1.4 Cholinergic Pharmacology II

Question 1

Cholinoceptor blocking drugs are divided into _________ antagonists and ________ antagonists

Answer 1

muscarinic, nicotinic

Question 2

antimuscarinics: ________ compounds used for effects in eye or CNS, and ________ amines selectively produce peripheral effects

Answer 2

tertiary - eye or CNS

quaternary - peripheral

Question 3

prototypic anticholinergic drug is _______, which causes reversible blockade

Answer 3

atropine

Question 4

Muscarinic antagonist effect on eye:

• blockade by topical atropine results in ________
• paralysis of _______ muscle (cycloplegia)
• contraindicated in ________

Answer 4

mydriasis (dilation)

ciliary

acute glaucoma

Question 5

Muscarinic antagonist effects on cardiovascular system:

-atropine produces _________

Answer 5

tachycardia

Question 6

M antagonist effect on respiratory system:

• ________ and reduction of secretion
• not as useful as beta-adrenceptor stimulants in treatment of asthma

Answer 6

bronchodilation

Question 7

M antagonist effect on GI tract:

• _______ motility and secretion
• can be useful as preoperative adjuvant before abdominal surgery

Answer 7

reduces

Question 8

M antagonist effect on GU tract

-can produce urinary _________

Answer 8

retention

Question 9

M antagonist effect on sweat glands

• suppresses _________ sweating
• body temp can be _______

Answer 9

thermoregulatory

elevated

Question 10

tolterodine is an M2 selective antagonist, which treats urinary ________

Answer 10

urgency and frequency

Question 11

reversal of cholinergic poisoning requires a ______ drug, and large doses of _______ may be needed

Answer 11

tertiary (not quaternary)

atropine

Question 12

• dry mouth, mydriasis, tachycardia, flushed skin, delirium
• can be treated with physostigmine or symptom management
• contraindications in glaucoma and prostatic hyperplasia

Answer 12

atropine poisoning (adverse effects of cholinoceptor blocking drugs)

Question 13

• block actions of acetylcholine and other agonists at nicotinic receptors
• receptors located on PNS and SNS autonomic ganglia
• non selectivity produces limiting side effect profiles
• all synthetic amines, originally developed for HTN

Answer 13

ganglion blocking drugs

Question 14

______ readily enters the CNS –> sedation, tremor, choreiform movements, mental aberrations

Answer 14

mecamylamine

Question 15

Ganglion blocking drugs in eye:

• ciliary muscle ______
• moderate _______ of pupil

Answer 15

cycloplegia

dilation

Question 16

Ganglion blocking drugs in cardiovascular:

• ________ in blood pressure
• orthostatic hypotension
• moderate _______

Answer 16

decrease

tachycardia

Question 17

Ganglion blockers in GI tract:

-_______ secretion and motility, since tone is PNS

Answer 17

reduced

Question 18

Ganglion blockers in GU system:

• urinary ________
• sexual function impaired

Answer 18

retention

Question 19

atropine
scopolamine
homatropine
pirenzipine
tropicamide
tolterodine
dicylclomine
fesoteridine
mepenzolate
solifenacin
oxybutynin
darifenacin
trospium

Answer 19

anticholinergics (M antagonists)

tertiary amines

Question 20

atropine methyl nitrate
methscopolamine
ipatropium
propantheline
glycopyrrolate

Answer 20

anticholinergics - quaternary amines (lack central effects)

Question 21

hexamethonium
trimethaphan
mecamylamine

Answer 21

ganglion blocking drugs

Question 22

pralidoxime (2-PAM)

Answer 22

cholinesterase regenerator