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PHARMACOLOGY (2nd year) > AUTONOMIC DRUGS > Flashcards

AUTONOMIC DRUGS Flashcards

1
Q
  1. The parasympathetic preganglionic fibers leave the CNS through
    these cranial nerves
    A. 1, 5, 9, 10
    B. 10, 3, 7, 9
    C. 3, 7, 5, 10
    D. 2, 7, 10, 5
    E. None of the above
A

ANSWER: B. 10, 3, 7, 9. The parasympathetic preganglionic
fibers leave the CNS through the cranial nerves (CN 3:
Oculomotor, CN 7: Facial, CN 9: Glossopharyngeal, and CN 10:
Vagus).

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2
Q
  1. The primary receptor type of autonomic ganglia
    A. Cholinergic: nicotinic
    B. Cholinergic: muscarinic
    C. Adrenergic: beta 1
    D. Adrenergic: beta 2
    E. Dopaminergic: D1-5?
A

ANSWER: A. Cholinergic: nicotinic.

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3
Q
  1. Most thoracolumbar preganglionic fibers are?
    A. Short
    B. Long
    C. In networks
    D. Connected to organs
    E. None of the above
A

ANSWER: A. Short. Most thoracic and lumbar sympathetic
preganglionic fibers are short and terminate in ganglia located
in the paravertebral chains that lie on either side of the spinal
column. Most of the remaining sympathetic preganglionic fibers
are somewhat longer and terminate in prevertebral ganglia,
which lie in front of the vertebrae, usually on the ventral surface
of the aorta.

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4
Q
  1. Cholinergic drugs act on receptors normally stimulated by?
    A. Norepinephrine
    B. Acetylcholine
    C. Epinephrine
    D. Dopamine
    E. None of the above
A

ANSWER: B. Acetylcholine

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5
Q
  1. It catalyzes the rate-limiting step in catecholamine biosynthesis
    A. L-amino acid decarboxylase
    B. Dopamine beta-hydroxylase
    C. Phenylethanolamine-N-methyl transferase
    D. Tyrosine hydroxylase
    E. Dopa decarboxylase
A

ANSWER: D. Tyrosine hydroxylase catalyzes the rate-limiting
step in the biosynthesis of catecholamines, the conversion of
Tyrosine to Dopa.

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6
Q
  1. Parasympathetic direct cardiac effects?
    A. Decrease heart rate, decrease contractility
    B. Increase heart rate, increase contractility
    C. Increase AV nodal conduction velocity
    D. Decrease heart rate, increase contractility
    E. Increase heart rate, decrease contractility
A

ANSWER: A. Decrease heart rate, decrease contractility

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7
Q
  1. Drug that prevents the storage of acetylcholine in synaptic
    vesicle?
    A. Botulinum toxin
    B. Vesamicol
    C. Metyrosine
    D. Tetrodotoxin
    E. None of the above
A

ANSWER: B. Vesamicol. Acetylcholine (ACh) is transported into
the storage vesicle by a vesicle-associated transporter (VAT),
which can be inhibited by vesamicol.

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8
Q
  1. The rate-limiting step in catecholamine biosynthesis can be
    blocked by?
    A. Botulinum Toxin
    B. Hemicholinium
    C. Synaptosomal nerve-associated membrane proteins
    D. Metyrosine
    E. Vesamicol
A

ANSWER: D. Metyrosine.
see figure

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9
Q
  1. The acetylcholine vesicle release process can be blocked by?
    A. Hemicholinium
    B. Vesamicol
    C. Botulinum toxin
    D. Vesicle-associated membrane proteins
    E. Synaptosomal nerve-associated membrane proteins
A

ANSWER: C. Botulinum toxin. The resulting increase in
intracellular calcium causes fusion of vesicles with the surface
membrane and exocytotic expulsion of acetylcholine and
cotransmitters into the junctional cleft. This step can be blocked
by botulinum toxin.

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10
Q
  1. In the cytoplasm, acetylcholine is synthesized from choline and
    Acetyl-CoA by what enzymes?
    A. Acetylcholinesterase
    B. Choline acetyltransferase
    C. Vesicle associated transporter
    D. Phenylethanolamine-N-methyltransferase
    E. None of the above
A

ANSWER: B. Choline acetyltransferase. Acetylcholine (ACh) is
synthesized in the cytoplasm from acetyl-CoA and choline
through the catalytic action of the enzyme choline
acetyltransferase (ChAT).

