Chapter 15 - Cholinesterase Inhibitors

Question 1

Cholinesterase Inhibitors - def

Answer 1

prevent the breakdown of acetylcholine by acetylcholinesterase.

Question 2

Cholinesterase inhibitors are very specific. T/F?!

Answer 2

FALSE. They are not. Which means they should not be used as much for treatments.

Question 3

Two basic categories of cholinesterase inhibitors -

Answer 3

Reversible (short lasting) and Irreversible (Long lasting.)

Question 4

Reversible cholinesterase inhibitor - Name

Answer 4

Neostigmine

Question 5

Neostigmine - clinical applications - treats..

Answer 5

Myasthenia gravis - a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body.
Also treats reversal of nondepolarizing neuromuscular blockade, glaucoma, and Alzheimer’s.

Question 6

Neostigmine - carries a ___ charge.

Answer 6

+.

Question 7

Neostigmine __ transmission at all junctions where ACH is the transmitter.

Answer 7

intensifies.

Question 8

Acetylcholine + Cholinesterase/H20 =

Answer 8

Choline + Acetic Acid.

Question 9

Pharmacokinetics - Neostigmine -

Answer 9

Oral or Injection. Oral must be much larger than parenteral. Lasts 2-4 hours.

Question 10

Therapeutic Use - Neostigmine -

Answer 10

treatment of Myasthenia Gravis.

Question 11

Neostigmine - Adverse Effects

Answer 11

Excessive salivation, increased gastric secretions, urinary urgency, etc.

Question 12

Irreversible Cholinesterase Inhibitors - clinical applications

Answer 12

Same action as reversible cholinesterase inhibitors, are longer acting, used primarily in the treatment of glaucoma, and commonly found in insecticides.

Question 13

All irreversible cholinesterase inhibitors contain an atom of ____

Answer 13

phosphorus.

Question 14

Irreversible Cholinesterase Inhibitors are __ lipid soluble.

Answer 14

highly.

Question 15

Irreversible Cholinesterase Inhibitors - prototype drug?

Answer 15

Echothiophate

Question 16

Poisoning of Organophosphate-Cholinesterase Inhibitors - Symptoms

Answer 16

Overdose of cholinesterase inhibitors can produces a state of cholinergic crisis (excessive muscarinic stimulation and neuromascular blockade.)

Question 17

Treatment for Poisoning of Organophosphate-Cholinesterase Inhibitors -

Answer 17

oxygen, mechanical ventilation, atropine

Question 18

Myasthenia Gravis - def

Answer 18

neuromuscular disorder characterized by muscle weakness and rapid fatigue.

Question 19

Symptoms of Myasthenia Gravis -

Answer 19

ptosis - drooping eyelids. difficulty breathing, symptoms result from autoimmune disorder disorder due to Ab’s formed against nicotinic, receptors on skeletal muscles….

Question 20

Treatment for Myasthenia Gravis -

Answer 20

neostigmine.

Question 21

Myasthenic Crisis - def - occurs when…

Answer 21

occurs when clients are inadequately medicated 9 insufficient Ach at NMJ.

Question 22

Cholinergic crisis - def - caused by…

Answer 22

overdose of cholinesterase inhibitor. Treated by….respiratory support and atropine.