Acetylcholinesterase

Question 1

what is myasthenius gravis?

Answer 1

have autoantibodies against nicotinic receptors for ACh; get decreased transmission of signals
eyes drooping, muscle weakness

Question 2

what is the drug given to diagnose myasthenias gravis?

Answer 2

edrophonium - a quaternary alcohol
active for about 30min
renal metabolism

Question 3

what drug is given to treat myasthenius gravis?

Answer 3

pyridostigmine
4 hour activity, renal metabolism
side effects - gi symptoms (nausea and vom), increased salvation, constriced pupils, etc

Question 4

what is the ACh connection with alzheimer’s?

Answer 4

patients have reduced neurotransmission due to deficiency in cholinergic neurons

Question 5

what drugs do you give for alzheimers?

Answer 5

donezipil, rivastigmine, galantimine

Question 6

what inducers can increase donezipil metbaolism?

Answer 6

CYP2D6 and CYP3A4 inducers - phenytoic, carbamazepine, dexamethasone, rifampin, phenobarbital

Question 7

what are some adverse effects of alzheimer meds?

Answer 7

malaise, appetite loss, insomnia, muscle cramps, GI symptoms, chest pain, seizures, tarry stools

Question 8

what is glaucoma?

Answer 8

intraocular pressure high?

Question 9

what drugs do you give for glaucoma?

Answer 9

echothiophate, DFP, physostigmine, demecarium to increase ACh at synapses controlling the iris sphinchter

organophosphates have also been used

Question 10

what substances cause anti-cholinergic activity?

Answer 10

scopolamine, atropine - they block the binding of acetyl choline to nicotinic receptors

Question 11

what antihistamines have anticholinergic activity at high doese?

Answer 11

benadryl (diphenydramine) and dimethylhydrinate (dramamine)

Question 12

what do you give for ODs of anticholinergics or antihistamine?

Answer 12

physostigmine
30min (transdermal patch for 24h)
Gi symptoms

Question 13

what do you give for dry mouth (xerstoma)? and how does it work?

Answer 13

physostigmine, increases ACh which increases saliva release