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11
Q
  1. This drug can block the reuptake of noradrenergic transmitters
    into the nerve terminal
    A. Reserpine
    B. Cocaine
    C. Guanethidine
    D. Metyrosine
    E. Bretylium
A

ANSWER: B. Cocaine. NET can be inhibited by cocaine and
certain antidepressant drugs, resulting in an increase of
norepinephrine activity in the synaptic cleft.

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12
Q
  1. Rate limiting step in acetylcholine synthesis
    A. Availability of acetate
    B. Choline acetate activity
    C. Choline uptake
    D. Vesicular protein synthesis
    E. Acetylcholinesterase activity
A

ANSWER: A. Availability of acetate

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13
Q
  1. Inhibits choline transfer into cholinergic vesicles
    A. Atropine
    B. Bretylium
    C. Reserpine
    D. Vesamicol
    E. All of the above
A

ANSWER: D. Vesamicol

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14
Q
  1. Influx of this ion promotes fusion between axoplasmic
    membrane and nearby vesicles
    A. Potassium
    B. Chloride
    C. Calcium
    D. Sodium
    E. All of the above
A

ANSWER: C. Calcium. Release of transmitters occurs when
voltage-sensitive calcium channels in the terminal membrane
are opened, allowing an influx of calcium. The resulting increase
in intracellular calcium causes fusion of vesicles with the surface
membrane and exocytotic expulsion of acetylcholine and cotransmitters into the junctional (synaptic) cleft.

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15
Q
  1. Which is not a choline ester?
    A. Arecoline
    B. Acetylcholine
    C. Bethanechol
    D. Carbachol
    E. Methacholine
A

ANSWER: A. Arecoline. Acetylcholine and methacholine are
acetic acid esters of choline and β-methylcholine, respectively.
Carbachol and bethanechol are carbamic acid esters of the same
alcohols.

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16
Q
  1. Which among the following choline ester drugs is the most
    susceptible to hydrolysis by the enzyme cholinesterase?
    A. Arecoline
    B. Carbachol
    C. Acetylcholine
    D. Metacholine
    E. Bethanecol
A

ANSWER: C. Acetylcholine.

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17
Q
  1. Which among the following choline ester drugs has the most
    muscarinic action?
    A. Acetylcholine
    B. Bethanecol
    C. Carbachol
    D. Methacholine
    E. Arecoline
A

ANSWER: D. Methacholine. See above table.

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18
Q
  1. This direct-acting cholinomimetic drug is used for postoperative
    ileus and urinary retention?
    A. Pilocarpine
    B. Carbachol
    C. Arecoline
    D. Bethanecol
    E. Nicotine
A

ANSWER: Bethanecol

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19
Q
  1. Effects of direct-acting cholinoceptor stimulants except?
    A. Sinoatrial node: positive chronotropy
    B. Bronchial muscles: bronchoconstriction
    C. Sphincter muscle of iris: miosis
    D. Gastrointestinal tract motility: increase
    E. All are correct
A

ANSWER: A. Sinoatrial node: positive chronotropy

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20
Q
  1. The ff are indirect acting cholinomimetic drugs except
    A. Acetylcholine
    B. Neostigmine
    C. Echothiophate
    D. Edrophonium
    E. Carbaryl
A

ANSWER: A. Acetylcholine is a direct-acting cholinomimetic
drug.

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21
Q
  1. The following are effects of anticholinesterase except?
    A. Miosis
    B. Bradycardia
    C. Reduced muscle contraction
    D. Hypersalivation
    E. All are correct
A

ANSWER: C. Reduced muscle contraction. Anticholinesterases
aka cholinesterase inhibitors block the degradation of
acetylcholine and thereby prolong its action. Because the
primary action is to amplify the actions of endogenous
acetylcholine, the effects are similar (but not always identical)
to the effects of the direct-acting cholinomimetic agonists.

