Cholinergic Receptor Inhibiting Drugs Flashcards

1
Q

Do drugs the block muscarinic receptors have any effect on nicotinic receptors?

A

no

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2
Q

Name the 6 tertiary amines that block muscarinic receptors.

A

atropine, scopolamine, dicyclomine, tropicamide, tolterodine, benztropine

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3
Q

What effect is atropine and tropicamide used to produce and which receptor does it block?

A

mydriasis and cycloplegia (paralysis of the ciliary muscle); M3

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4
Q

What is scopolamine used to treat and which receptor does it block?

A

prevent or reduce motion sickness; muscarinic, subtype unknown

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5
Q

What is dicyclomine used to treat and which receptor does it block?

A

reduce transient hypermotility of the GI tract; M1 and M3

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6
Q

What is tolterodine used to treat and which receptor does it block?

A

Transient cystitis, postoperative bladder spasms, incontinence; M3

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7
Q

What is benztropine used to treat?

A

manifestations of parkinson’s disease

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8
Q

Which if the tertiary amines crosses the blood brain barrier?

A

benztropine

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9
Q

Name the 2 quaternary amines that block muscarinic receptors and which receptor do they block?

A

Ipratropium and Tiotropium; M3

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10
Q

What are the 2 quaternary amines (Ipratropium and Tiotropium) used to treat and which one is longer acting?

A

asthma and COPD; Tiotropium is longer acting

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11
Q

Which of the following is a ganglionic blocker and which receptor does it block?
Hexamethonium, succinylcholine, Tubocurarine, Mivacurium or Botulinum Toxin A

A

Hexamethonium; blocks Nn receptor

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12
Q

Which of the following is a depolarizing blocker and which receptor does it block?
Hexamethonium, succinylcholine, Tubocurarine, Mivacurium or Botulinum Toxin A

A

Succinylcholine; blocks Nm receptor by overstimulating the receptor with depolarization causing desensitization to further Ach stimulation

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13
Q

Which of the following are nondepolarizing blockers and which receptor do they block?
Hexamethonium, succinylcholine, Tubocurarine, Mivacurium or Botulinum Toxin A

A

Tubocurarine and Mivacurium; block Nm receptor

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14
Q

Which of the following is a local paralytic and which does it block?
Hexamethonium, succinylcholine, Tubocurarine, Mivacurium or Botulinum Toxin A

A

Botulinum toxin A; blocks vesicle fusion and Ach release by degrading SNAP-25

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15
Q

What is Hexamethonium used to treat?

A

for hypertensive emergencies and to produce hypotension for “bloodless field” surgeries; rarely used

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16
Q

What is succinylcholine used for?

A

Brief procedures (ex: tracheal intubation, reset dislocated joints); short lasting effects

17
Q

What is Tubocurarine used for and how long does it last?

A

Muscle relaxant for surgery without deep anesthesia; lasts 30-60mins

18
Q

What is Mivacurium used for?

A

Muscle relaxant for surgery without deep anesthesia; hydrolyzed more rapidly than tubocurarine so its short acting

19
Q

What are the combined toxicities for the nondepolarizing and depolarizing blockers?

A

respiratory paralysis which can lead to death

20
Q

What is the non-depolarizing blocker used in capital punishment?

A

pancuronium

21
Q

Which drugs are cholinesterase inhibitors good at reversing the effects of; nondepolarizing blockers, depolarizing blockers or ganglionic blockers?

A

non-depolarizing blockers

22
Q

What is Botulinum Toxin A used for?

A

Reduce frown lines and wrinkles, achalasia (abnormal esophageal contractions) strabismus (misalignement of eyes) and oromandibular dystonia (spasms of face and jaw)

23
Q

Do ganglionic blockers block the parasympathetic nervous system, sympathetic nervous system or both?

A

both; they block the Nn receptor

24
Q

Do muscarinic receptor antagonists block the parasympathetic nervous system, sympathetic nervous system or both?

A

parasympathetic

25
What is the mnemonic for an overdose of atropine (and other antimuscarinic drugs)?
"dry as a bone, blind as a bat, red as a beet, and mad as a hatter"
26
Why is atropine a good drug to use for poisoning with cholinesterase inhibitors?
its a tertiary amine so it can interact well with the CNS and the peripheral muscarinic receptors
27
What is meant by "dry as a bone" with overdose of antimuscarinics?
decreased sweating, lacrimation and salivation
28
What is meant by "blind as a bat" with overdose of antimuscarinics?
blockade of accommodation and excessive pupil dilation
29
What is meant by "red as a beet" with overdose of antimuscarinics?
dilation of cutaneous vessels in upper body (atropine flush)
30
What is meant by "mad as a hatter" with overdose of antimuscarinics?
inhibition of CNS muscarinic receptors with complex consequences
31
What is the atropine fever?
hyperthermia from the block of thermoregulatory sweating by antimuscarinics **Dangerous in infants and small kids**
32
How does hexamethonium lead to hypotension?
blood vessels main input is vasoconstrictor fibers from the SNS, so blocking the output from ganglions blocks the vasoconstriction signal leading to vasodilation and hypotension
33
Which type of antimuscarinic can cross the BBB, quaternary amines or tertiary amines?
tertiary amines
34
Is tropicamide used for long acting antagonism of M3 or short acting?
short acting because it is rapidly metabolized