Cholinergics Flashcards

1
Q

M1

A

Nerves Gq

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2
Q

M2

A

Heart nerves smooth muscle

Gi

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3
Q

M3

A

Glands SM, endothelium

G1

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4
Q

M4

A

CNS Gi

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5
Q

M5

A

CNA Gq

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6
Q

Nm

A

Skeletal muscle
Pentameric a2bdelta game/epsilon
NaK depolarizing channel

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7
Q

Non

A

Postganglionic cells body , dendrites, CNS
A and b only
Na K depolarizing ion channel

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8
Q

Entropic

A

Misalignment of the eyes caused by hypermetropic accommodative error

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9
Q

Eye

A

M2, M3

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10
Q

Heart SA/AV

A

M2

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11
Q

Atria

A

M2

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12
Q

Ventricle

A

M2

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13
Q

Endothelium

A

M3

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14
Q

Glands

A

M2,3

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15
Q

Lung

A

M2,M3

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16
Q

Lung

A

M2,M3

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17
Q

GI

A

M2,M3

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18
Q

CNS

A

M1-M5

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19
Q

Most organs

A

M3 predominant

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20
Q

Heart

A

M2

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21
Q

Smooth muscle

A

M2,3

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22
Q

What direct agonists are susceptible to acetylcholinesterase

A

Methacholine a bit not carb or beth

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23
Q

Which direct cholinergic agonist has nicotonic cation

A

Carabachol

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24
Q

Muscadine

A

Charged but can cross the BBB and is highly toxic (muschrooms)

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25
Q

AChe inhibitors

A

Alcohols (reversible)
Carbamic acid esters-reversible but no longer lasting than alcohols
Organophosphate -irreversible (covalent)

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26
Q

Charged AChE inhibitor

A

Insoluble in lipids
Do not cross BBB, poor PO absorption
Edrophonium, pyridostigmine, neostigmine, echothiophate, ambenonium

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27
Q

Neutral AChe inhibitors

A

Can cross BBB and readily absorbed
Organophosphates
Tertiary agents (physostigmine, donepezil, galantamine, rivastigmine, tacrine)

28
Q

Cevimeline

A

Direct acting cholinergic Oral tablet used to treat dry mouth in patients with sjorgen

29
Q

Varenicline

A

Smoking cessation
Partial agonist bindsa4b2 Nn

Stimulation and sustained release of mesolimbic dopamineare thought to reduce craving and withdrawal symptoms

30
Q

Adverse effects varenicline

A

Nausea, neuropsychiatric (behavior changes, agitation, depressed, suicidal, suicide)

31
Q

Uses for direct acting cholinergic

A

Post op ileus, congenital megacolon, urinary retention, esophageal reflux, zerosterma, sjorgen

32
Q

Who are muscarinic stimulants contraindicated in

A

Asthma, hyperthyroidism, coronary insuffiency, acid peptic disease

33
Q

How get nicotine poisoning

A

Cigarettes and insecticides

34
Q

Symptoms of nicotonic poisoning

A

CNS stimulation, skeletal muscle and end plat depolarization, respiratoy paralysis, hypertension, cardiac arrhythmia

35
Q

How treat ACH toxicity

A

Atropine and an anticonvulsant(diazepam a anticonvulsant)

36
Q

Drugs used for ophthalmology

A

Atropine, cyclopentolate, homatropine, scopolamine, tropicamide

37
Q

Drugs for respirator

A

Tiotropium

38
Q

Urinary drugs

A
Darifenacin
Oxybutaynin
Solifenacin
Tolterodine
Trospium
39
Q

Drugs for movement disorders

A
Benztropine
Biperiden
Orphenadrine
Procylidine
Trihexyphenidyl
40
Q

What are homatropine and atropine used for

A

Prevent synechia formation in uveitisand iritis -long acting mydriasis and cycloplegia for 14 days

41
Q

Ipratopium and tiotropium

A

Tiotropium is longer

42
Q

Bladder receptor to prevent urgency for anticholinergic

A

M3

43
Q

What selective M3 drugs for preventing urinary urgency

A

Darifenacin, solifenacin, tolterodine

Longer half lives and reduced xerosterma and constipation

44
Q

Contraindications for anticholinergics

A

Glaucoma
Prostatic hyperplasia
Acid peptic disease

45
Q

Dopamine agonist

A

Fenoldpam D1 receptor

Dopamine equal D1=D2

46
Q

Partial B agonists

A

Acebutolol
Labetalol
Pindolol
Penbutolol

47
Q

Penbutolol

A

B1 and B2 non selective blocker

48
Q

Partial b agonist and ISA

A

Block sympathetic effects but have submaximal effects

Less risk for bradycardia, increases VLDL/HDL and other effects of beta receptor blockade

49
Q

Adverse effects of beta blockers

A

Sedation, sleep disturbances, depression
Increase VLDL and decrease HDL with chronic use
May exacerbate hypoglycemia in type 1 diabetes patients on insulin

50
Q

Cocaine

A

Indirect adrenomimetics

Inhibits re uptake of DA and NE

51
Q

Selegiline and phenelzine

A

Indirect adrenomimetics

Inhibitors of MAO

52
Q

Amphetamines, methylphenidate, tyramine

A

Indirect adrenomimetics

Reverse NA and DA uptake mechanism and increase their release

53
Q

Silicosis

A

A1 selective

54
Q

Emphetamine and methamphetamine

A

Marked stimulant effect on mood and alertness
Decrease appetite
Drug abuse

55
Q

Methylphenidate

A

Used in children with ADHD similar to amphetamine but has an abuse potential

56
Q

Cocain

A

Inhibitors transmitter reuptake at adrenergic synapses
Peripheral and intense central action
Local anesthetic properties
Heavily abused

57
Q

Phenelzine and selegiline

A

Inhibitors of MAO
Increase NE stores in CNA
Antidepressant action

58
Q

Tyramine

A

Indirect adrenergic agonist
Product of tyrosine metabolism that is found in cheese, meats, smoked and pickled fish

Releases stored NE from presynaptic adrenergic terminals
Metabolized by MAO in liver
May lead to increase in BP in patients taking MOA inhibitors

59
Q

Metytosine

A

Indirect acting inhibits synthesis of tyrosine hydroxilare at pre synaptic neuron

60
Q

Guanethidine

A

Indirect acting prevents storage and depletes NE at synapse

61
Q

Direct acting

A

Right on post synaptic neuron

62
Q

Cocain

A

Indirect acts at synapse preventing reuptake

63
Q

Phenelzine

A

MOA inhibitor in presynaptic neuron indirect

64
Q

Amphetamine and ephedrine

A

Synapse release agent

65
Q

Direct acting

A

On post synaptic neuron