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22
Q
  1. Long-term therapy for myasthenia gravis is usually
    accomplished with?
    A. Pyridostigmine
    B. Physostigmine
    C. Neostigmine
    D. Edrophonium
    E. Echothiophate
A

ANSWER: A. Pyridostigmine. Edrophonium is for acute
treatment only. While both pyridostigmine and neostigmine are
both used for treatment of myasthenia gravis, pyridostigmine
has a longer duration of action (4-6 hours).

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23
Q
  1. This anticholinesterase organophosphate drug was used as an
    ophthalmic solution for treating glaucoma?
    A. Neostigmine
    B. Echothiophate
    C. Edrophonium
    D. Physostigmine
    E. Pyridostigmine
A

ANSWER: B. Echothiophate. See above table.

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24
Q
  1. Which of the following reversible cholinesterase inhibitor is not
    used in the treatment of myasthenia gravis?
    A. Physostigmine
    B. Pyridostigmine
    C. Neostigmine
    D. Edrophonium
    E. All drugs can be used
A

ANSWER: A. Physostigmine is used for anticholinergic
poisoning. Refer to #23 table.

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25
Q
  1. Anticholinesterase used for atropine intoxication
    A. Neostigmine
    B. Physostigmine
    C. Pyridostigmine
    D. Echothiophate
    E. NOTA
A

ANSWER: B. Physostigmine is used for anticholinergic
poisoning

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26
Q
  1. Effect of Atropine on the heart?
    A. Tachycardia
    B. Bradycardia
    C. Hypercapnia
    D. Bradyarrhythmia
    E. No effect on the heart
A

ANSWER: A. Tachycardia. Atropine will increase the heart rate.

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27
Q
  1. Atropine is previously used prior to general anesthesia to reduce
    A. Nausea and vomiting
    B. Muscle tone
    C. Oral secretions
    D. Anxiety
    E. All of the above
A

ANSWER: C. Oral secretions. The use of atropine became part
of routine preoperative medication when anesthetics such as
ether were used, because these irritant anesthetics markedly
increased airway secretions and were associated with frequent
episodes of laryngospasm. Preanesthetic injection of atropine or
scopolamine could prevent these hazardous effects.

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28
Q
  1. Which of the following antimuscarinic drug is often effective in
    preventing or reversing vestibular disturbances especially
    motion sickness?
    A. Homatropine
    B. Atropine
    C. Benztropine
    D. Tropicamide
    E. Scopolamine
A

ANSWER: E. Scopolamine. Certain vestibular disorders respond
to antimuscarinic drugs (and to antihistaminic agents with
antimuscarinic effects). Scopolamine is one of the oldest
remedies for seasickness and is as effective as any more recently
introduced agent.

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29
Q
  1. The following are clinical uses of muscarinic blocking drugs
    except?
    A. Parkinson’s disease
    B. Hypertension
    C. COPD
    D. Hypermotility
    E. Prevention of synechia
A

ANSWER: B. Hypertension. The sinoatrial node is very sensitive
to muscarinic receptor blockade. Moderate to high therapeutic
doses of atropine cause tachycardia in the innervated and
spontaneously beating heart by blockade of vagal slowing.

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30
Q
  1. Oxybutynin that is used to relieve bladder spasm after
    prostatectomy, is somewhat selective to what specific receptor?
    A. M1
    B. M2
    C. M3
    D. M4 and M5
    E. AOTA
A

ANSWER: C. M3

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31
Q
  1. The prototype drug for parasympatholytic group is?
    A. Homatropine
    B. Atropine
    C. Scopolamine
    D. Dicyclomine
    E. Glycopyrrolate
A

ANSWER: B. Atropine

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32
Q
  1. The definitive treatment for organophosphate poisoning is?
    A. Atropine
    B. Ipratropium
    C. Physostigmine
    D. None of the above
A

ANSWER: A. Atropine. Treatment: 1–2 mg of Atropine sulfate
may be given intravenously every 5–15 minutes until signs of
effect (dry mouth, reversal of miosis) appear.

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33
Q
  1. Primary effects of muscarinic blocking agents except
    A. Miosis
    B. Bronchodilation
    C. Decreased salivary secretion
    D. Increased heart rate
    E. Mydriasis
A

ANSWER: A. Miosis. The primary effect in the eye is mydriasis
(dilation).

