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Final - Pharm - Neuro/Psych > Cholinergic Agonists > Flashcards

Cholinergic Agonists Flashcards

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1
Q

other name for sympathetic divisioin

A

adrenergic - fight or flight

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2
Q

neurotransmitter - preganglionic

A

acetylcholine

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3
Q

neurotransmitter - end organs (sympathetic)

A

norepinephrine

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4
Q

receptors that receive norepinephrine (sympathetic)

A

alpha and beta

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5
Q

other name for parasympathetic division

A

cholinergic - rest and digest

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6
Q

what stops (metabolizes) relationship with norepinephrine

A

MAO and COMT

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7
Q

neurotransmitter (parasympathetic)

A

acetylcholine

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8
Q

receptors for acetylcholine (parasympathetic)

A

nicotinic or muscarinic

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9
Q

what stops (catabolizes) relationship (parasympathetic)

A

acetylcholinesterase or pseudocholinesterase

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10
Q

if a medication is an agonist what does it do

A

makes it more - promote cholinergic response

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11
Q

if medication is an antagonist what does it do

A

decreases it - stop it

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12
Q

cholinergic agonist aka

A

parasympathoneumetic - mimics parasympathetic nervous system

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13
Q

cholinergic agonists (parasympathoneumetics) do this

A

increase the action of acetycholine - promote rest and digest

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14
Q

direct acting agonist acts just like

A

acetylcholine - protype is bethanecol

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15
Q

**what does bethanecol do

A

**used for urinary retention

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16
Q

one class of drugs direct acting on nicotinic

A

nicotine

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17
Q

indirect acting cholinergic agonists - acts on nicotinic and muscarinic

A

binding to acetylcholinesterase - promote action of acetylcholine - binds for a short time - reversible drugs

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18
Q

what disease process would indirect acting cholinergic agonists help

A

myasthenia gravis - immune system is destroying receptors for acetylcholine

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19
Q

prototype for indirect acting cholinergic agonists

A

neostigmine - lasts 2-4 hours

20
Q

what binds irreversibly to acetylcholine

A

nerve gas and insecticides

21
Q

to reverse cholinergic agonist (toxic effect)

A

cholinergic antagonist - atropine

22
Q

if we block acetylcholine what system is going to dominate

A

sympathetic

23
Q

antagonizing in cholinergic system acting on muscarinic receptors prototype

A

atropine - blocks acetylcholine - making sympathetic nervous system dominate

24
Q

what acts on nicotinic receptors

A

neuromuscular blockers - acting on nicotinic receptors

25
Q

2 ways neuromuscular blockers (nicotinic receptors) work

A

depolarizing or non-depolarizing - acting on skeletal muscles blocking the impulses with a result a paralysis of that muscle

26
Q

cholinergic agonists have 2 actions what are they

A

directly (act like acteylcholine)

indirectly (binding to acetylcholinesterase)

27
Q

prototype for DIRECT acting cholinergic/muscarinic agonist (

A

bethanecol chloride

28
Q

bethanecol chloride is given for

A

post-op/postpartum urinary retention

29
Q

how does bethanecol work

A

relaxes sphincter muscles - increases voiding pressure - increasing peristalsis in urinary system

30
Q

when wouldn’t you want to give bethanecol

A

a blockage causing rupture (will still cause peristalsis)

31
Q

what is bethanecol contraindicated for

A

asthma/copd patients (parasympathetic nervous system constricts bronchioles)

32
Q

cholinergic adverse effects

A

reflect system they are stimulating

33
Q

if you take too much of a cholinergic agonist what will it cause, whether direct or indirect

A

cholinergic crises

34
Q

prototype for myasthenia gravis (INDIRECT cholinergic agonist - ache inhibitor)

A

neostigmine

35
Q

if pt is in cholinergic crisis what can you give to reverse it

A

atropine (not long lasting) and supportive therapy

36
Q

are indirect cholinergic agonists reversible

A

yes

37
Q

most common 1st symptom of myasthenia gravis

A

eye droop/lid lag

38
Q

what does neostigmine do

A

makes more acetylcholine, receptors are being destroyed to keep make muscles stronger

39
Q

what time of day are the muscles exhausted in myasthenia gravis

A

night-time

40
Q

what should a pt. on neostigmine do

A

keep diary - how was muscle strength/when it was time for the next dose

41
Q

if muscle strength is good at time of next dose what do we do with the dosage

A

keep the dose the same - if weak muscle, increase dose

42
Q

what is important for a pt to wear if they are dx with myasthenia gravis

A

medic alert bracelet

43
Q

if pt is in ER and we need to determine whether they are in a myasthenia vs a cholinergic crises what can we do

A

***tensillon or edrophonium test

44
Q

what happens in a tesnillon/edrophonium test

A

give smallest dose of indirect acting cholinergic agonist (neostigmine)

45
Q

if pt is in a myasthenic crises when given a tensillon/edrophonium test will they get better or worse

A

better

46
Q

if tensillon is given and pt gets worse what type of crises are they in

A

cholinergic crises - give atropine

47
Q

drugs that have a positive charge cant

A

cross the blood-brain barrier

Final - Pharm - Neuro/Psych (11 decks)

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