Cholinergic Drugs Affecting ANS

Question 1

Autonomic Nervous System (ANS) Divisions

Answer 1

Sympathetic-adrenergic-alpha/beta

Parasympathetic-cholinergic-muscunaric

Question 2

Do Parasympathetic and Sympathetic divisions have opposite responses?

Answer 2

True

Question 3

Major neurotransmitter of parasympathetic NS

Answer 3

Acetylcholine

Question 4

Muscarinic Receptors

Answer 4

M1-stimulate salivary glands and stomach
M2- (cardiac) dec heart rate, contractive force of atria, pacemaker
M3-smooth muscle contraction/bronchoconstriction

Question 5

Nicotinic Receptors

Answer 5

Located at the ganglionic synapse in both PNS and SNS

Can block during hypertensive crisis

Question 6

Post ganglionic neuron difference

Answer 6

SNS(NE)

PNS(Ach)

Question 7

Indirect mimetic MOA/Drugs

Answer 7

(-)AchE which increases half-life of Ach in synapse so longer duration of action

Physostigmine(Antilirium)
Donepezil(Aricept)

Question 8

Donepezil(Aricept)

Answer 8

Alzheimer’s drug, crosses BBB

Question 9

Physostigmine(antilirium)

Answer 9

Antidote to excessive anticholinergics

Ex nightshade poisoning

Question 10

Organophosphates

Answer 10

Other indirect cholinomimetic

Ex sarin gas or pesticides

Question 11

Myastenia gravis

Answer 11

Autoimmune disease with dec nicotinic receptors in skeletal muscles

Neostigmine(prostigmin)

Question 12

Direct mimetic moa/drugs

Answer 12

Directly agonizing muscarinic (M) receptors

Bethanecol(urecholine)

Question 13

Bethanecol (urecholine) moa

Answer 13

(+) M receptors to increase smooth muscle tone

Tx:stimulate urination, treat dry mouth

Question 14

Direct antagonist

Answer 14

Atropine (AtroPen)

Question 15

Atropine (AtroPen) Moa

Answer 15

M receptor blocker- anticholinergic

Tx-antidote to sarin/organophosphates,

used in cholinergic crisis

Question 16

Cholinergic excess

Answer 16

Hypersalvation
Pupil constriction 
Muslce twitching
Pale, sweating
Difficulty breathing

Can use atropine