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34
Q
  1. This drug directly interacts with and activate adrenoreceptors
    A. Tricyclic antidepressants
    B. Tyramine
    C. Epinephrine
    D. Cocaine
    E. COMT inhibitors
A

ANSWER: C. Epinephrine

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35
Q
  1. This drug induces the release of catecholamines by displacing
    them from adrenergic nerve endings
    A. Monoamine oxidase inhibitors
    B. Tyramine
    C. Tricyclic antidepressants
    D. Cocaine
    E. Norepinephrine
A

ANSWER: B. Tyramine. Induce release of catecholamines by
displacing them from adrenergic nerve endings is the
mechanism of action of Tyramine.

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36
Q
  1. Vasopressor of first choice in the management of shock?
    A. Dopamine drip
    B. Epinephrine
    C. Norepinephrine drip
    D. Dobutamine drip
A

ANSWER: C. Norepinephrine.

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37
Q
  1. Alpha 2 receptor agonist that is used in the treatment of
    hypertensive emergency?
    A. Clonidine
    B. Oxycarbamazine
    C. Ipratropium
    D. Dobutamine
    E. Phenylephrine
A

ANSWER: A. Clonidine. Clonidine, Methyldopa (for pregnant
with high bp), Guanfacine and Guanabenz are useful in the
treatment of hypertension. Dobutamine is used as a
pharmacologic cardiac stress test. Phenylephrine increases BP
without increasing heart rate. Ipratropium is an anticholinergic
drug

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38
Q
  1. Adverse effects from using phenoxybenzamine includes all of
    the following except:
    A. Inhibition of ejaculation
    B. Bradycardia
    C. Orthostatic hypotension
    D. Nasal stuffiness
    E. Sedation
A

ANSWER: B. Bradycardia. Adverse effects of
Phenoxybenzamine: (a) Orthostatic hypotension and
Tachycardia (b) Nasal stuffiness and inhibition of ejaculation (c)
Enters the CNS – may cause fatigue, sedation and nausea.

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39
Q
  1. Which of the following alpha receptor blocker does not
    dissociate from receptors and the block cannot be surmounted
    with sufficiently high concentrations of agonists?
    A. Labetalol
    B. Phentolamine
    C. Phenoxybenzamine
    D. Prazosin
    E. All of the above
A

ANSWER: C. Phenoxybenzamine. Phenoxybenzamine is an
irreversible drug that do not dissociate and cannot be
surmounted. Phentolamine and Prazosin are reversible
antagonists that dissociate from receptors and the block can be
surmounted with sufficiently high concentrations of agonists.
Labetalol is a beta-receptor blocker

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40
Q
  1. Selective alpha antagonist like prazosin, terazosin, alfuzosin and
    tamsulosin are indicated in?
    A. Benign prostatic hyperplasia
    B. Hypertensive emergencies
    C. Pheochromocytoma
    D. Erectile dysfunction
    E. All of the above
A

ANSWER: A. Benign Prostatic Hyperplasia (BPH)

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41
Q
  1. An alpha-adrenoceptor antagonist that was used in the
    treatment of male erectile dysfunction is?
    A. Phentolamine
    B. Prazosin
    C. Yohimbine
    D. Labetalol
    E. None of the above
A

OTHERTERM- SILDENAFIL
ANSWER: C. Yohimbine. Treat male erectile dysfunction but has
been superseded by phosphodiesterase-5 inhibitors like

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42
Q
  1. An alpha-adrenoceptor antagonist that was used in the
    treatment of male erectile dysfunction is?
    A. Phentolamine
    B. Prazosin
    C. Yohimbine
    D. Labetalol
    E. None of the above
A

ANSWER: C. Yohimbine. Treat male erectile dysfunction but has
been superseded by phosphodiesterase-5 inhibitors like
sildenafil.

