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ANS Pharmacology > Cholinergics > Flashcards

Cholinergics Flashcards

1
Q

What direct cholinergic agonists are sensitive to cholinesterase

A

Acetylcholine ++++, methacoline +

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2
Q

What drugs are direct pure mAChR agonists

A

Methacoline, bethanechol, pilocarpine

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3
Q

What direct cholinergic agonists can cross the membrane

A

Alkaloids

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4
Q

What direct cholinergic agonists are used to cause miosis in intraocular surgery

A

ACh, carbachol, pilocarpine

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5
Q

What direct cholinergic agonists is used to treat urinary retention

A

Bethanechol

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6
Q

What direct cholinergic agonist is used to treat heart burn

A

Bethanechol

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7
Q

What direct cholinergic agonists are used to treat glaucoma

A

Carbachol, pilocarpine

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8
Q

What direct cholinergic agonists is used to treat sjogrens/xerostomia

A

Pilocarpine

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9
Q

What direct cholinergic agonist is used to treat smoking

A

Varenicline

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10
Q

What are the side effects of varenicline

A

Nausea, neuropsychiatric

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11
Q

What are the symptoms of a muscarinic toxicity

A

Sludge. Salivation, lacrimation, urination, defecation, GI, emesis

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12
Q

What are the contraindications for direct cholinergic agonists

A

Asthma, hyperthyroidism, coronary insufficiency, acid peptic disease

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13
Q

What are the symptoms of nicotinic toxicity

A

CNS stimulation, skeletal m end plate depolarization, respiratory paralysis, hypertension, Arrhythmias

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14
Q

Tx for nicotinic toxicity

A

Atropine and diazepam

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15
Q

What are the 3 types of AChE inhibitors and what about their binding

A

Alcohols - reversible
Carbamic acid esters - reversible and longer lasting
Organophosphates - irreversible

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16
Q

What are the charged AChE inhibitors

A

Edrophonium, pyridostigmine, neostigmine, echothiophate, ambenonium

17
Q

What are the neutral AChE inhibitors

A

Physostigmine, donepezil, galantamine, rivastigmine, tacrine

18
Q

What are the uses for AChE inhibitors

A

Glaucoma, dementia, antidote to anticholinergics, reversal of neuromuscular paralysis, myasthenia gravis

19
Q

What can cause anticholinergics poisoning

A

Atropine, antihistamine, TCAs, sleep aids, cold preparations

20
Q

What are the symptoms of anticholinergics poisoning

A

Cutaneous vasodilation, anhidrosis, anhydrotic HTN, nonreactive mydriasis, delirium, hallucinations, reduced desire to urinate

21
Q

What are the symptoms of AChE inhibitor poisoning

A

Sludge plus muscle fasciculations

22
Q

Treatment for AChE inhibitor toxicity

A

Atropine and pralidoxine

23
Q

Do choline esters cross membranes? Why?

A

No because they are permanently charged

24
Q

Drugs used for cholinergic poisoning?

A

Atropine + pralidoxine

25
Q

What are the anticholinergics used to treat parkinson disease

A

Tertiary amines - benzotropine, trihexyphenidyl, and procyclidine. This is used in combination with dopaminergic therapy.

26
Q

What is the anticholinergic used to treat motion sickness

A

Scopolamine - PO,injection, transdermal

27
Q

What are the role of anticholinergics in anesthesia? Ex?

A

Atropine is given to block responses to vagal reflexes induced by surgical manipulation of viscera.
Atropine or glycopryrrolate is paired with the cholinesterase inhibitor neostigmine to block its parasympathetic effects

28
Q

What anticholinergics are used to prevent synechia formation in uveitis and irits (iris adhering to lens or cornea)?

A

Homatropine or atropine

28
Q

What anticholinergics are used to treat asthma and COPD?

A

Ipratropium and tiotropium

28
Q

What mAChR antagonists are used to treat GI hypermotility?

A

Lomotil - combination of atropine and diphenoxylate

29
Q

What specific receptor is targeted for symptomatic relief in Tx of urinary urgency

A

M3

30
Q

What are the selective M3 antagonists?

A

Oxybutynin, darifenacin, solifenacin, and tolterodine

31
Q

What are the side effects of oxybutynin

A

dry mouth/eyes, dizziness, constipation, blurred vision

32
Q

What are the adverse effects of antimuscarinic agents used to reduce GI secretion

A

Mydriasis (pupillary dilation) & cycloplega (paralysis of ciliary m - loss of accomodation)

33
Q

What are the contraindications for anticholinergics?

A

Glaucoma, prostatic hyperplasiam acid-peptic disease

34
Q

What are the symptoms of anticholinergic overdose?

A

Dry as a bone, blind as a bat, red as a beet, mad as a hatter, hot as a hare. Tx with AChE inhibitors

ANS Pharmacology (3 decks)

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