Cholinergic Pharmacolgy II

Question 0

What nicotinic antagonist historically was used extensively for chronic hypertension largely supplanted by adrenergic receptor-selective agents, some limited specific uses in CV regulation?

Answer 0

Hexamethonium

Question 1

What drug blocks ANS functioning by deducing which branch SNS or PNS exercises dominant control of various organs?

Answer 1

Hexamethonium

Question 2

What nicotinic antagonist was used for centuries along the amazon and Orinoco rivers to immobilize and paralyze wild animals and cause death from paralysis of skeletal muscle? (Not well absorbed through GI tract so possible to use it for hunting and then eat animal)

Answer 2

Curare

Question 3

What nicotinic receptor antagonist blocks function at the NMJ, active components of curare extracts, and has a very long duration of action?

Answer 3

D-tubocurarine

Question 4

What nicotinic antagonist causes motor weakness giving way to total flaccid paralysis, effects small rapidly moving muscles first (eyes, jaws, larynx), then limbs and trunk and then intercostal muscles and diaphragm, after drug removal recovery goes in reverse order?

Answer 4

D-Tubocurarine

Question 5

What depolarizing blocking agent is essentially to ACh molecules linked together, actively excites receptor but has no way of turning signal off so results in flaccid paralysis, not degraded by AChE but is rapidly degraded by BChE?

Answer 5

Succinylcholine

Question 6

What drugs can be used in surgery for relaxation of skeletal muscle to facilitate operative manipulations particularly abdominal and short duration blockers for intubation, bronchoscopy, esophagoscopy?

Answer 6

Tubocurarine derivatives and succinylcholine

Question 7

What drug us used to treat focal dystonia by persistent inhibition of ACh release from neurons supplying skeletal muscle?

Answer 7

Botulinum toxin (Botox)

Question 8

What is an example of a quaternary alcohol AChE inhibitor that uses electrostatic binding, short lived for 2-10min and used in the diagnoses of MG?

Answer 8

Edrophonium

Question 9

What are the 3 groups of AChE inhibitors?

Answer 9

Quaternary alcohol, carbamate esters, organophosphates

Question 10

What are 3 examples of carbamate ester AChE inhibitors that use covalent bonding and are long lived up to 6hr?

Answer 10

Neostigmine, physostigmine, pyridostigmine

Question 11

What are 3 examples of organophosphate AChE inhibitor, that are extremely stable and can bind as long as 100hrs and are irreversible after aging?

Answer 11

Malathion, parathion, echothiophate

Question 12

What agent can push and organophosphate AChE inhibitor off the binding cleft before aging?

Answer 12

Pralidoxime

Question 13

What are some therapeutic uses of AChE inhibitors?

Answer 13

MG, atony or urinary bladder, paralytic ileus, glaucoma, muscarinic antagonist poisoning

Question 14

What is used to differentiate between MG and cholinergic crisis?

Answer 14

Endrophonium

Question 15

Skeletal muscle weakness due to depolarization of motor end plate by high concentrations of ACh (ex: ChE inhibitor overdose) describes what?

Answer 15

Cholinergic crisis

Question 16

If edrophonium causes further weakness then what is the prognosis?

Answer 16

Cholinergic crisis

Question 17

If edrophonium improves muscle strength than what is the prognosis?

Answer 17

MG

Question 18

What two drugs can be used to treat MG and increase response to myasthenic muscle to repetitive nerve impulses, preservation of endogenous ACh and step wise increase of dosage to find optimal dosage?

Answer 18

Neostigmine, pyridostigmine

Question 19

What are 3 possible ways to be exposed to AChE inhibitor toxicity?

Answer 19

Side effect of ChE inhibitor therapy, accidental exposure (insecticide spraying), warfare agents

Question 20

What are 3 AChE inhibitor warfare agents?

Answer 20

Sarin, Vx, Soman

Question 21

What warfare agent is volatile and mainly has inhalation exposure?

Answer 21

Sarin

Question 22

What warfare agent is very persistent can remain on the body, terrain for extended periods of time, mainly has skin exposure but also through inhalation?

Answer 22

Vx

Question 23

What warfare agent is moderately volatile inhalation or skin contact very rapid “aging” occurs in minutes?

Answer 23

Soman

Question 24

In general what kind of effects do AChE inhibitors amplify?

Answer 24

PNS

Question 25

What drug helps alleviate symptoms of AChE inhibitor toxicity by binding reversibly to AChE molecules and releasing them when it’s effects wear off, protects from irreversible binding of nerve gas agents (used extensively as prophylactic agents during 1990-1991 gulf war)?

Answer 25

Pyridostigmine

Question 26

What are 4 treatments of AChE inhibitor toxicity?

Answer 26

Pyridostigmine, heroic doses of atropine, pralidoxime, artificial respiration and anticonvulsants

Question 27

What drug is effective for PNS effects induced by nerve gas agents but is ineffective against skeletal muscle neuromuscular effects?

Answer 27

Atropine

Question 28

What drug will effectively reverse all symptoms by regenerating AChE has been used as prophylactic agent for agricultural workers however must be applied before aging or organophosphate inhibitors?

Answer 28

Pralidoxime

Question 29

What can be used incase of several AChE inhibitor intoxication?

Answer 29

Artificial respiration and anticonvulsants