cholinergic agonist (direct-acting cholinomimetic)

Question 1

bethanechol moa

Answer 1

selective muscarinic agonist (M1, M2, M3) in peripheral tissues

Question 2

bethanechol clinical app

Answer 2

postoperative ileus, neurogenic ileus, urinary retention

Question 3

bethanechol admin

Answer 3

oral, im

Question 4

bethanechol duration of action

Answer 4

~30 min

Question 5

bethanechol PK

Answer 5

poor lipid solubility & does NOT enter CNS

Question 6

bethanechol toxicity/interactions

Answer 6

parasympathetic effects

bronchospasm in asthma

Question 7

pilocarpine moa

Answer 7

partial muscarinic agonist (M1, M2, M#) in peripheral tissues

Question 8

pilocarpine clinical app

Answer 8

glaucoma

sjogren’s (inc salivation)

Question 9

pilocarpine admin

Answer 9

oral lozenge

topical (eyedrops)

Question 10

pilocarpine duration of action

Answer 10

0.5-2h

Question 11

pilocarpine PK

Answer 11

good lipid solubility

Question 12

pilocarpine toxicity/interactions

Answer 12

parasymp effects
bronchospasm in asthma
vasoconstriction (ganglionic effect)

Question 13

ACh moa

Answer 13

nicotinic
muscarinic agonist
receptor: nicotinic & muscarinic
L: muscle cell membrane

Question 14

Ach clinical app

Answer 14

during eye surgery - contraction of the sphincter muscles of the iris –> miosis
contraction of the ciliary muscle –> accommodation spasm

Question 15

ACh admin

Answer 15

topical (opthalmic/intraocular)

Question 16

ACh duration of action

Answer 16

~20 min, up to 6h

Question 17

ACh PK

Answer 17

rapidly hydrolyzed by cholineresterase

Question 18

ACh toxicity/interactions

Answer 18

bradycardia, flushing, hypotension
diaphoresis
cloudy vision, corneal decompensation, corneal edema
dyspnea

Question 19

Muscarine moa

Answer 19

binds to postganglionic cholinergic neurons in the ANS

does not cross BBB (Not in CNS)

Question 20

Muscarine admin

Answer 20

oral (consumption of mushroom)

Question 21

Muscarine duration of action

Answer 21

2-6 hours

Question 22

Muscarine toxicity/interactions

Answer 22

SLUDGE/DUMBBELLS

Question 23

Nicotine moa

Answer 23

selective nicotinic agonist
activates autonomic postganglionic neurons
skeletal muscle endplate (PNS + CNS)

Question 24

Nicotine clinical app

Answer 24

smoking cessation

insecticides

Question 25

Nicotine admin

Answer 25

oral (gum)
transdermal
inhalation

Question 26

Nicotine duration of action

Answer 26

1-6 hours

Question 27

Nicotine PK

Answer 27

high lipid solubility

Question 28

Nicotine toxicity/interactions

Answer 28

Acute: increase GI activity, hypertension
OD: seizures, paralysis, coma, death
Long term: GI & CV risk factors

Question 29

Chantix moa

Answer 29

partial agonist at one specific nicotinic receptor

Question 30

Chantix clinical app

Answer 30

smoking cessation

Question 31

Chantix admin

Answer 31

oral

Question 32

Chantix duration of action

Answer 32

12-24 h

Question 33

Chantix toxicity/interactions

Answer 33

hypertension
sweating
GI activity

Question 34

Chantix PK

Answer 34

high lipid solubility

Question 35

Succinylcholine moa

Answer 35

selective for neuromuscular end plate

Question 36

Succinylcholine clinical app

Answer 36

muscle relaxation (clinically mimics effects of cholinergic antagonist; paralysis)

Question 37

Succinylcholine admin

Answer 37

IV

Question 38

Succinylcholine duration of action

Answer 38

5-10 min

Question 39

Succinylcholine PK

Answer 39

highly polar

Question 40

Succinylcholine toxicity/interactions

Answer 40

prolonged action in people w abnormal levels of butyrylcholinesterase