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Pharmacology > Cholinergics > Flashcards

Cholinergics Flashcards

1
Q

Afferent Neuron

A

away from target organ

reflexes- baroreceptor reflex and emotional stimuli

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2
Q

Efferent Neuron

A

to target organ

pre and post ganglionic

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3
Q

Preganglionic Neuron

A

cell body in CNS
from brainstem or spinal cord to ganglia
myelinated

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4
Q

Postganglionic Neuron

A

cell body originates in ganglia
nonmyelinated
ends at target organ

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5
Q

Sympathetic Neuron Origins

A

from T1-T12 or L1-L5

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6
Q

Sypathetic Neurons

A

synapse in ganglia chains

short pre, long post

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7
Q

Parasympathetic Neuron Origins

A

CN 3, 7, 9, 10

S2-S4

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8
Q

Parasympathetic Neurons

A

long pre, short post

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9
Q

Sympathetic Affects

A 
eyes- dilate
heart- increase beats
lungs- bronchodilate
GI- vasoconstrict- slows mvmt
Urinary- stops
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10
Q

Parasympathetic Affects

A 
eyes- constrict
heart- decrease beats
lungs- bronchoconstrict
GI- vasodilate- increase mvmt
Urinary- increases
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11
Q

Neurotransmitter acting on nicotinic receptors

A

ACh

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12
Q

Neurotransmitter acting on muscarinic receptors

A

ACh

parasympathetic

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13
Q

Neurotransmitter acting on A and B receptors

A

NE

sympathetic

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14
Q

What is different about sweat glands?

A

part of sympathetic but have a muscarinic receptor and so respond to ACh

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15
Q

Nn

A

acts on nerves

ganglia, adrenal medulla

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16
Q

Nm

A

acts on skeletal muscles
voluntary actions
still uses ACh

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17
Q

Adrenal Medulla

A

stim by ACh
releases Epi and NE into blood
aka neurohumoral

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18
Q

Andrenergic

A

NE acting on a A or B receptor

cardiac and smooth mm, glands, nerve terminals

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19
Q

Dopaminergic

A

Dopamine acting on dopamine receptor

renal vascular smooth muscle

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20
Q

Cholinergic

A

nicotinic and muscarinic

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21
Q

Nervous system required for life

A

Parasympathetic

symp not needed

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22
Q

Dual Innervation of Para and Symp

A

Para dominates

Symp only dominates when it is the only one present

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23
Q

Organs that receive only sympathetic innervation

A

blood vessels
adrenal medulla
pilomotor muscles
sweat glands

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24
Q

Cannot release Epinephrine

A

nerves

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25
Q

Rate limiter in Ach release

A

Choline transported into nerve

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26
Q

Allows Ach to be released from vesicles inside the nerve

A

Ca channels

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27
Q

3 Fates of Ach

A

binds to receptor
broken down by acetylcholine-esterase; choline recycled
reuptake at presynaptic receptor

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28
Q

Presynaptic Receptor

A

M2- Gi

for negative feedback

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29
Q

Increasing cAMP has what affect on nerves?

A

closes Ca channels

Ach release stopped

30
Q

M agonist affect on nerves

A

more Ach released, more parasympathetic affects

31
Q

Ach-esterase inhibitor affect on nerves

A

more Ach stays in system, more parasympathetic affects

32
Q

Botox affect on nerves

A

inhibits release of Ach

stops sweat, mm paralysis

33
Q

Spider Venom affect on nerves

A

more Ach released

more para affects

34
Q

M1 Receptors

A

in brain

35
Q

M2 Receptors

A

heart

presynaptic ganglion

36
Q

M3

A

everything else

37
Q

M1, M3, M5 interact with

A

Gs

38
Q

M2 and M4 interact with

A

Gi

39
Q

Muscarinic Agonists

A

bind muscarinic receptors
same affects as Ach but longer half life
para affects + sweating

40
Q

Examples of Muscarinic Agonists

A 
bethanechol
carbachol
methacholine
pilocarpine
cevimeline
41
Q

Blood vessels under the effect of muscarinic agonist

A

vasodilate from nitric oxide release

42
Q

Bethanechol

A

muscarinic agonist

stim smooth muscle of GI and bladder

43
Q

Carbachol

A

muscarinic agonist

rarely used

44
Q

Methacholine

A

muscarinic agonist

inhaler- causes bronchoconstriction to diagnose non-apparent asthma

45
Q

Pilocarpine

A

muscarinic agonist

glaucoma

46
Q

Cevimeline

A

muscarinic agonist

for xerostomia/ Sjogren’s syndrome- stim salivary secretion to fix cottonmouth

47
Q

Sjogren’s Syndrome

A

autoimmune disease causing decreased secretions

48
Q

Treating Glaucoma

A 
decrease production
increase drainage (muscarinic agonist)
49
Q

Fixing muscarinic toxicity

A

atropine

epinephrine

50
Q

Examples of Ach-esterase Inhibiters

A 
physostigmine
pyridostigmine
neostigmine
edrophonium
donepezil
51
Q

Physostigmine

A

Ach-esterase inhibitor
tertiary amine- lipid sol
can enter CNS and cause seizure

52
Q

Pyridostigmine/ Neostigmine

A

Ach-esterase inhibitor

treat myasthenia gravis

53
Q

Edrophonium

A

Ach-esterase inhibitor

diagnose myasthenia gravis- results in rapid increase in muscle strength

54
Q

Myasthenia Gravis

A

autoimmune disease where antibodies attack Nm receptors

weakness in skeletal mm, especially face- ptosis

55
Q

Donepezil

A

Ach-esterase inhibitor
treat Alzheimer’s
can enter CNS

56
Q

Alzheimer’s

A

loss of cholinergic neurons- not enough Ach

57
Q

Irreversible Ach-esterase Examples

A

sarin nerve gas

parathion and malathion (insecticides)

58
Q

Pralidoxime

A

frees enzyme of irreversible Ach-esterase inhibitor if given in proper time frame

59
Q

Toxicity of Ach-esterase Inhibitors

A

DUMBBEELSS
diarrhea, urination, miosis, bradycardia, bronchoconstriction, excitation of CNS, emesis, lacrimation, salivation, sweating

60
Q

Treating Ach-esterase Inhibitor toxicity

A

atropine- muscarinic blocker

61
Q

Most dangerous part of Ach inhibitor toxicity

A

diaphragm paralysis

wont be treated with atropine since has a Nm receptor

62
Q

Antimuscarinic Agents

A

block muscarinic receptors

63
Q

Atropine

A

Muscarinic blocker
gets into CNS
half life of 2 hrs; can last 72 hrs + in eye

64
Q

Meds to dilate pupil

A 
muscarinic blockers
atropine (72 hrs)
homatropine (24 hrs)
cyclopentolate (2-12 hrs)
tropicamide (.5-4 hrs)
65
Q

Scopolamine

A

M blocker

motion sickness

66
Q

Parkinsons

A

from loss of dopaminergic neurons

too little dopamine and too much Ach

67
Q

Treating Parkinsons

A

M blocker

68
Q

Motion Sickness

A

stimulation of M receptors

69
Q

Asthma and COPD

A

bronchoconstriction

treat with M blockers- bronchodilation

70
Q

Tolterodine, Oxybutynin

A

M blocker

reduce urgency

71
Q

Toxicity of M Antagonists

A 
decreased salivation
vasodilation
CNS effects
no accommodation
can be fatal in infants- overheating
acute angle closure glaucoma in elderly

Pharmacology (12 decks)

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