Cholinergic Pharm Flashcards
This drug acts as a M3 antagonist. By blocking the M3 receptor, it will treat urinary incontinence and hyperhidrosis
Oxybutynin
This cholinesterase re-activater drug is used in conjunction with atropine to treat organophosphate poisoning (insecticides) and/or overdose of cholinesterase inhibitors like Neostigmine or Pyridostigmine.
Pralidoxime
These two drugs are mAchR antagonists at the M3 receptor and are used to treat COPD and asthma. This works well for Pt who can’t take adrenergic agents due to side effects. This medication is take as an inhaler
Ipratropium and/or Tiotropium
This M1 receptor antagonist is used as an adjuvant treatment for Parkinson’s disease. It is contraindicated in Pt with narrow-angle glaucoma.
Benztropine
M1 receptors are located in the corpus stratum in the brain. AKA: This drug can cross the BBB
This drug is a competitive muscarinic receptor antagonist that both blocks M3 in the gut and crosses the BBB and blocks M1 receptors to decrease signaling to the vestibule. This allows it to treat motion sickness. What else can blocking the M3 receptors do?
Scopolamine
Causes dec. GI tract motility, cycloplegia (paralysis of ciliary muscles of the eye), and also urine retention & mydriasis
This is the go-to (competitive) muscarinic antagonist drug which treats bradycardia during cardiac emergencies, treats cholinesterase inhibitor poisoning (nerve gas, insecticides, physostigmine, etc), and can help dilate eyes if given in drops.
What are the side effects of this drug?
Atropine
Classic muscarinic blocking symptoms (over-stim of sympathetics): tachycardia, xerostomia (decreased salivation), hyperthermia, decreased GI tract motility, cycloplegia w/ mydriasis.
This drug is used to treat myasthenia gravis and to stimulate the GI tract and bladder. It’s also used to anesthesiologist to overcome non-depolarizing neuromuscular blockade (pancuronium or vecuronium). This is because it is a reversible chonlinesterase inhibitor.
What are some side effects?
Neostigmine
Parasympathetic side effects (it blocks degradation of Ach by stopping AchE): diarrhea, bronchoconstriction, salivation, bradycardia.
–It does NOT cross the BBB and therefore does not produce CNS side effects like sedation or psychosis.
This drug is a reversible AchE inhibitor and is used to treat atropine poisoning and can be used within solution to treat glaucoma (stim’s outflow of aqueous humor from the eye & therefore dec intraocular pressure).
Physostigmine
This drug is used to treat wide-angle glaucoma by covalently (irreversibly) binding and inhibiting AchE, causing drastically increased stimulation of both nicotinic and muscarinic receptors
What are the side effects and what are 3 similar drugs (2 are poisons not used clinically)?
Echothiophate
Isoflurophate - used in conjunction for glaucoma tx
Parathion and malathion - these are poisons
This drug is used to treat neurogenic ileus and urinary retention in postpartum or postoperative period (after child birth). Since this drug fixes bladder atony and retention, it must be a _____. It does not cross the BBB and has no effect on M1 receptors.
Bethanechol
It is a muscarinic agonist (M2 and M3)
This drug is the treatment of choice for both narrow- and wide-angle glaucoma. It also stimulates tear production and can help with xerostomia (dry mouth) and dry eyes (keratoconjunctivitis sicca). It contracts the sphincter muscle of the iris and contracts the ciliary muscle, meaning that this is a _____.
Pilocarpine
Muscarinic agonist
This drug pair is used for myasthenia gravis. One diagnoses it and the other treats it. They are both reversible AchE inhibitors
Edrophonium is used to diagnose MG
Pyridostigmine treats MG
This drug is used to diagnose reactive airway diseases like asthma by inhaling it and checking for smooth muscle contraction of the bronchi. This means it is a _____
Methacholine
muscarinic agonist
This drug is used in the treatment of Alzheimer’s disease, which merely slows its progression by about 6 months. It is a reversible AchE inhibitor
Tacrine
Antihistamine overdose causes extreme systemic blockage of acetylcholine receptors, leaving the Pt in a highly sympathetic state. What general agent would you treat this with? What would you use if the Pt is showing CNS symptoms?
A cholinesterase inhibitor (TP-PEEN)
Use Uncharged AchE inhibitor if Pt is showing CNS symptoms like delirium (e.i. Physiostigmine)
