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Pharm > Cholinergic Drugs Chapter 20 > Flashcards

Cholinergic Drugs Chapter 20 Flashcards

1
Q

Acetylcholine

A

The neurotransmitter responsible for the transmission of nerve impulses to effector cells in the parasympathetic nervous system.

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2
Q

Acetylcholinesterase

A

The enzyme responsible for the breakdown of acetylcholine.

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3
Q

Alzheimer’s disease

A

A disease of the brain characterized by progressive mental deterioration manifested by confusion, disorientation, and loss of memory, ability to calculate, and visual-spatial orientation.

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4
Q

Atony

A

A lack of normal muscle tone.

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5
Q

Cholinergic crisis

A

Severe muscle weakness and respiratory paralysis due to excessive acetylcholine; often seen in patients with myasthenia gravis as an adverse effect of drugs to treat the disorder.

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6
Q

Cholinergic receptor

A

A nerve receptor stimulated by acetylcholine

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7
Q

Miosis

A

The contraction of the pupil

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8
Q

Muscarinic receptors

A

Cholinergic receptors located post-synaptically in the effector organs such as smooth muscle, cardiac muscle, and glands supplied by parasympathetic fibers.

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9
Q

Nicotinic receptors

A

cholinergic receptors located in the ganglia(where presynaptic and postsynaptic nerve fibers meet) of both the parasympathetic nervous system and the sympathetic nervous system; so named because they can be stimulated by the alkaloid nicotine.

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10
Q

Parasympathomimetics

A

Drugs that mimic the parasympathetic nervous system-also referred to as cholinergic agonist drugs.

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11
Q

True or False:
Cholinergic Drugs,
Cholinergic agonist, and parasympathomimetics
are drugs that do not stimulate the parasympathetic nervous system (PNS)

A

False they refer to the class of drugs that stimulate the PNS.

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12
Q

True or False: The parasympathetic nervous system (PNS) is the opposite of the Sympathetic nervous system?

A

True

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13
Q

What does acetylcholine do?

A

is the neurotransmitter responsible for the transmission of nerve impulses to effector cells in the PNS.

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14
Q

What does the cholinergic receptor do?

A

this receptor binds acetylcholine and mediates its actions.

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15
Q

How many type of cholinergic receptor are there?

A

There are two types of receptors: nicotinic and muscarinic.

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16
Q

True or False: Nicotinic receptors are only found in the PNS?

A

False, they are found in the ganglia of the PNS and also the sympathetic nervous system.

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17
Q

What are nicotinic receptors stimulated by?

A

Nicotine

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18
Q

Where are the muscarinic receptors found?

A

they are located postsynaptically in the effector organs (smooth muscle, cardiac muscle, and glands) supplied by the parasympathetic fibers.

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19
Q

What are the muscarinic receptors stimulated by?

A

alkaloid muscarine, a substance isolated from mushrooms.

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20
Q

True or False: Cholinergic drugs (cholinergic agonist or parasympathomimetics) mimic the effects of acetylcholine?

A

True, they stimulate cholinergic receptors either directly or indirectly.

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21
Q

What do direct acting cholinergic agonist bind to?

A

They bind directly too cholinergic receptors and active them.

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22
Q

What do indirect acting cholinergic agonist stimulate?

A

they stimulate the post synaptic release of acetylcholine at the receptor site. This then allows acetylcholine to bind to and stimulate the receptor. Indirect-acting cholinergic drugs (also known as cholinesterase inhibitors) work by inhibiting the action of acetylcholinesterase.

23
Q

True or False: Acetylcholinesterase is an enzyme responsible for breaking down acetylcholine?

A

True, and is referred to as cholinesterase

24
Q

When acetylcholine finds to the receptor stimulation occurs and binding takes place, the permeability of the cell changes what depolarizes the cell?

A

Once binding takes place on the membranes of the effector cell the permeability of the cell changes calcium and sodium are permitted to flow into the cell and depolarizes the sell membrane and stimulates the effector organ.

25
Q

What are Cholinergic drugs primary used for?

A

Cholinergic drugs are used for their target effects on the gastrointestinal tract, bladder and eye.

26
Q

What effects do cholinergic drugs on the intestines and bladder?

A

cholinergic drugs stimulate the intestines and bladder and results in an increase in gastric secretions, GI motility and urinary frequency, increased salvation and sweating.

