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FIRST AID PHARM > ANS drugs > Flashcards

ANS drugs Flashcards

1
Q

systemic effects of cholinomimetic drugs

A

Increase ACh activity:

  • miosis, accommodation
  • decrease heart rate by decreasing conduction velocity
  • Increase secretions (glands, sweating, lacrimation, salivation)
  • Increase GI/GU motility by relaxing external sphincters and increasing secretion
  • bronchoconstriction and increased secretion in lung
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2
Q

Contraindications for cholinomimetics

A

COPD, asthma, peptic ulcers

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3
Q

examples of direct acting cholinomimetics (4)

A

Bethanechol, carbachol, methacholine, pilocarpine

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4
Q

Bethanechol: class and clinical use

A

direct acting muscarinic agonist: post op ileus, neurogenic ileus, urinary retention

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5
Q

Carbachol: class and clinical use

A

direct acting muscarinic agonist: constrict pupil for glaucoma patients

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6
Q

Methacholine: class and clinical use

A

direct acting muscarinic agonist: challenge test to Dx asthma

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7
Q

Pilocarpine: class and clinical use

A

direct acting muscarinic agonist: stimulate sweating (CF sweat test), tears, salivation (dry mouth in Sjogrens), constrict pupil for glaucoma

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8
Q

Mechanism of indirect acting cholinomimetics

A

Anticholinesterases

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9
Q

-stigmines: class

A

AChE inhibitors

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10
Q

Donepezil: class and clinical use

A

AChE inhibitor: Alzheimer disease

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11
Q

Galantamine: class and clinical use

A

AChE inhibitor: Alzheimer

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12
Q

Rivastigmine: class and clinical use

A

AChE inhibitor: Alzheimer

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13
Q

Edrophonium: class and clinical use

A

AChE inhibitor: Dx myasthenia gravis

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14
Q

Which anticholinesterase is used to Dx myesthenia gravis? Which is used to treat it? What is the difference between the two

A

Edrophonium: Pyridostigmine (and neostigmine): the length of time that they remain active

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15
Q

Which AChE inhibitor crosses the BBB? When is it used?

A

physostigmine: atropine (muscarinic antagonist) overdose

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16
Q

Neostigmine: class and clinical use

A

AChE inhibitor: postop ileus, reverse NMJ blockade, urinary retention

17
Q

What does an AChE inhibitor overdose look like? What is the common cause?

A

DUMBBELSS (Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle, Lacrimation, Sweating, Salivation): Organophosphates from pesticides

18
Q

How do you treat an AChE inhibitor intoxication

A

causes ^ in ACh in the terminal, give atropine to block ACh receptors and pralidoxime to regenerate AChE

19
Q

Systemic effects of muscarinic antagonists

A

Sympathetic responses: decreased secretion (dry mouth, dry eyes, no sweating, decreased GI), hyperthermia and red skin (no sweating), mydriasis and cycloplegia, tachycardia, slow movement, urinary retention/constipation, CNS (hallucination, behavioral excitation)

20
Q

What are some classes of drugs that have atropine-like side effects?

A

anthistamines, antipsychotics, TCAs, Quinidine, amantidine, meperidine

21
Q

Atropine: class and clinical use

A

Muscarinic antagonist: produce mydriasis for eye exams, antisecretory, antidote for AChE inhibitor overdose

22
Q

What are some shorter acting versions of atropine

A

tropicamide, homatropine

23
Q

Ipratropium: class and clinical use

A

muscarinic antagonist: asthma, COPD

24
Q

Scopolamine: class and clinical use

A

muscarinic antagonist: motion sickness, sedation

25
Q

Benztropine: class and clinical use

A

muscarinic antagonist: parkinsons, dystonia

26
Q

Glycopyrrolate: class and clinical use

A

muscarinic antagonist: decrease airway secretions, drooling, etc

27
Q

Hyoscyamine: class and clinical use

A

muscarinic antagonist: antispasmodic in IBS

28
Q

Dicyclomine: class and clinical use

A

muscarinic antagonist: antispasmodic in IBS

29
Q

tiotropium: class and clinical use

A

muscarinic antagonist: asthma, COPD

30
Q

oxybutynin: class and clinical use

A

muscarinic antagonist: reduce bladder spasm in an overactive bladder

31
Q

solifenacin: class and clinical use

A

muscarinic antagonist: reduce bladder spasm in an overactive bladder

32
Q

tolterodine: class and clinical use

A

muscarinic antagonist: reduce bladder spasm in an overactive bladder

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