Cholinergic Drugs

Question 1

Acetylcholine/Nicotine

Answer 1

direct cholinergic agonist - can bind muscarnic or nicotinic receptors (used for miosis aka pupil constriction),,,nicotine only binds nicotinic receptors (low doses cause ganglionic stimulation while high doses cause ganglionic/neuromuscular blockade)

Question 2

Bethanechol

Answer 2

direct cholinergic agonist - used for urinary retention

Question 3

Methacholine

Answer 3

direct cholinergic agonist - used to test for bronchial airway hyper reactivity

Question 4

Pilocarpine

Answer 4

direct (partial) cholinergic agonist - tertiary, used for glaucoma and dry mouth

Question 5

Edrophonium

Answer 5

AchE inhibitor (indirect-acting cholinergic agonist) - quaternary, used for myasthenia gravis, increases muscle strength, used for reversal of non-depolarizing neuromuscular blockers [binds reversibly, short-lived inhibition]

Question 6

Physostigmine

Answer 6

AchE inhibitor (indirect-acting cholinergic agonist) - carbamate - tertiary, used to treat over dose of anti-cholinergic drugs [covalent bond with enzyme]

Question 7

Neostigmine

Answer 7

AchE inhibitor (indirect-acting cholinergic agonist) - carbamate - quaternary, used for myasthenia gravis, also used for urinary retention and reversal of non-depolarizing neuromuscular blockers [covalent bond with enzyme]

Question 8

Malathon

Answer 8

AchE inhibitor (indirect-acting cholinergic agonist) - organophosphate [phosphorylate the enzyme - covalent bond that is stable and hydrolyzes slowly]

Question 9

Sarin

Answer 9

AchE inhibitor (indirect-acting cholinergic agonist) - organophosphate - [phosphorylate the enzyme - covalent bond that is stable and hydrolyzes slowly]

Question 10

Pyridostigmine

Answer 10

AchE inhibitor (indirect-acting cholinergic agonist) - carbamate - quaternary, used for myasthenia graves

Question 11

Atropine

Answer 11

muscarinic antagonist - general antagonist

Question 12

Scopolamine

Answer 12

muscarinic antagonist - used for prevention of motion sickness

Question 13

Ipratropium

Answer 13

muscarinic antagonist - used for chronic obstructive pulmonary disorder (COPD) and asthma

Question 14

Tropicamide

Answer 14

muscarinic antagonist - used as an eye dilator

Question 15

Hexamethonium

Answer 15

ganglion blocker - it removes dominant control, acts by antagonism of nicotinic receptors

Question 16

Tubocurarine

Answer 16

neuromuscular blocker - non-depolarizing competitive antagonist, used as an adjuvant in anaesthesia to relax skeletal muscle

Question 17

Succinylcholine

Answer 17

neuromuscular blocker - depolarizing blocker, binds nicotinic receptor and depolarizes it (desensitizes it), leads to flaccid paralysis, used in rapid endotracheal intubation and electroconvulsive therapy

Question 18

Botulinum toxin

Answer 18

Acts presynaptically - Inhibits ACh release, used for treatment of muscle spasms and facial wrinkles