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43
Q
  1. An ultra-short-acting beta 1-selective adrenoreceptor
    antagonist that is rapidly metabolized by esterases in red blood
    cell
    A. Esmolol
    B. Atenolol
    C. Nadolol
    D. Timolol
    E. None of the Above
A

ANSWER: A. Esmolol. Ultra-short-acting beta 1-selective
adrenoceptor antagonist. Esterases in red blood cells rapidly
metabolize esmolol to a metabolite that has a low affinity for
beta receptors. Metoprolol and Atenolol preferable in patients
with diabetes or peripheral vascular disease when therapy with
a beta blocker is required. Nadolol has a very long duration of
action. Timolol has excellent ocular hypotensive effects when
administered topically in the eye.

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44
Q
  1. Immediate precursor in the synthesis of noradrenaline?
    A. Midodrine
    B. Adrenaline
    C. Epinephrine
    D. Dopamine
A

ANSWER: D. Dopamine. Tyrosine is converted to dopamine and
transported into the vesicle by VMAT, which can be blocked by
reserpine and tetrabenzine. Dopamine is converted to
norepinephrine in the vesicle by dopamine-beta-hydroxylase.

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45
Q
  1. Most highly selective beta 1-adrenergic receptor blocker?
    A. Timolol
    B. Nadolol
    C. Nebivolol
    D. Labetalol
    E. Carvedilol
A

ANSWER: C. Nebivolol.

46
Q
  1. Beta-receptor antagonist drug with the longest duration of
    action?
    A. Levobunolol
    B. Betaxolol
    C. Metoprolol
    D. Atenolol
    E. Nadolol
A

ANSWER: Nadolol

47
Q
  1. Propranolol, which is a beta 1 and 2 adrenoceptor antagonist, is
    indicated for the ff diseases except:
    A. Migraine
    B. Glaucoma
    C. Arrythmia
    D. Bronchial asthma
    E. Angina pectoris
A

ANSWER: D. Bronchial asthma

48
Q
  1. The following are beta 1 selective antagonist except?
    A. Timolol
    B. Esmolol
    C. Propranolol
    D. Atenolol
    E. All of the above is correct
A

ANSWER: A. Timolol / C. Propranolol both has no selectivity.

49
Q
  1. The prototype beta-receptor antagonist drug?
    A. Metoprolol
    B. Atenolol
    C. Timolol
    D. Propranolol
    E. Nadolol
A

ANSWER: D. Propranolol

50
Q
  1. Preferred beta blocker drug for patients with diabetes or
    peripheral vascular disease
    A. Propranolol
    B. Esmolol
    C. Metoprolol
    D. Nadolol
    E. None of the above
A

ANSWER: C. Metoprolol. Metoprolol and Atenolol preferable in
patients with diabetes or peripheral vascular disease when
therapy with a beta blocker is required.

51
Q
  1. The primary transmitter at ANS ganglia, at the somatic neurons
A

ANSWER: Acetylcholine

52
Q
  1. The primary transmitter at most sympathetic postganglionic
    neurons
A

ANSWER: Norepinephrine

53
Q

Sympathetic Nervous System – originates from thoracolumbar

A

(Thoracic 1-T12 and L1-L2)

54
Q

Parasympathetic – originates from Craniosacral

A

(CN 3- Oculomotor, CN 7- Facial, CN 9- Glossopharyngeal, CN 10- Vagus)

55
Q

Five Key Features of Neurotransmitter Function

A

(SSR-TR)
1. SYNTHESIS
2.STORAGE
3.RELEASE
4.TERMINATION OF ACTION OF THE TRANSMITTER
5.RECEPTOR EFFECTS

56
Q

There are two types of transmission:

A

1.CHOLINERGIC TRANSMISSION
2.ADRENERGIC TRANSMISSION

57
Q

involves the transmission of Acetylcholine

A

CHOLINERGIC TRANSMISSION

58
Q

involves release of Norepinephrine/Noradrenaline

A

ADRENERGIC TRANSMISSION

59
Q

WHAT TYPE OF TRANSMISSION
Choline is transported into the cytoplasm at the terminal button by a sodium-dependent choline transporter (CHT). This symporter can be blocked by research drugs called ___

A

CHOLINERGIC TRANSMISSION

HEMICHOLINIUMS

60
Q

Once the acetylcholine is formed, it must be stored inside a vesicle by a vesicle-associated transporter (VAT).

