Chapter 18: Cholinesterase Inhibitors and Their Use in Myasthenia Gravis

Question 1

Myasthenia Gravis

Answer 1

• autoimmune process in which antibodies attack nicotine receptors on skeletal muscles
• characterized by fluctuating muscle weakness and predisposition to rapid fatigue

Question 2

Myasthenia Gravis Common Symptoms

Answer 2

• ptosis, dysphagia, and weakness of the skeletal muscles

Question 3

Myasthenia Gravis Treatment with cholinesterase inhibitors beneficial effects

Answer 3

• increased muscle strength

Question 4

Myasthenia Gravis Treatment with cholinesterase inhibitors side effects

Answer 4

• excessive muscarinic response

Question 5

sings of undermedication

Answer 5

ptosis and difficultly swallowing

Question 6

sings of overmedication

Answer 6

• excessive salvation

Question 7

Cholinergic crisis

Answer 7

• characterized by extreme muscle weakness or frank paralysis and signs of excessive muscarinic stimulation

Question 8

treatment for cholinergic crisis

Answer 8

• respitory support and atropine

Question 9

Myasthenic crisis

Answer 9

extreme muscle weakness,
- caused by insufficient ACh at the neuromuscular junction
- inadequate medication

Question 10

if a myasthenic crisis is left untreated

Answer 10

can result in dealth as a result of the paralysis of the muscles of respiration

Question 11

what is used to relieve a myasthenic crisis

Answer 11

Cholinerase inhibitor
- neostigmine

Question 12

Cholinesterase inhibitors

Answer 12

• drugs that prevent the degration of ACh by acetylcholinesterase

Question 13

why do cholinesterase inhibitors have limited therapeutic uses

Answer 13

• lack selectivity

Question 14

what are the therapeutic applications of cholinesterase inhibitors

Answer 14

• myasthenia gravis
• glucoma
• alzheimers disease
• parkinsons disease
• dementia
• muscarinic antagonist poisoning

Question 15

Pridostigmine [Mestinon] is used for

Answer 15

management of myasthenia gravis

Question 16

Pridostigmine [Mestinon] mechanism of action

Answer 16

• decreased the breakdown of ACh , to make it more avaliable

Question 17

Pridostigmine [Mestinon] side effects

Answer 17

• bradycardia, bronchial constriction, urinary urgency, increased granular secretions, increased tone and motility of GI tract, miosis, focusing of the lens for near vision

Question 18

Pridostigmine [Mestinon] neuromuscular effects for therapeutic doses

Answer 18

• increases force of contraction in the skeletal muscles

Question 19

Pridostigmine [Mestinon] neuromuscular effects for toxic doses

Answer 19

decrease force of contraction

Question 20

Pridostigmine [Mestinon] CNS effects for therapeutic doses

Answer 20

mild stimulation

Question 21

Pridostigmine [Mestinon] CNS effects for toxic doses

Answer 21

depression of the CNS

Question 22

Pridostigmine [Mestinon] precautions and contradictions

Answer 22

• obstruction of GI or urinary tract
• peptic ulcer disease, asthma

Question 23

Drugs for alzhemimers Disease

Answer 23

• Donepezil (Aricept)
• Galantamine (Reminyl)
• Rivastigmine (exelon)