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Cholinergic Pharmacology Flashcards

1
Q

Used for the treatment of bladder and bowel atony (post-surgery or spinal cord injury)

A

Betanechol

M3 receptor agonist

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2
Q

Direct-acting muscarinic agonists

A

Bethanechol
Pilocarpine
Muscarine

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2
Q

MOA of Bethanechol

A

Activates muscarinic receptors; increases IP3 and DAG

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3
Q

Used for Sjogren’s syndrome (increases salivation); was used in glaucoma (causes ciliary muscle contraction, opening or trabecular meshwork, increased outflow)

A

Pilocarpine

M3 receptor agonist

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4
Q

Triad of Sjogren Syndrome

A

Xerostomia
Xerophthalmia
Rheumatoid arthritis

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6
Q

Alkaloid found in mushrooms; causes mushroom poisoning of fast-onset type

A

Muscarine

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7
Q

Used for smoking cessation

A

Nicotine

Varenicline

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8
Q

Indirect-acting cholinomimetic (alcohol)

A

Edrophonium

Shortest-acting cholinesterase inhibitor

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9
Q

Direct-acting nicotinic agonists

A

Nicotine
Varenicline
Succinylcholine

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9
Q

MOA of edrophonium

A

Inhibitor of cholinesterase; amplifier of endogenously released ACh

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9
Q

Indications of edrophonium

A

Reversal of Nm block by nondepolarizing drugs; diagnosis of myasthenia gravis (Tensilon test)

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10
Q

Indirect-acting cholinomimetic (organophosphates)

A

Insecticides:

Parathion
Malathion
Sarin
Tabun

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11
Q

Indirect acting cholinomimetic (carbamates)

A

Neostigmime
Pyridostigmine
Physostigmine

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11
Q

Indirect-acting cholinomimetic (for Alzheimer’s)

A

Rivastigmine
Galantamine
Donepezil
Tacrine (obsolete)

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12
Q

Indirect-acting cholinomimetics

A 
Edrophonium
Neostigmine
Pyridostigmine
Physostigmine
Rivastigmine
Galantamine
Donepezil
Tacrine
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12
Q

Used for the treatment of myasthenia gravis

A

Neostigmine
(Indirect-acting cholinomimetic)

Others:
Pyridostigmine
Physostigmine

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13
Q

Indirect-acting cholinomimetic used for the treatment of glaucoma

A

Physostigmine

Indirect-acting cholinomimetic

13
Q

Used for the reversal of severe atropine poisoning (IV)

A

Physostigmine

14
Q

How is Tensilon test performed?

A

Edrophonium 2mg is injected via IV after baseline muscle strength has been measured. If no rxn occurs after 45s, an additional 8mg may be injected. If the patient has MG, an improvement that lasts about 5min can usually be observed.

15
Q

Indirect-acting cholinomimetic used for the treatment of Alzheimer’s disease

A

Rivastigmine
(Indirect-acting cholinomimetic)

Others:
Galantamine
Donepezil
Tacrine (obsolete)

16
Q

Antidote for organophosphate poisoning (1st choice)

A

Atropine

Nonselective muscarinic antagonist

17
Q

Signs and symptoms of organophosphate poisoning

A 
DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation
Lacrimation
Sweating
Salivation
18
Q

Toxicities of atropine

A

All parasympatholytic effects plus sedation, delirium, hyperthermia, flushing

19
Q

MOA of Indirect-acting cholinomimetics

A

Inhibits acetylcholinesterase; amplifies endogenously released Ach

20
Q

Antidote for organophosphate poisoning and nerve gas poisoning

A

Pralidoxime

Cholinesterase regenerator

21
Q

Muscarinic antagonist used for asthma and COPD

A

Ipatropium

Tiotropium

22
Q

Muscarinic antagonist used for Parkinson’s disease

A

Benztropine
Biperiden
Trihexyphenidyl

23
Q

Preferred bronchodilator in patients with comorbid COPD and heart disease

A

Ipatropium

24
Q

Muscarinic antagonist used for motion sickness

A

Scopolamine

25
Q

Contraindications to muscarinic blockers

A

Infants
Hyperthermia due to decreased sweating
Acute angle-closure glaucoma
BPH

26
Q

Nondepolarizing neuromuscular blockers

A

Tubocurarine
Pancuronium
Atracurium
Vecuronium

27
Q

Depolarizing neuromuscular blockers

A

Succinylcholine

28
Q

Chemical antagonist of organophosphates; used for organophosphate poisoning

A

Pralidoxime

29
Q

MOA of pralidoxime

A

Cholinesterase regenerator:

Binds phosphorus of organophosphate; breaks organophosphate bond with cholinesterase

30
Q

How is pralidoxime given?

A

Must be administered before 6-8 hours of organophosphate bond with cholinesterase occurs

31
Q

M1-selective antimuscarinic drugs

A

Pirenzepine

Telenzepine

32
Q

Indications of M1-selective antimuscarinic drugs (Pirenzepine, Telenzepine)

A

Peptic disease

33
Q

Antinicotinic ganglion blocker; blocks all autonomic effects

A

Hexamethonium

35
Q

M3 selective antimuscarinics

A

Darifenacin
Fesoterodine
Solifenacin
Tolterodine

36
Q

The most dangerous effect of the antimuscarinic drugs in children and is potentially lethal in infants

A

Atropine fever

37
Q

A drug which causes vasodilation that can be blocked by atropine

A

Bethanechol

38
Q

Indications of M3-selective antimuscarinics

A

Urinary urgency; incontinence

Pharmacology (31 decks)

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