A

inhibited by VESAMICOL

61
Q

inhibit the release of stored choline

A

BOTULINUM TOXIN

62
Q

Once the acetylcholine is released in the synaptic cleft, it will be degraded by____ and others would bind on cholinergic receptors and others will go back into the nerve by the acetylcholine autoreceptors.

A

acetylcholinesterase (AChE)

63
Q

Tyrosine is transported into the noradrenergic nerve ending by a sodium-dependent carrier.

A

ADRENERGIC TRANSMISSION

64
Q

Tyrosine is converted to dopamine by the rate limiting enzyme ____ and it can be blocked by ____

A

Tyrosine is converted to dopamine by the rate limiting enzyme tyrosine hydroxylase and it can be blocked by metyrosine

65
Q

From dopamine it will converted into norepinephrine by
_______ and transported into the vesicle by the vesicular monoamine transporter (VMAT), which can be blocked by ______ and _____. The same carrier transports norepinephrine (NE) and several related amines into these vesicles.

A

—dopamine β-hydroxylase
—blocked by
reserpine and tetrabenazine.

66
Q

which blocks the vesicular monoamine transporter (VMAT)

A

RESERPINE
TETRABENZINE

67
Q

rate limiting enzyme in the convertion if tyrosine to dopamine

A

TYROSINE HYDROXYLASE

68
Q

in adrenergic transmission
After release, norepinephrine diffuses out of the cleft or is transported into the cytoplasm of the terminal by the norepinephrine transporter (NET), which can be blocked by ___________ and ____________

A

COCAINE
DEPRESSANTS

69
Q

CHOLINOCEPTOR

A
  1. MUSCARINIC
  2. NICOTINIC
70
Q

ADRENOCEPTOR

A
  1. alpha adrenoceptor
  2. beta adrenoceptor
  3. dopamine receptor
71
Q

Bind to and activate muscarinic or nicotinic receptors.

A

DIRECT-ACTING CHOLINOMIMETIC DRUGS

72
Q
  • Produce their primary effects by inhibiting
    acetylcholinesterase, which hydrolyzes acetylcholine to choline and acetic acid.
  • there will be an increase in the concentration of acetylcholine receptors in the synaptic cleft
A

INDIRECT-ACTING CHOLINOMIMETIC DRUGS

73
Q

SUSCEPTIBILITY TO CHOLINESTERASE

  1. Acetylcholine chloride
  2. Methacholine chloride
A

SUSCEPTIBILITY TO CHOLINESTERASE

  1. Acetylcholine chloride. ++++
  2. Methacholine chloride +
74
Q

MUSCARINIC ACTION

  1. Acetylcholine chloride
  2. Methacholine chloride
A

MUSCARINIC ACTION

  1. Acetylcholine chloride +++
  2. Methacholine chloride ++++

—In Methacholine chloride it is mostly in the muscarinic receptor that it will activate.

75
Q

NICOTINIC ACTION

  1. Acetylcholine chloride
  2. Methacholine chloride
A

NICOTINIC ACTION

  1. Acetylcholine chloride +++
  2. Methacholine chloride none
76
Q

When you inject acetylcholine in patients,
the heart rate and the contraction of the heart will ____.

increase or decrease?

A

DECREASE

77
Q

When you inject acetylcholine in your patients
what happens to the bronchial glands?

A

+there will be SECRETION

78
Q

The antidote for acetylcholine overdose is _____.
and will ____ the heart rate.
(increase or decrease)

A

ATROPINE
-INCREASE

79
Q

used as a diagnostic test for myasthenia gravis

A

EDROPHONIUM

80
Q

MYASTHENIA GRAVIS TREATMENT

A
  1. NEOSTIGMINE
  2. PYRIDOSTIGMINE
81
Q

Organic derivatives of phosphoric acid

A

ECHOTHIOPHATE

82
Q

In GLAUCOMA, the optic nerve is damaged due to increase intraocular pressure in the eyes.
The normal intraocular pressure is 10-21 mmHg.

