Cholinergic

Question 1

Cholinergic agents - direct acting cholinomimetics

Answer 1

Cholinergic agonist, express the same symptoms of parasympathetic nervous system

Question 2

Bethanenchol & pilocarpine

Answer 2

Muscarinic cholinergic receptor agonist. Direct acting
Bethanechol- treatment of gi/urinary bladder paralysis
Pilocarpine- treatment of glaucoma

Question 3

Nicotine

Answer 3

Nicotinic cholinergic receptor agonist.

Question 4

Glaucoma treatment (pilocarpine)

Answer 4

Muscarinic cholinergic receptor on ciliary muscle in eye. If you’re using a cholinergic agonist you relax the ciliary muscle, allow schlemms canal to open and allows pressure to go down.

Question 5

Why are antimuscarinic drugs contraindicated in patients with glaucoma

Answer 5

There is a Muscarinic cholinergic receptor on the iris that relaxes the muscle so the pressure in the eye can be reduced. If you block it with an antimuscarinic drug, you won’t get the relaxation

Question 6

Varenicline (chantix)

Answer 6

Reduced craving for and decreases pleasure effects from cigarettes PARTIAL AGONIST

Question 7

Indirect acting cholinomimetics (cholinergics)

Answer 7

PNS neostigmine (doesn’t pass bbb) - myasthenia gravis
Donepazil (passes bb and produces central effects) Alzheimer’s

Question 8

Indirect acting cholinomimetics mechanism of action

Answer 8

Acetylcholinesterase (achase) inhibitors - ACH accumulates in synapse and produces cholinergic response

Question 9

Neostigmine

Answer 9

Used to treat gi and urinary paralysis, glaucoma, myesthenia gravis , treatment of anticholinergic effects produced by other drugs like phenothiazines

Question 10

Donepezil

Answer 10

Used to treat systems of Alzheimer’s disease associated with loss of cholinergic control of short term memory. Not curative

Question 11

Memory foundation

Answer 11

Sensory inputs activate memory circuits “acquisition”, cholinergic pathways form short term memories, through repetition you develop new synaptic connections “consolidation” and that makes long term memories.

Alzheimer’s is associated with neuro degeneration of cholinergic pathways

Question 12

Myesthenia gravis Is an autoimmune disorder associated with destruction of what receptors ?

Answer 12

Nicotinic Cholinergic receptors at the neuromuscular junction of skeletal muscle

Question 13

Sarin nerve gas and parathione is an insecticide. What is the antidote for these ?

Answer 13

Pralidoxime (Pam) breaks chemical bonds between drugs and a chase (acetylcholinesterase)

Question 14

Describe causes and strategies that are used to treat life threatening state of cholinergic poisoning

Answer 14

If you give too much of a cholinergic agent the receptors are too saturated so they won’t produce a response. Cholinergic crisis Too much drug is, occurs soon after dose. treatment is give an anticholinergic agent. Myesthenic crisis is not enough drug. Occurs at the end of doseage. Treatment for myesthenic crisis is give more drug. Same symptoms but can tell the different around dosing times.

Question 15

Cholinergic crisis

Answer 15

Too much drug, receptors are too saturated and can’t receive nerve impulse. give an anticholinergic agent. Occurs soon after dose of cholinergic meds

Question 16

Myesthenic crisis

Answer 16

Need more drug, happens at the end of a dosage, treatment is giving a cholinergic agonist

Question 17

CholinoLYTIC mechanism of action

Answer 17

Cholinergic antagonist, anticholinergic agents, Muscarinic cholinergic receptor antagonists

Question 18

Muscarnic cholinergic receptor antagonist

Answer 18

They bind to the Muscarinic cholinergic receptor and block it so nothing else can bind to it resulting in decreased parasympathetic response

Question 19

Atropine uses

Answer 19

Induces mydriasis (dilation), reduces secretions (preop for anesthesia ), treatment of ventricular Bradycardias, treatment of severe diarrhea & urinary incontinence

Question 20

Why is atropine not an ideal med?

Answer 20

Has a lot of side effects and isn’t as targeted to one symptoms

Question 21

Scopolamine

Answer 21

Used in treatment of motion sickness, inhibits cholinergic activation of emesis center

Question 22

Solifenacin (vesicare)

Answer 22

Selective m3 Muscarinic cholinergic receptor antagonist , helps with bladder incontinence

Question 23

Detrusor muscle

Answer 23

Muscle that controls the urinary bladder

Question 24

Where are m1, m2, and m3 receptors

Answer 24

M1- salivary glands
M2- heart
M3- smooth muscle of bladder, gi tract and eyes

Question 25

Cholinolytic toxicology (anticholinergic )

Answer 25

Extreme dry mouth, hallucinations, not sweating when hot

Question 26

Mechanism of action of baclofen

Answer 26

gaba receptor agonist that suppresses motor neuron activity and nerve conduction

Question 27

Skeletal muscle relaxation meds

Answer 27

Baclofen, botulism, pancuronium

Question 28

Pancuronium MOA

Answer 28

nicotinic receptor antagonist on skeletal muscle. Non depolarizing relation because it blocks excitation contraction coupling (depolization)

Question 29

Succinylcholine

Answer 29

Activates the ach receptor and causes depolization but remains bound to the receptor for a prolonged period of time.

Question 30

Botulism neurotoxin

Answer 30

Inhibit membrane fusion proteins (synaptin and snap25) necessary for exocytosis of ach by motor neurons, blocks excitation secretion coupling. This effect causes skeletal muscle paralysis

Question 31

Atropine treats what ?

Answer 31

Cholinergic crisis with ingestion of poisonous mushroom

Question 32

What med is a depolarizing skeletal muscle relaxant

Answer 32

Succinylcholine