For the heart reduced heart rate and vasodilation.

27
Q

True or False: Cholinergic drugs cause an increase in heart rate and vast dilation.

A

False, cholinergic drugs reduced heart rate and vasodilation.

28
Q

True or False: Pulmonary effects include causing the bronchi to constrict?

A

True. cholinergic drugs cause the bronchi of the lunch to constrict and the airways too narrow.

29
Q

True or False: Cholinergic drugs affect muscarinic and nicotinic receptors in the same dosage amounts?

A

False, cholinergic drugs primarily affect the muscarinic receptors but only at high dosages do the nicotinic receptors become stimulated

30
Q

What are the direct acting drugs carbachol, pilocarpine, and echothiophate used for?

A

They are used to reduced intraocular pressure in patients with glaucoma or those going undergoing ocular surgery.

31
Q

Direct acting drugs such as carbachol, pilocarpine, and echothiophate are poorly absorbed orally, except which one?

A

the one exception is the direct acting cholinergic drug bethanechol, which is administered orally.

32
Q

What does bethanechol affect?

A

Bethanechol affects the detrusor muscle of the urinary bladder and the smooth muscle of the GI tract.

33
Q

What is Bethanechol used for?

A

It is used postoperatively to treat atony of the bladder and the GI tract.

34
Q

How to indirect acting drugs work on acetylcholine?

A

indirect drugs work by increasing acetylcholine concentrations at the receptor sites, which leads to stimulation of the effector cells.

35
Q

What is the indirect-acting drug physostigmine used for?

A

The indirect-acting drug physostigmine is considered the antidote for anticholinergic poisoning as well as poisoning by irreversible cholinesterase inhibitors such as the organophosphates and carbamates, which are common classes of insecticides.

36
Q

True or False: Indirect acting drugs are used to treat Alzheimer’s disease?

A

True, this is because patients have decreased levels of acetylcholine.

37
Q

How do cholinergic drugs work on Alzheimers?

A

Increase concentrations of acetylcholine in the brain by inhibiting cholinesterase.

38
Q

What are the cholinesterase inhibitors used to treat Alzheimers?

A

the indirect acting cholinergic drugs are donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)

39
Q

What are some contraindications for the use of cholinergic drugs?

A

Drug allergy,
GI or genitourinary (GU) tract obstruction, bradycardia,
defects in cardiac impulse conduction, hyperthyroidism,
epilepsy,
hypotension,
chronic obstructive pulmonary disease

40
Q

What are the adverse effects of cholinergic drugs ?

A 
Over stimulation of the PNS
syncope,
hypotension with reflex tachycardia
hypertension
bradycardia
41
Q

What happens when you overdose on cholinergic drugs?

A

It is cholinergic crisis and the symptoms include circulatory collapse, hypotension, bloody diarrhea, shock, and cardiac arrest.

42
Q

What is a cholinergic antagonist for cholinergic crisis?

A

Atropine

43
Q

What are the effects of cholinergic poisoning?

A

use the acronym SLUDGE, which stands for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis.

44
Q

What are the uses for bethanechol?

A

Postoperative and postpartum functional urinary retention

45
Q

What are the uses for Donephezil (aricept)

A

Alzheimers

46
Q

What are the uses for Memantine

A

Alzheimers

47
Q

What are the uses for physostigmine (Antilirium)

A

Reversal of anticholinergic drug effects and tricyclic antidepressant overdose

48
Q

What are the uses for pyridostigmine (Mestinon) (C)

A

Myasthenia gravis Antidote for neuromuscular blocker toxicity

49
Q

True or False: Cholinergic drugs stimulate the PNS?

A

True

50
Q

True or False: parasympathomimetics AKA cholinergic drugs mimic the action of acetylcholine?

A

True

51
Q

True or False: If a patient is taking drugs that mimic the actions of the PNS, giving the client more parasympathomimetics helps PNS actions?

A

False, adverse effects or toxicity may be increase.

52
Q

How long would it take for therapeutic response to occur for Alzheimers

A

6 weeks

53
Q

True or False: Patients taking cholinergics must change positions quickly because it effects postural hypotension.

A

False, Patients taking cholinergics must change position slowly to avoid dizziness and fainting, which may result as an adverse effect of postural hypotension.

Pharm (6 decks)

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