Cholinergic Drugs I

Question 1

choline acetyl transferase

Answer 1

catalyzes formation of Ach from acetyl-CoA and choline

Question 2

acetylcholinesterase

Answer 2

major means of inactivation of Ach by degrading it into choline and acetyil-CoA; choline is transported back into axon terminal

Question 3

muscarinic receptors

Answer 3

postganglionic parasympathetic neurons innervating heart, smooth muscle, and exocrine glands; also postganglionic sympathetic neurons innervating sweat glands

Question 4

sympathetic activation of sweat glands (muscarinic)

Answer 4

increased secretion

Question 5

parasympathetic activation of heart (muscarinic)

Answer 5

slow heart rate (bradycardia); reduced rate of spontaneous depolarization of SA node and increased refractory period of AV node

Question 6

parasympathetic activation of blood vessels (muscarinic)

Answer 6

vasodilator; results from production of NO at muscarinic receptors of vascular endothelial cells

Question 7

parasympathetic activation of GI tract (muscarinic)

Answer 7

increase tone and motility, secretory activity; relaxation of sphincters

Question 8

parasympathetic activation of bladder (muscarinic)

Answer 8

contraction of detrusor and relaxation of sphincter

Question 9

parasympathetic activation of eye (muscarinic receptor)

Answer 9

pupillary contraction and ciliary contraction for near vision

Question 10

parasympathetic activation of bronchi (muscarinic receptor)

Answer 10

constriction

Question 11

parasympathetic activation of exocrine glands (muscarinic receptor)

Answer 11

secretion of tears, saliva, mucus, stomach acid, digestive enzymes

Question 12

choline esters

Answer 12

direct-acting muscarinic cholinergic agonists; Ach with chemical groups attached to protect from AchE

Question 13

examples of choline esters

Answer 13

bethanechol, methacholine, carbachol

Question 14

bethanechol uses

Answer 14

relief of postoperative GI distension, constipation, and urinary retention

Question 15

topical carbachol use

Answer 15

wide-angle glaucoma and cataract surgery

Question 16

cholinomimetic muscarinic alkaloids

Answer 16

direct-acting agonists; not same structure as acetylcholine

Question 17

cholinomimetic muscarinic alkaloid examples

Answer 17

muscarine, pilocarpine, and cevimeline

Question 18

cevimeline

Answer 18

used for Sjogren Syndrome

Question 19

Sjogren Syndrome

Answer 19

immune systems attacks healthy cell in salivary glands and eyes causing decrease in tearing and saliva

Question 20

topical pilocarpine

Answer 20

cataract surgery

Question 21

cholinesterase inhibitors

Answer 21

indirect-acting agonists

Question 22

cholinesterase inhibitors can be _

Answer 22

reversible (overcome with more AchE) or irreversible (dangerous, can not be overcome unless new enzyme made)

Question 23

reversible cholinesterase inhibitors

Answer 23

physostigmine, neostigmine, edrophonium, pyridostigmine, donepezil, and carbamate insecticides

Question 24

irreversible cholinesterase inhibitors

Answer 24

isoflurophate (DFP), organophosphate insecticides (parathion, diazinon, and malathion), and nerve gases (sarin, tabun, soman, novichok)

Question 25

Alzheimer’s disease treatment

Answer 25

galantamine, donepezil, and rivastigmine

Question 26

Myasthenia gravis treatment

Answer 26

pyridostigmine

Question 27

reverse effects of neuromuscular blockers with _

Answer 27

neostigmine

Question 28

atropinic poisonings treatment

Answer 28

physostigmine

Question 29

signs of toxicity from organophosphorus compounds

Answer 29

wheezing (bronchoconstriction), sweating, miosis (pupil contraction), cramps, and bradycardia

Question 30

treatment for organophosphorus toxicity

Answer 30

termination of exposure, artificial respiration, IV atropine (repeated every 5-10 minutes until sign of relief), and IV 2-PAM (slowly for reactivation of enzyme)