cholinergic neurons

Question 1

Cholinergic neurons are those that utilize ___?

Answer 1

Acetylcholine (ACh)

Question 2

Six sequential steps of neurotransmission

Answer 2

o	Synthesis
o	Storage
o	Release
o	Binding of ACh to receptor
o	Degradation in synaptic cleft
o	Recycling of choline and acetate

Question 3

________ will block the degradation and increase time ACh is acting on postsynaptic receptors

Answer 3

ACh esterase inhibitors

Question 4

What are the Two families distinguished on basis of their different affinities for agents that mimic the action of ACh

Answer 4

Nicotinic

Muscarinic

Question 5

GPCRs are slower and are seen on nicotinic or muscarinic receptors?

Answer 5

muscarinic

Question 6

Muscarinic Receptors recognize _____.

Answer 6

muscarine

Question 7

where are Muscarinic Receptors mainly located

Answer 7

Located primarily (but not exclusively) at the neuroeffector junction of the parasympathetic nervous system

Question 8

firs three subclasses of muscarininc receptors?

Answer 8

o M1: gastric parietal cells
o M2: cardiac cells and smooth muscle
o M3: bladder, exocrine glands, smooth muscle

Question 9

Nicotine at [___] stimulates and at [___] inhibits (due to desensitization)

Answer 9

low

high

Question 10

Locations of nicotine receptors

Answer 10

o CNS
o Adrenal medulla
o Autonomic ganglia
o NMJ

Question 11

Direct-Acting Cholinergic Agonists Mimic the effects of ____ by binding directly to cholinergic receptors

Answer 11

ACh

Question 12

Direct-Acting Cholinergic Agonists- As a group these drugs show little _____ so their use is limited

Answer 12

specificity

Question 13

Indirect-Acting Cholinergic Agonists (AChE inhibitors ) _________which degrades ACh

Answer 13

Inhibits acetylcholinesterase (AChE)

Question 14

Cholinergic Agonists Effects: what is DUMBBELSS

Answer 14

o	Diarrhea
o	Urination
o	Miosis
o	Bronchorrhea**
o	Bradycardia**
o	Emesis
o	Lacrimation
o	Sweating
o	Salivation**

Question 15

Cholinergic Agonists Effects: what is SLUDGEMM

Answer 15

o	Salivation
o	Lacrimation
o	Urination
o	Diarrhea
o	GI upset**
o	Emesis
o	Miosis
o	Muscle spasms**

Question 16

these Bind to ACh receptors but do NOT trigger the usual receptor-mediated response, they Block Ach from binding to receptor

Answer 16

Cholinergic Antagonists

Question 17

Cholinergic Antagonists Three main groups/uses

Answer 17

o Muscarinic receptors of the parasympathetic nerves (aka: antimuscarinic agents)
o Nicotinic receptors of the sympathetic and parasympathetic ganglia
o Nicotinic receptor on skeletal muscle (aka: neuromuscular blockers)

Question 18

these Cause inhibition of all muscarinic functions

Answer 18

Antimuscarinic Agents

Question 19

Anticholinergic Effects

Answer 19

• Hot as a hare: increased body temperature
• Blind as a bat: mydriasis (dilated pupils), blurred vision
• Dry as a bone: dry mouth, dry eyes, decreased sweat, constipation, urinary retention
• Red as a beet: flushed face
• Mad as a hatter: confusion/delirium/euphoria
• Bloated as a toad: constipation, urinary retention, ileus
• And the heart runs alone: tachycardia

Question 20

ABCDs of anticholinergic effects:

Answer 20

o	Anorexia
o	Blurry vision
o	Constipation/
Confusion
o	Dry Mouth
o	Sedation/
o	Stasis of urine

Question 21

MANY drugs have anticholinergic effects that are not the main MOA. what are some examples?

Answer 21

Examples: antihistamines, opioid analgesics, antipsychotics, antidepressants, antiemetics, muscle relaxants