Cholinergics

Question 1

Neostigmine

Answer 1

AChE inhibitor
Uses: SM contraction (GI and bladder voidance)
Glaucoma
Myasthenia gravis
Reverse neuromuscular blockers

Question 2

Pyridostigmine

Answer 2

AChE inhibitor
Uses: similar to neostigmine with longer duration of action
most common myasthenia gravis treatment

Question 3

Edrophonium

Answer 3

AChE inhibitors
rapid onset, short duration of action
Uses: Dx of myasthenia gravis “Tensilon Test”
IV injection improves muscle strength in MG patients

Question 4

Organophosphates

Answer 4

irreversible AChE inhibitor

toxic

Question 5

Pralidoxime

Answer 5

reactivate AChE following organophosphate poisoning if before “aging”

Question 6

Atropine

Answer 6

MAChR antagonist

-dose dependent effects

Question 7

Atropine

Answer 7

MAChR antagonist
-dose dependent effects
Potential uses
-eye: mydriasis, promotes dry eye
-respiratory tract: promotes bronchial dilation, dries secretion (post-op), impairs bronchociliary action
-heart: tachycardia, enhanced conduction (treat AV block)
-GI: antispasmotic effect, treat IBD
-Urinary tract: decrease contractile tone, frequency
-antidote for cholinergic crisis, insecticide poisoning

Question 8

Ipratropium

Answer 8

MAChR antagonist

• similar to atropine
• used for asthma/COPD, bronshodilation that does not inhibit mucociliary clearance
• treatment of rhinorrhea

Question 9

Titotropium

Answer 9

MAChR antagonist

• more bronchoselective (less M2 affinity)
• used for COPD, inhalation of dry powder