Autonomic Written

Question 1

Direct acting cholinomimetics act by __

Answer 1

Stimulates Muscarinic receptors

Question 2

Mechanism of action of acetylcholine

Answer 2

Stimulates both muscarininc and Nicotinic
- small dose —> Muscarinic (blocked by Atropine)
- Large dose —> Nicotinic n ( blocked by G blocker) & Nicotinic m (blocked by Curare)

Question 3

Mechanism of action of physostigmine & Neostigmine

Answer 3

Indirect acting; inhibits choline estrase—> accumulation of endogenous acetylcholine

Question 4

Mechanism of organophosphrous compounds

Answer 4

• Act on choline estrase enzyme
• first is loose & reversible inhibition
• Then noncompetetive irreversible inhibition
• accumulation of acetylcholine —> Muscarinic and Nicotinic action
  But this action ends only when the body resynthesis

Question 5

Mechanism of organophosphrous compounds

Answer 5

• Act on choline estrase enzyme
• first is loose & reversible inhibition
• Then noncompetetive irreversible inhibition
• accumulation of acetylcholine —> Muscarinic and Nicotinic action
  But this action ends only when the body resynthesis

Question 6

Mechanism of action of oximes

Answer 6

• Reactivates choline estrase enzyme that is bound to organophosohorus compounds
• however, not effective in late stage due to because of enzyme aging

Question 7

Uses of Pilocarpine

Answer 7

1. Glaucoma + doesn’t produce eye twitches
2. Counteracts mydrasis of fundus examination
3. Promotes hair growth (VD)
4. Sialugoge —> increase saliva secretion in dry mouth

Question 8

Uses of physostigmine

Answer 8

-Treatment of Atropine poisoning
-Eye drops that do not cause twitches for glaucoma, counteract mydriasis, cut recent adhesions between iris & lens

Question 9

Uses of neostigmine

Answer 9

• Eye:Glaucoma
• GIT: paralytic ileus
• Urinary: post op urine retention
• skeletal muscles: myasthenia Gravis (both diagnosis & Treatment)
  -Antidote to Atropine toxicity

Question 10

Uses of Edrophonium

Answer 10

• Diagnosis of myasthenia gravis
• treatment of myasthenia crisis
• Diagnosis of cholinergic crisis
• Curare poisoning

Question 11

Uses for pyridostigmine & Ambenonium

Answer 11

Treatment of myasthenia gravis

Question 12

Uses for Rivastigmine

Answer 12

Treatment of Alzheimer’s

Question 13

Uses of Atropine

Answer 13

1. Preanesthetic medication:
   - counteract excess vagal tone
   - counteract morphine effect on Respiratory center
   - prevent bronchopneumonia & Lung collapse by reducing secretions
2. Vasovagal attack
3. CVS: Heart block
4. GIT: intestinal colic
5. Urinary: urinary colic

Question 14

Uses of Hyoscine

Answer 14

Preanesthetic medication that is better than Atropine because:
* Strong antisecretory
* No tachycardia