VASODILATION
1. relieve ICP
2. decrease formation of aqeous humor
3. contract ciliary body to have outflow of aqeous humor

A

ECHOTHIOPHATE

83
Q

CHOLINOMIMETICS

A

• Treat diseases of the eye (glaucoma, accommodative
esotropia)
In glaucoma, the optic nerve is damaged due to increase intraocular pressure in the eyes. The normal intraocular pressure is 10-21 mmHg.
• Gastrointestinal and urinary tracts (postoperative atony, neurogenic bladder)
• Neuromuscular junction (myasthenia gravis, curare- induced neuromuscular paralysis)
• Treat patients with Alzheimer’s disease
• Treatment of Atropine overdosage
• Atrial arrhythmias (rare)

84
Q

decrease in ACETYLCHOLINE
to increase it give CHOLINOMIMETICS

A

ALZHEIMERS DISEASE

85
Q

Smoking cessation
Insecticides

A

Nicotine

86
Q

Post operative and neurogenic ileum
Urinary retention

A

Bethanechol

87
Q

GlaucOma
sjogrens syndrome

A

Pilocarpine

88
Q

(C-A-P)

CNS neurons,
autonomic postganglionic cell bodies
presynaptic sites

A

M1 RECEPTOR SUBTYPE

89
Q

(M-S)

Myocardium
smooth muscle organs

A

M2 RECEPTORS

90
Q

Effector cell membranes
- glandular
- smooth muscle cells

A

M3 RECEPTORS

91
Q

Î in CNS than Periphery

A

M4 & M5 RECEPTORS

92
Q

They block the effects of parasympathetic autonomic
discharge ( acetylcholine )

A

Muscarinic Antagonists
Antimuscarinic
Parasympatholytic

93
Q

Prototype

A

Atropine

94
Q

For asthma
COPD
Î airway

A

Tiotropium

95
Q

↓ lackimation

A

Glycopyprolate

96
Q

Mydriatic
Cycloplegic

A

Tropicamide

97
Q

Peptic disease
Hypermotility

A

Dicyclomine

98
Q

Î acetylcholine
↓ dopamine

A

Parkinson’s disease

99
Q

Combination of an antimuscarinic agent with a
dopamine precursor drug (LEVODOPA) provide an effective therapy

A

PARKINSONS DISEASE

100
Q

− Involve muscarinic cholinergic transmission
− Antimuscarinic drugs

A

MOTION SICKNESS

101
Q

treatment for Motion sickness

A

SCOPOLAMINE

102
Q

____ greatly facilitates ophthalmoscopic examination
of the retina
-Antimuscarinic agents (topically as eye drops or ointment)
-Prevent synechia (adhesion) formation in uveitis and iritis

A

MYDRIASIS

103
Q

CARDIOVASCULAR DISORDERS
a. Vasovagal attack (give __ to increase the heart rate)
b. Hyperactive carotid sinus reflexes
c. Graves’ disease (hyperthyroidism) also have such
antibodies that may facilitate the development of atrial
fibrillation.

A

ATROPINE
r related antimuscarinic agent

104
Q

COPD

A

(A-T-I-U) x -IUM
ACLIDINIUM
TIOTROPIUM
IPRATROPIUM
UMECLIDINIUM

105
Q

GASTROINTESTINAL DISORDERS
a. Peptic Ulcer Disease
b. Common traveler’s diarrhea
c. Other mild or self-limited conditions of hypermotility

A

Atropine + diphenoxylate (LOMOTIL)

106
Q

Bladder spasm after urologic surgery (prostatectomy)

A

OXYBUTYNIN (M3 RECEPTOR)

107
Q

Urinary incontinence

A

Propiverine (anti-muscarinic)

108
Q

Benign Prostatic Hyperplasia

A

α-adrenoceptor antagonist
combined with a muscarinic antagonist

109
Q

CHOLINERGIC POISONING
a. Cholinesterase inhibitor insecticides
b. Chemical warfare “nerve gases”
c. Organophosphorus poisoning

A

ATROPINE SULFATE

1–2 mg of Atropine sulfate
INTRAVENOUSLY every 5–15 minutes until signs of effect
( dry mouth, reversal of miosis) appear.

110
Q

Organophosphate poisoning and insecticide poisoning are treated with antimuscarinic drugs.
○ In insecticide poisoning, there is low heart rate, increased secretions, miotic, breathing problems due to bronchial secretions, and increased bronchial activity.

A

CHOLINERGIC POISONING

PHARMACOLOGY (2nd year) (18 decks)

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