Cholinergics

Question 1

Nicotine mechanism of action

Answer 1

Activation of neuronal nicotinic receptors

Question 2

Nicotine indication

Answer 2

Withdrawal symptoms of smoking cessation

Question 3

Succinyllcholine mechanism of action

Answer 3

Depolarizing block of muscle nicotinic receptors

Question 4

Acetylcholine mechanism of action

Answer 4

Nicotinic and muscarinic agonist

Question 5

Acetylcholine indication

Answer 5

No therapeutic use because of rapid degradation

Question 6

Methacholine mechanism of action

Answer 6

Muscarinic agonist

Question 7

Methacholine indication

Answer 7

Diagnosis of subclinical asthma

Test for severity of asthma

Question 8

Carbachol mechanism of action

Answer 8

Muscarinic and nicotinic receptor agonist

Question 9

Carbachol indication

Answer 9

Miotic agent in ocular surgery

Reduces pressure following ocular surgery

Question 10

Bethanechol mechanism of action

Answer 10

Muscarinic agonist

Question 11

Bethanechol indication

Answer 11

Urinary retention

Bladder atony

Question 12

Pilocarpine mechanism of action

Answer 12

Muscarinic agonist

Question 13

Pilocarpine indication

Answer 13

Dry mouth from head/neck radiation or Sjogrens syndrome

Narrow angle glaucoma

Question 14

Neostigmine mechanism of action

Answer 14

AchE inhibitor

Question 15

Neostigmine indication

Answer 15

Myasthenia gravis

Reversal of neuromuscular block

Question 16

Edrophonium mechanism of action

Answer 16

AchE inhibitor

Question 17

Edrophonium indication

Answer 17

diagnosis of myasthenia gravis

Reversal of neuromuscular block

Question 18

Physostigmine mechanism of action

Answer 18

Reversible AchE inhibitor

Question 19

Physostigmine indication

Answer 19

Delirium from anticholinergic drugs

Glaucoma

Question 20

Donepezil mechanism of action

Answer 20

Reversible AchE inhibitor

Question 21

Deonepezil indication

Answer 21

Alzheimers disease

Question 22

Pralidoxime mechanism of action

Answer 22

Peripheral AchE reactivator

Question 23

Pralidoxime indication

Answer 23

Respiratory muscle weakness from organophosphate poisoning

Question 24

Echothiophate mechanism of action

Answer 24

Irreversible AchE inhibitor

Question 25

Echothiophate indication

Answer 25

Open angle glaucoma

Question 26

Atropine mechanism of action

Answer 26

Muscarinic antagonist

Question 27

Atropine indication

Answer 27

``` Excess secretions during surgery Increased frequency/urgency of urination with cystitis Hypertonic gut Organophosphate poisoning Bradycardia ```

Question 28

Scopolamine mechanism of action

Answer 28

Muscarinic antagonist

Question 29

Scopolamine indication

Answer 29

Motion sickness | Anti-saliagogue in surgery

Question 30

Glycopyrrolate mechanism of action

Answer 30

Muscarinic receptor antagonist

Question 31

Glycopyrrolate indication

Answer 31

Protect against excessive muscarinic activation during reversal of neuromuscular block Anti-saliagogue

Question 32

Toxicity of methacholine

Answer 32

bronchiole constriction

Question 33

Contraindication of methacholine

Answer 33

β blockers will prevent reversal of constriction

Question 34

Carbachol toxicity

Answer 34

Excessive muscarinic activation (bronchoconstriction, reduced cardiac condition)

Question 35

Bethanechol toxicty

Answer 35

Bradycardia, bronchoconstriction | Less effect on M2 receptors than carbachol

Question 36

Bethanechol contraindications

Answer 36

asthma, peptic ulcers, bradycardia

Question 37

Pilocarpine toxicity

Answer 37

Excessive muscarinic activation (slowed AV conduction) Hypotension Excessive salivation Bronchoconstriction

Question 38

Neostigmine toxicity

Answer 38

muscarinic and nicotinic excess

Question 39

Edrophonium toxicity

Answer 39

bradycardia cardiac standstill Excess can appear like myasthenia gravis

Question 40

Edrophonium contraindications

Answer 40

intestinal blockade or urinary obstruction

Question 41

Physostigmine side effects

Answer 41

Convulsions, respiratory and CV depression | due to increased ACh at muscarinic and nicotinic receptors

Question 42

Physostigmine contraindications

Answer 42

asthma, CV disease, intestinal obstruction

Question 43

Organophosphate toxicity

Answer 43

DUMBBELLS | diarrhea, urination, miosis, bradycardia, bronchorrea, emesis, lacrimation, salivation

Question 44

Succinylcholine contraindications

Answer 44

Patients with Hx of familial hyperthermia or skeletal muscle myopathies