(5) Autonomic Nervous System Drugs I (Acetylcholine) Flashcards

1
Q

Methacholine

A

Class-direct-acting cholinergic receptor agonist Effect- binds muscarinic receptors in airway Txt-asthma challenge test

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2
Q

Carbachol

A

Class- direct-acting cholinergic receptor agonist Effect-Constricts pupil &; relieves intraocular pressure Txt- glaucoma

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3
Q

Bethanechol

A

Class- direct-acting cholinergic receptor agonist Effect-stimulates bladder or GI w/o cardio involvement

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4
Q

Nicotine

A

Class- direct-acting cholinergic receptor agonist Txt- smoking cessation

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5
Q

Pilocarpine

A

Class-direct-acting cholinergic receptor agonist Effect-M1 receptor agonist for sweat, tears, saliva -contracts ciliary mm &; pupillary sphincter Txt-open&; closed-angle glaucoma -Xerostomia (dry mouth)

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6
Q

Neostigmine

A

Class-reversible cholinesterase inhibitor Effect-Increase ACh NOT in CNS Txt- Myasthenia gravis

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7
Q

Edrophonium

A

Class- reversible cholinesterase inhibitor Effect-Increase ACh Txt- myasthenia gravis diagnosis

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8
Q

Physostigmine

A

Class-reversible cholinesterase inhibitor Effect-Increase ACh & penetrates CNS Txt-Myasthenia gravis & “phyxes” Atropine overdose

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9
Q

Pyridostigmine

A

Class- reversible cholinesterase inhibitor Effect-increase ACh Txt-long-acting myasthenia gravis

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10
Q

3 Reversible Cholinestearse Inhibitor Txt for Alzheimer’s Disease

A

Donepezil, Galantamine, Rivastigmine

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11
Q

Irreversible cholinesterase inhibitors

A

Organophosphates (pesticides, sarin gas) Malathion (not hydrolyzed by insects)

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12
Q

Signs of organophosphate toxicity

A

SLUDGE- salivation, lacrimation, urination, diarrhea, gastric emptying DUMBBLESS- diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal mm; CNS, lacrimation sweating, salivation

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13
Q

2 methods to increase aqueous humor outflow for primary angle glaucoma

A

Muscarinic receptor agonists Prostaglandin analogs

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14
Q

3 methods to decrease aqueous humor production for primary angle glaucoma

A

alpha-2 receptor agonists B-receptor antagonists Carbonic anhydous inhibitors

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15
Q

Atropine

A

Class-anticholinergic (competitive antagonist) belladonna alkaloid Effect-blocks M1, M2, M3 Txt-bradycardia &; cholinesterase inhibitor overdose

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16
Q

Scopolamine

A

Class-anticholinergic (competitive antagonist) Effect-greater CNS effect than atropine Txt-motion sickness

17
Q

Hyoscyamine

A

Class- anticholinergic (competitive antagonist) Txt-GI spasms/ IBD

18
Q

Ipratropium; tiotropium

A

Class- anticholinergic (competitive antagonist) synthetic Txt-Asthma/ COPD

19
Q

Dicyclomine

A

Synthetic Anticholinergic for IBD

20
Q

Tropicamide

A

Synthetic anticholinergic for topical eye exams

21
Q

Benztropine

A

Synthetic anticholinergic for Parkinson’s and drug-induced Parkinson’s

22
Q

3 anticholinergic drugs for overactive bladder

A

Oxybutinin, Tolterodine, Solifenacin

23
Q

Effects of anticholinergic drugs

A

Mydriasis, sweating, decreased secretion, bronchodilation, increased HR, decreased GI motility, atonic bladder

24
Q

Contraindications for anticholinergic drug use

A

glaucoma, prostatic hyperplasia, dementia, delirium

25
Q

Signs of anticholinergic toxicity

A

Increased temp, dry/ flushed skin, tachycardia, urinary retention, disorientation, cycloplegia, mydriasis

26
Q

D-tubocurarine

A

Class- Non-depolarizing nicotinic ACh antagonist Effect- NMJ blocking Txt-mm relaxation during surgery

27
Q

Succinylcholine

A

Class- depolarizing nicotinic ACh antagonist Effect- NMJ block Txt-sustained mm paralysis during sedation

28
Q

Cevimeline (Evoxac)

A

new synthetic direct agonist for xerostomia and dry eyes used after radiation tx or for pts with Sjogren’s syndrome

29
Q

Components of FDA-Approved Drug label

A

Animal Pharmacology Clinical Studies Indications & Usage Contraindications Precautions Adverse Reactions Overdosage Dosage & Administration How Supplied

30
Q

What is the Anticholinergic Risk Scale?

A
  • ASR is a way to quantify the risk of drugs w/ anticholinergic properties on geriatric patients (in efforts to prevent delirium, falls & cognitive impairment) - The scale ranges from 1 to 3 points (3 = highest risk)
31
Q

Name 2 important drugs listed under the 3 point column of the Anticholinergic Risk Scale.

A
  1. Diphenhydramine 2. Chlorpheniramine (These are both Antihistamines that have Anticholinergic properties)
32
Q

Signs of Organophosphate Toxicity?

A

Organophosphates = sarin gas & pesticides - DUMBBELSS: Diarrhea, Urination, Miosis, Bradycardia, Bronchoconstriction, Excitation of Skeletal muscle & CNS, Lacrimation, Salivation & Sweating - SLUDGE: Sweating, Lacrimation, Urination, Diarrhea, Gastric Emptying

33
Q

Dose-Related Atropine Toxicity

A