Cholinergic Flashcards

1
Q

Acetylcholine (ACh)

A

Amine type: Quaternary
Receptor: Muscarinic
Uses: Rapid miosis, cataract surgery

Direct effects:

  • vasodilation (M3)
  • dec. cardiac rate (M2)
  • dec. rate of conduction SA & AV (M2)
  • dec. contractile force (M2)

Low dose:

  • vasodilation (M3)
  • reflex tachycardia
  • Inc. HR
  • dec. MAP & PVR

High dose:

  • vasodilation (M3)
  • bradycardia (M2)
  • dec. HR, MAP & PVR
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2
Q

Bethanechol

A
Amine type: Quaternary
Receptor: muscarinic agonist
Use:
- urinary bladder atony
- post-op & postpartum urinary retention
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3
Q

Carbachol

A
Amine type: quaternary 
Receptor: muscarinic agonist
Uses:
- Miosis
- Reduces intraocular pressure after cataract surgery
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4
Q

Methacholine

A

Amine: quaternary
Receptor: muscarinic agonist
Use:
- diagnosis of bronchial airway hyperreactivity

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5
Q

Pilocarpine

A
Amine: tertiary
Receptor: partial muscarinic agonist
Use:
- Acute angle-closure glaucoma (second line)
- Dry mouth, radiotherapy
- Dry mouth, Sjorgen's syndrome
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6
Q

Nicotine

A

Amine: tertiary
Receptor: selective agonist
Use:
- smoking cessation therapy

Low dose:
- ganglionic stimulation by depolarization

CV system: (sympathomimetic)
- inc. HR & BP

GI & Urinary tracts: (parasympathomimetic)

  • nausea
  • vomiting
  • diarrhea
  • voiding of urine

Secretions:
- stimulate salivary & bronchial

High doses:
- ganglionic blockade & neuromuscular blockade

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7
Q

Edrophonium

A
Amine: quaternary
Receptor: reversible
Use:
- diagnosis of Myasthenia Gravis
- reverse neuromuscular block
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8
Q

Physostigmine

A

Amine: tertiary
Receptor: NMJ
Use:
- overdoses of anticholinergic drugs

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9
Q

Neostigmine

A
Amine: quaternary
Receptor: NMJ
Use:
- postop urinary retention
- neuromuscular blockade reversal after surgery
- Myasthenia gravis
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10
Q

Pyridostigmine

A

Amine: quaternary
Receptor: NMJ
Use:
- Myasthenia gravis

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11
Q

Echothiophate

A

Amine:
Receptor:
Use:
- glaucoma, rarely

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12
Q

Malathion

A

Amine:
Receptor:
Use:
- insecticide

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13
Q

Sarin

A

Amine:
Receptor:
Use:
- synthetic toxic agent

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14
Q

Alzheimer Disease, mainstay therapy

A

AChE Inhibitors:

  • Donepezil
  • Rivastigmine
  • Galantamine
  • Pralidoxime (split phosphorus-enzyme bond)
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15
Q

Atropine

A
Amine: tertiary
Receptor: M2/M3 antagonists
Use:
- antispasmodic (GI & bladder)
- antidote for cholinergic agonists
- dec. respiratory secretions prior to surgery
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16
Q

Scopolomine

A
Amine: tertiary
Receptor: M3 antagonist
Use:
- mydriasis & cycloplegia diagnostic procedures
- nausea & vomiting
17
Q

Ipratropium

Tiotropium

A
Amine: quaternary
Receptor: M3 antagonist
Use:
- COPD
- Asthma
18
Q

Cyclopentolate
Homatropine
Tropicamide

A
Amine: tertiary
Receptor: M3 antagonist
Use:
- mydiasis, fundoscopy
- mydriasis w/cycloplegia
19
Q

Benztropine

Trihexyphenidyl

A
Amine: tertiary
Receptor: M3 antagonist
Use:
- Parkinson's disease
- Extrapyramidal effects of antipsychotic drugs
20
Q

Glycopyrrolate

A
Amine: quaternary
Receptor: M3 antagonist
Use:
- dec. secretions
- prevent bradycardia, surgical
- peptic ulcers, adjunctive
- severe drooling
21
Q

Oxybutynin

Tolterodine

A

Amine: tertiary
Receptor: M3 antagonist
Use:
- overactive bladder

22
Q

Hexamethonium

A
Ganglion blocker
Receptor: Nn
Use:
- HTN
- Research
23
Q

Mecamylamine

A

Ganglion blocker
Receptor: Nn
Use:
- HTN

24
Q

Tubocurarine

A
NMJ blocker
Amine: quaternary
Receptor: Nm
Use:
- Anaesthesia, surgery (relax skeletal muscle)
- Non-depolarizing

Adverse:
- malignant hyperthermia

25
Q

Succinylcholine

A
NMJ blocker
Amine: quaternary
Receptor: Nm
Use:
- rapid endotracheal intubation
- ECT

Adverse:
- malignant hyperthermia

26
Q

Hemicholinium-3

A

Amine:
Receptor:
Use:
- research

Inhibit ACh synthesis

Blocks CHT (prevents uptake of choline)

27
Q

Vesamicol

A

Amine:
Receptor:
Use:
- research

Inhibit ACh storage

Blocks ACh-H antiporter

28
Q

Botulinum toxin

BoTox

A
Amine:
Receptor:
Use:
- muscle spasms (blepharospasm)
- facial wrinkles 

Inhibits ACh release