Cholinergic Drugs Chapter 20

Question 1

Acetylcholine

Answer 1

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

Question 2

Acetylcholinesterase

Answer 2

The enzyme responsible for the breakdown of acetylcholine.

Question 3

Alzheimer’s disease

Answer 3

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.

Question 4

Atony

Answer 4

A lack of normal muscle tone.

Question 5

Cholinergic crisis

Answer 5

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.

Question 6

Cholinergic receptor

Answer 6

A nerve receptor stimulated by acetylcholine

Question 7

Miosis

Answer 7

The contraction of the pupil

Question 8

Muscarinic receptors

Answer 8

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

Question 9

Nicotinic receptors

Answer 9

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.

Question 10

Parasympathomimetics

Answer 10

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

Question 11

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

Answer 11

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

Question 12

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

Answer 12

True

Question 13

What does acetylcholine do?

Answer 13

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

Question 14

What does the cholinergic receptor do?

Answer 14

this receptor binds acetylcholine and mediates its actions.

Question 15

How many type of cholinergic receptor are there?

Answer 15

There are two types of receptors: nicotinic and muscarinic.

Question 16

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

Answer 16

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

Question 17

What are nicotinic receptors stimulated by?

Answer 17

Nicotine

Question 18

Where are the muscarinic receptors found?

Answer 18

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

Question 19

What are the muscarinic receptors stimulated by?

Answer 19

alkaloid muscarine, a substance isolated from mushrooms.

Question 20

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

Answer 20

True, they stimulate cholinergic receptors either directly or indirectly.

Question 21

What do direct acting cholinergic agonist bind to?

Answer 21

They bind directly too cholinergic receptors and active them.

Question 22

What do indirect acting cholinergic agonist stimulate?

Answer 22

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.

Question 23

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

Answer 23

True, and is referred to as cholinesterase

Question 24

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

Answer 24

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.

Question 25

What are Cholinergic drugs primary used for?

Answer 25

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

Question 26

What effects do cholinergic drugs on the intestines and bladder?

Answer 26

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.

Question 27

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

Answer 27

False, cholinergic drugs reduced heart rate and vasodilation.

Question 28

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

Answer 28

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

Question 29

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

Answer 29

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

Question 30

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

Answer 30

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

Question 31

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

Answer 31

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

Question 32

What does bethanechol affect?

Answer 32

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

Question 33

What is Bethanechol used for?

Answer 33

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

Question 34

How to indirect acting drugs work on acetylcholine?

Answer 34

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

Question 35

What is the indirect-acting drug physostigmine used for?

Answer 35

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.

Question 36

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

Answer 36

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

Question 37

How do cholinergic drugs work on Alzheimers?

Answer 37

Increase concentrations of acetylcholine in the brain by inhibiting cholinesterase.

Question 38

What are the cholinesterase inhibitors used to treat Alzheimers?

Answer 38

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

Question 39

What are some contraindications for the use of cholinergic drugs?

Answer 39

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

Question 40

What are the adverse effects of cholinergic drugs ?

Answer 40

``` Over stimulation of the PNS syncope, hypotension with reflex tachycardia hypertension bradycardia ```

Question 41

What happens when you overdose on cholinergic drugs?

Answer 41

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

Question 42

What is a cholinergic antagonist for cholinergic crisis?

Answer 42

Atropine

Question 43

What are the effects of cholinergic poisoning?

Answer 43

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

Question 44

What are the uses for bethanechol?

Answer 44

Postoperative and postpartum functional urinary retention

Question 45

What are the uses for Donephezil (aricept)

Answer 45

Alzheimers

Question 46

What are the uses for Memantine

Answer 46

Alzheimers

Question 47

What are the uses for physostigmine (Antilirium)

Answer 47

Reversal of anticholinergic drug effects and tricyclic antidepressant overdose

Question 48

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

Answer 48

Myasthenia gravis Antidote for neuromuscular blocker toxicity

Question 49

True or False: Cholinergic drugs stimulate the PNS?

Answer 49

True

Question 50

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

Answer 50

True

Question 51

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

Answer 51

False, adverse effects or toxicity may be increase.

Question 52

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

Answer 52

6 weeks

Question 53

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

Answer 53

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