Cholinergic

Question 1

Carbachol

Answer 1

• Agonist, direct parasympathomimetic, muscarinic and nicotinic
• not hydrolyzed by acetylcholinesterase
• Used topically to treat Gluacoma

Question 2

Bethanechol

Answer 2

• Agonist, direct parasympathomimetic, muscarinic only
• Lacks cardiovascular effects
• Used to treat urinary retention

Question 3

Pilocarpine

Answer 3

• Agonist, direct parasympathomimetic, muscarinic only
• Used topically to treat Gluacoma
• Ciliary muscle contraction-> aqueous humor flows out-> reduced intraocular pressure

Question 4

Muscarine

Answer 4

• Agonist, Muscarinic

- No therapeutic application

Question 5

Physostigmine

Answer 5

• Reversible acetylcholinesterase inhibitor, indirect parasympathetomimetic
• Carbamate
• Topical(Gluacoma), systemic(Myasthinia Gravis)
• Also neostigmine

Question 6

Endrophonium

Answer 6

• Ach-ase inhibitor, indirect parasympathetomimetic
• Quarternary alcohol
• Myasthenia Gravis diagnosis(short half-life)

Question 7

Horny goat weed

Answer 7

• Epimedium sagittatum
• Ach-ase inhibitor, indirect parasympathetomimetic
• indirect stimulation of vascular M3 receptors->NO production-> vasodilation(same effect as sildenifil)

Question 8

Malathion

Answer 8

• irreversible Ach-ase inhibitor
• organophosphate insecticide
• Also parathion, paraoxon

Question 9

Sarin

Answer 9

• irreversible Ach-ase inhibitor
• organophosphate nerve gas
• Also tabun, soman
• antidote-> prelodoxin

Question 10

Atropine

Answer 10

• muscarinic antagonist, parasympatholytic
• pupil dilation for ophthalmology
• Treat bradycardia, mushroom and Ach-ase inhibitor poisoning

Question 11

Scopolamine

Answer 11

• Muscarinic antagonist, parasympatholytic
• Antiemetic(nausea, motion sickness)
• AKA Hyoscine

Question 12

Ipratropium

Answer 12

• Muscarinic antagonist

- inhalation for asthma and bronchitis

Question 13

Pirenzpine

Answer 13

• Muscarinic antagonist

- Peptic ulcers-> selectively inhibits M1-> gastric mucosa->reduce gastric acid production

Question 14

N-Butyl-Scopolamine

Answer 14

• muscarinic antagonist

- Spasmolytic, intestinal or menstrual cramps

Question 15

Nondepolarizing blockers

Answer 15

• Nicotinic competitive antagonist
• action can be reversed by competition
• Prevent depolarization of end plate

Question 16

Depolarizing blockers

Answer 16

• nicotinic agonist
• Act by triggering sustained depolarization of neuromuscular end plate
• cannot be hydrolyzed by Ach-esterase
• Not reversible

Question 17

d-Tubocurarine

Answer 17

• nicotinic parasympatholytic
• Non depolarizing blocker
• previously used as muscle relaxant for surgery
• problem: triggers histamine release-> decrease in blood pressure

Question 18

Pancuronium

Answer 18

• nicotinic parasympatholytic long-lasting
• Non depolarizing blocker
• synthetic Quarternary ammonium compound
• little to no histamine release
• other: vecuronium(intermediate-long)<15min

Question 19

Succinylcholine

Answer 19

• Nicitinic parasympatholytic
• depolarizing blocker
• diametric acetylcholine
• fast acting, short duration(approximately 10min)
• initial muscle twitching