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Pharm Test 2 > Anticholinergic > Flashcards

Anticholinergic Flashcards

1
Q

Direct ags

A 
Ach
Carbachol
Bethanechol
Nicotine
Varenicline
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2
Q

Indirect-Acting ags

A

Neostigmine (t1/2 short)
Physostigmine
Donepezil
Sarin (t1/2 long)

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3
Q

Ach Release Blocker

A

Botulinium toxin

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4
Q

Muscarinic blocker

A

Atropine

Ipratropium

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5
Q

Nicotinic Blockers

A

Trimethaphan
Vecuronium
Succinylcholine

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6
Q

AchE reactivator

A

Pralidoxime

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7
Q

Muscarinic ags

Uses

A

Overcoming postop paralytic ileus = from atropine, opioids

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8
Q

Muscarinic ags

SE

A

HypoTN
Diarrhea
Vomiting
Bronchial constriction

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9
Q

Muscarinic Ags

Contraindication

A 
Asthma
Heart condition
Peptic ulcer
GI
Urinary Tract Obstruction
Hyperthyroidism
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10
Q

Glaucoma = Primary open angle

Tx

A

Carbachol

Constrict iris/ciliary muscle

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11
Q

Preanesthetic meds

A

Atropine

Reduce secretions

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12
Q

Need bronchodilation in COPD

A

Ipratroprium

Muscarinic Antags

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13
Q

Neuronal nicotinic receptor - where?

A

Post gangionic sympa + parasympa

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14
Q

Nicotinic Receptors

Postsynaptic function

A
  • depols

* excitation of neurons/muscle

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15
Q

Nicotinic Receptors

Presynaptic

A

Enhance release of NTs in CNS

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16
Q

Nicotinic agonists

Vecuronium to (receptor)

A

Nm (skeletal muscle)

17
Q

Nicotinic antags

Trimpethaphan

A

A3B2 (ganglion)

18
Q

Nicotine

How pass thru BBB?

A

Uncharged
Bind to presynaptic receptor = release NT

Nicotinic ag

19
Q

Removing public smoking reduces admissions for

A

Acute Coronary Syndrome in NON-SMOKERS

20
Q

Addictions stimulate ______Pathway

A

Midbrain reward pathway (up dopa in nucleus accumbens)

21
Q

Receptors on nicotic-target neuron to nucleus accumbens

22
Q

Nicotine stimulates what PERIPHERALLY?

A
  • all autonomic ganglia + adrenal medulla

* UP BP + HR

23
Q

Smoking cessation tx

A
  • Nicotine
  • Varenicline = A4B2 partial ag (blocks nicotine)
  • Buprorion
  • Counseling/support = make sure they are READY first
24
Q

Indirect Cholinergic Ags

Mech

25
Q

Indirect Cholinergic Ags

Low/moderate doses =

A

enhance ACh action = Muscarinic receptors

*NO EFFECT = vascular smooth muscle/BP (no cholinergic innervation)

26
Q

What Rx diagnoses MG?

A

INDIRECT CHOL AG (ANTI-AchE)

Edrophonium

27
Q

Glaucoma: Rx

A

Physostigmine

Anti-AchE

28
Q

What is similar to physostigmine, but CAN’T cross BBB?

A

Neostigmine

29
Q

Myesthenia Gravis Tx

A

Neostigmine

+Atropine (buffer unwanted muscarinic receptor activation)

30
Q

How reverse Vecuronium? (skeletal muscle blocker)

A

Neostigmine

31
Q

Alzheimer’s Tx

A

Donepezil
(Anti-AchE)

1 per day, crosses BBB
decreases enzyme activity 40%
CAN’T SLOW PROGRESSION

32
Q

Irreversible Anti-AchEs

Rx + symptoms

A

Sarin
Parathion

SLUDGE
Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis

33
Q

Tx Sarin gas/Parathion

A

Atropine (Block muscarinic)

Pralidoxime (reactivate AchE)

34
Q

Which blocks nicotinic ganglion? (Sympa, para, adrenal)

A

Trimethaphan

Dissecting Aortic Aneurysm

35
Q

Vecuronium

A

PARALYZE skeletal muscle

  • no activation b/f block
  • highly charged, NO BBB cross
  • NO analgesia
  • REVERSE = Neostigmine + Atropine
36
Q

How to paralyze skeletal muscle?

A

Vecuronium

Succinylcholine

37
Q

Succinylcholine

A

*PARALYZE skeletal muscle
*activation b/f block
*NO REVERSE w/ neostigmine (AchE metab)
*Use: rapid sequence induction intubation ER
SE = hyperkalemia, arrythmia

38
Q

Rapid Sequence Induction Intubation ER

Rx?

A

Succinylcholine

39
Q

Botulinum Toxin

A

Block release of Ach by cleaving SNAP 25 (presynapse)

Pharm Test 2 (13 decks)

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