatation? | Tropicamide |
| What effect do Anti Muscarinics have on the eye, mydriasis or miosis? | Mydriasis (iris muscle relaxation) |
| What cardiovascular effect do Anti Muscarinics have on the heart? | They cause tachycardia |
| What Anti Muscarinics are used to treat COPD? | Tiotropium and ipratropium |
| What effect do Anti muscarinics have on the lungs? | Broncholiation and inhibition of respiratory secretions. |
| What are the GI effects of Anti muscarinics? | Xerostomia, reduced GI motility, reduced GI acid secretions |
| What are some therapeutic uses for Anti Muscarinics in the GI tract? | Antimotility and antidiarrhea |
| What Anti Muscarinic drug is used to treat diarrhea? | Dicyclomine |
| What are some theraputic uses of Anti Muscarinic drugs on the GU? | Treats incontinence and over active bladder. |
| What Anti Muscarinic drugs treat incontinence and over active bladder? | tolterodine (Detrol), Solifenacin (Vesicare) |
| What is scopolamine used for? | Sedation, amnesia, and anti emesis |
| What effects do toxic doses of antimuscarinic drugs have on the CNS? | Excitement, agitation, hallucinations, coma. |
| What part of the brain does Scopolamine act on? | The Vestibular system in the brain. |
| What antimuscarinic treats motion sickness? | Scopolamine |
| What antimuscarinic drug treats Parkinsons? | Benztropine |
| What are parathion and malathion? | pesticides |
| What effect do Anti Muscarinic drugs have on sarin, muscarine, and pesticides? | It is an antidote for them and prevents excessive muscarinic receptor stimulation. |
| What adverse effects do Anti Muscarinic drugs have on the eyes? | Mydriasis and far sightedness |
| What adverse effects do Anti Muscarinic drugs have on the heart? | Tachycardia |
| What adverse effects do Anti Muscarinic drugs have on the GI? | Xerostomia and constipation |
| What adverse effects do Anti Muscarinic drugs have on the GU? | urinary retention |
| What adverse effects do Anti Muscarinic drugs have on the CNS? | Amnesia, sedation, excitement/hallucinations |
| What is the only available Ganlgionic Blocking Drug and what is it used for? | Mecamylamine; to lower blood pressure |
| What type of control does the Somatic System elicit, voluntary or involuntary? | Voluntary control |
| Where are muscarinic receptors found? | The PSN. |
| Where are nicotinic receptors found? | The Somatic Nervous System where skeletal muscle is found. |
Created by:
jesusrvillarreal
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