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Pharm > Chapter 7-8: Indirect Acting Cholinomimetics > Flashcards

Chapter 7-8: Indirect Acting Cholinomimetics Flashcards

Test 2

1
Q

Describe Indirect acting Cholinomimetics

A

block acetylcholinesterase

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2
Q

Name the 3 types of Indirect acting Cholinomimetics

A
  1. Simple Alcohols: Edrophonium
  2. Carbamic acid esters of alcohol: Carbamates and -stigmine
  3. Organic derivatives of phosphoric acid: organophosphate
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3
Q

T/F: Simple acids lasts for a long time

A

F

Short time

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4
Q

Describe Organophosphates

A

Last for long time
can form covalent bonds

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5
Q

What medication is used for MG Dx testing?
What is the DOA?

A

Edrophonium (Simple alcohol)

5-15 mins

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6
Q

What 2 drugs treat MG? What is the DOA?

A

Neostigmine - 0.5-2 hrs
Pyridostigmine - 3-6 hrs

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7
Q

What is the Tx for Glaucoma? DOA? Classification?

A

Echothiophate

100 hours

Organophosphate

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8
Q

How fast do Indirect acting Cholinomimetics work?

A

150 mircoseconds

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9
Q

Organophosphate form _______ bonds in the active site with _______

A

Covalent

Phosphorous

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10
Q

What drug can break the covalent bond with organophosphates?

A

Pralidoxime

If given within the 1st few hours

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11
Q

Explain the MG diagnostic testing process

A

2mg IV Edrophonium - watch for negative side effect

8mg IV - watch for improvement to see if other Indirect acting Cholinomimetics will work

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12
Q

What are side effects of direct acting muscarinic overdose?

A

(-ine, choline esters, colorful mushrooms)

SLUDGEM!!!!!!

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13
Q

What is SLUDGEM

A

Salivation
Lacrimation
Urination
Defication
GI motility
Emesis
Miosis

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14
Q

What is the Tx for direct acting muscarinic SLUDGEM symptoms?

A

ATROPINE

or Pralidoxime

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15
Q

Describe Toxicity in direct acting nicotinic stimulants

A

40mg is fatal
Want to induce vomiting
usually child eating cigarettes
S/S: HA, N/V, Dizziness, Breathlessness, Collapse, LOC

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16
Q

What is a Cholinoceptor Blocking agent?

A

Cholinergic receptor blockers:

Antimuscarinic/Antinicotinic

or muscarinic/nicotinic antagonist

Blocks effects of natural ligands of the SNS and PNS at these receptors

17
Q

What is the Amanita phalloides?

A

“Deadly nightcap”

Noncolorful mushroom
inhibits mRNA synthesis
causes death within 4-7 days

18
Q

What is the antimuscarinic prototype?

A

Atropine

19
Q

Describe Atropine

A

Antimuscarinic
Plant based alkaloid
Racemic mixture of D and L

20
Q

In racemic atropine, the L isomer is ______ times more potent than the D isomer

A

100x

21
Q

What does belladonna mean?

A

Beautiful woman

22
Q

What does atropine or another plant based alkaloid do to the pupils?

A

dilate

23
Q

Describe Scopolamine

A

Antimuscarinic

Tx of motion sickness
very lipid soluble (patch)

Similar to atropine but shorter DOA

24
Q

Indications for antimuscarinics

A

block overproduction of PNS

25
Q

What is Atrovent

A

inhalant antimuscarinic – bronchodilating effects
Tx of asthma/COPD bronchospasms

26
Q

What is Cycloplegia?

A

Happens when you take a med that dilates your pupils

Paralysis of ciliary muscle

attaches to ciliary cords that hold lense in place and cant switch from near/far vision (accommodation)

Dont drive

27
Q

What drug is used by the eye doctor to dilate the pupils? DOA?

A

Tropicamide

4-6 hrs

28
Q

Summary of atropine effects: urine, HR, Eye, Salivation

A

Urine: decrease
HR: increase
Eye accommodation: decrease
Salivation: decrease

29
Q

Contraindications for antimuscarinics

A

Glaucoma (open/closed)
Elderly men (d/t BPH)

30
Q

Muscle relaxants =

A

Neuromuscular blocking drugs

31
Q

Where and how do muscle relaxants work?

A

Block nAch-R at the NMJ skeletal muscle end plate

32
Q

describe ion flow in nAch-R

A

Na+ floods in
Ca++ slowly comes in
K+ comes out

33
Q

What is Succinylcholine?

A

Depolarizing muscle relaxant

contracts onces, then relaxes and stays there

wont repolarize

34
Q

Nondepolarizing muscle relaxants are ________derivatives

A

curare

35
Q

How does non depolarizing muscle relaxants work?

A

by outcompeting Ach and blocking the actual channel

1 alpha subunit only needs to be blocked

36
Q

Depolarizing muscle relaxant clinical use and name:

A

Succs

Intubation

37
Q

Succs side effects (important ones only)

A

Hyperkalemia
MH
Apnea

38
Q

Name a few nondepolarizing muscle relaxants

A

Pancuronium - long acting

Atracurium - intermediate

Mivacurium - short

39
Q

Name 2 neuromuscular blockers reversals

A

Sugammadex
Neostigmine

Pharm (30 decks)

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