Cholinergic CIS

Question 1

What to remember about 1st gen anti-histamines?

Answer 1

They also have anticholinergic effects

anit-muscarinic effects in the brain can lead to drowsiness, delirium

Question 2

these drugs and their categories:

atropine
ipratropium
neostigmine
physostigmine
varenicline

Answer 2

atropine- antimusc
ipratropium- antimusc
neostigmine- AchE inhibitor- charged (quaternary)
physostigmine- AchE inhiitor (uncharged– use when CNS effects)
Varenicline- partial neuronal nAChR agonist

Question 3

These drugs and their categories:

bethanechol
carbachol
cevimeline
neostigmine
oxybutynin

Answer 3

Bethanechol- musc agonist
Carbachol- cholinergic agonist
Cevimeline- M3 selective musc agonist
neostigmine- AChE inhibitor
Oxybutynin- M3 selective muscrarinic antagonist, inhibits urinary bladder smoothe muscle contraction

Question 4

drug-induced acute angle glaucoma

Answer 4

muscarinic antagonists are contraindicated in patients predisposed to angle-closure glaucoma because they can lead to reduced aqueous humor outflow and (rarely) precipitate acute angle-closure glaucoma (by causing mydriasis, which closes the angle)

Question 5

These drugs and their categories:

Atropine
nicotine
pilocarpine
scopolamine

Answer 5

atropine- musc ant
nicotine-nic agonist
pilocarpine- musc agonist
scopolamine- musc antagonist

Question 6

For COPD, atropine or tiotroprium and why?

Answer 6

tiotroprium is easily aeosolized

they are both muscarinic antagonists, though