Anti-cholinergic Flashcards

1
Q

List the action & cholinergic receptors at the different organs.

A
  1. iris
  2. ciliary muscle
  3. salivary glands
  4. lungs
  5. heart
  6. gallbladder
  7. stomach
  8. GIT
  9. bladder
  10. genitals
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2
Q

What’s the only cholinergic receptor for the sympathetic system?

A

Sweat glands – M3

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3
Q

How is anticholinergic used in Parkison’s disease?

A

(benzotropine) inhibit ACh produced by cholinergic interneurons which inhibit action of dopamine –> increase dopamine

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4
Q

Which is the muscarinic receptor involved in nausea vomiting?

A

M1 in CNS

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5
Q

Cholinergic neurons in Alzheimer’s disease

A

severely damaged–> neurodeg associated cognitive decline

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6
Q

2 types of cholinergic agonists

A

direct indirect

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7
Q

What are the indirect cholinergic agents?

A

acetylcholinesterase inhibitor
reversible - physostigmine, neostigmine, pyridostigmine
irreversible - SARIN, soman, tabun, parathion, malathion

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8
Q

What are the 2 classes of anticholinergic agents?

A
  1. direct

2. indirect

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9
Q

Direct anticholinergic drugs

A

MUSCARINIC

  1. atropine
  2. benzatropine
  3. scopolamine
  4. ipratropium
  5. oxybutynin

NICOTINIC

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10
Q

Indirect anticholinergic drugs

A

ganglionic blockers

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11
Q

3 direct cholinergic agents

A
  1. acetylcholine - degraded by acetylcholinesterase
  2. carbamate choline esters- resistant to AChE but broken down by other choline esterases
  3. alkaloids - not broken down by cholinesterase
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12
Q

Name the direct cholinergic drugs.

A

MUSCARINIC

  1. Pilocarpine
  2. Bethanechol (choline esters)

NICTOTINIC

  1. nicotine (alkaloids)
  2. varenicline (partial agonist)

*ACh - choline esters– target both receptors

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13
Q

Name the indirect REVERSIBLE cholinergic agents

A
  1. Physostigmine/donepezil
  2. Neostigmine
  3. Pyridostigmine
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14
Q

*Pilocarpine

MOA
Clinical uses
Adverse effects

A

x

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15
Q

*Bethanechol

MOA
Clinical uses
Adverse effects

A

x

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16
Q

*Nicotine

MOA 2,6
Clinical uses
Adverse effects

A

x

17
Q

Nicotine is also an…

A

x

18
Q

*Varenicline

MOA
Clinical uses
Adverse effects

A

x

19
Q

*Donepezil

MOA
Clinical uses
Adverse effects

A

x

20
Q

*Neostigmine

MOA
Clinical uses
Adverse effects -

A

x

21
Q

*Sarin

MOA
Clinical uses
Adverse effects

A

x

22
Q

x

A

x

23
Q

What is parathion/malathion used as?

A

x

24
Q

Autonomic symptoms of organophosphate poisoning SLUD

A

x

25
Q

Acute sarin poisoning manifests as…

A

x

26
Q

Antidote of sarin poisoning (2)

A

x

27
Q

*Pralidoxime

MOA
Clinical uses
Limitations

A

x

28
Q

x

A

x

29
Q

x

A

x

30
Q

Name the direct anticholinergic agents.

A
  1. atropine
  2. benzotropine
  3. scopolamine/ hyoscine
  4. ipratropium
  5. oxybutynin
31
Q

Adverse effects of muscarinic antagonism

A

x

32
Q

*Atropine

MOA
Clinical uses
Adverse effects

A

x

33
Q

*Benzotropine

MOA
Clinical uses
Adverse effects

A

x