Cholinergic Indirect Acting Agonist [reversible]

Question 1

Name 7 reversible cholinesterase inhibitors

Answer 1

• Nivalin [GALANTHAMINE]
• Physostigmini salicylas [PHYSOSTIGMINE]
• Neostigmin [Syntostigmin, NEOSTIGMINE]
• Oxazyl [AMBENONIUM CHLORIDE]
• Kalymin [PYRIDOSTIGMINE]
• Tosmilen [DEMECARII BROMIDUM]
• Edrophonium

Question 2

Nivalin [GALANTHAMINE]

Answer 2

3* amine

For Alzheimer’s disease

Question 3

Physostigmine salicylas [PHYSOSTIGMINE]

Answer 3

3* amine

• increase intestinal and bladder motility
• reverses CNS and Cardiac effects of tricyclics antidepressants
• reverse CNS effects of atropine

Question 4

Neostigmin [Syntostigmin, NEOSTIGMINE]

Answer 4

4* amine

• prevents postoperative abdominal distension and urinary retention
• used in treatment of myasthenia gravis
• used as an antidote for competitive neuromuscular blockers
• has intermediate duration of action [0.5 to 2 hrs]

Question 5

Oxazyl [AMBENONIUM CHLORIDE]

Answer 5

4* amine

• similar action to neostigmine but longer duration
• chronic management of myasthenia gravis
• intermediate duration - 4 to 8 hrs

Question 6

Tosmilen [DEMECARII BROMIDUM]

Answer 6

4* amine

• treatment of glaucoma

Question 7

Kalymin [PYRIDOSTIGMINE]

Answer 7

4* amine

• chronic management of myasthenia gravis
• intermediate duration = 3 to 6 hrs

Question 8

Rivastigmine, galantamine, donepezil

Answer 8

• used as first line treatment for Alzheimer’s disease, though confers modest benefit
• can be used with memantine [N-methyl-D-aspartate agonist] with moderate to severe disease

Question 9

EDROPHONIUM

Answer 9

Myasthenia gravis diagnosis

Used as an antidote for competitive neuromuscular blockers

Short duration - 10 to 20 min