Cholinergics

Question 1

1. ) Effect of muscarinic receptor activation on the: HEART

2. ) What clinical situation would this be beneficial for ?

Answer 1

↓ HR/CV Force

Tachycardia

Question 2

1. ) Effect of muscarinic receptor activation on the: Bronchial Smooth Muscle
2. ) What clinical situation would this be beneficial for ?

Answer 2

Broncho-constriction

Asthma Diagnosis

Question 3

1. ) Effect of muscarinic receptor activation on the: Eyes

2. ) What clinical situation would this be beneficial for ?

Answer 3

Miosis to drain aqueous humor

Glaucoma

Question 4

1. ) Effect of muscarinic receptor activation on the: Glands

2. ) What clinical situation would this be beneficial for ?

Answer 4

↑ secretions

Xerostomia (dry mouth)-Sjogerns

Question 5

1. ) Effect of muscarinic receptor activation on the: GI-tract
2. ) What clinical situation would this be beneficial for ?

Answer 5

↑ GI motlity

Gastric Atony

Question 6

1. ) Effect of muscarinic receptor activation on the: Bladder
2. ) What clinical situation would this be beneficial for ?

Answer 6

↑ Urination

Urinary Retention

Question 7

1. ) Effect of muscarinic receptor activation on the: Vessels
2. ) What clinical situation would this be beneficial for?

Answer 7

↑ vasodilatation

Hypertension

Question 8

1. ) Effect of muscarinic receptor activation on the: CNS

2. ) What clinical situation would this be beneficial for?

Answer 8

↑ cognition/tremor

Alzheimer’s?– Use ONLY AChI

Question 9

1. ) Effect of muscarinic receptor inhibition on the: Glands

2. ) What clinical situation would this be beneficial for ?

Answer 9

↓ secretions

COPD

Question 10

1. ) Effect of muscarinic receptor inhibition on the: Bladder
2. ) What clinical situation would this be beneficial for ?

Answer 10

↓ urination

overactive bladder

Question 11

1. ) Effect of muscarinic receptor inhibition on the: CNS

2. ) What clinical situation would this be beneficial for ?

Answer 11

CNS depression
↓ tremors

Good for:

• Motion sickness
• Parkinsons

Question 12

What Muscarinic agonist is used for an asthma diagnosis?

Answer 12

Methacholine

Question 13

Nicotine Replacement Therapy MOA?

Answer 13

Agonist on the α4β2 receptors; reduces withdrawal sx – Types → gum; lozenge; patch; nasal spray; inhaler

Question 14

Varenicline

1. ) MOA?
2. ) Indication?

Answer 14

1. ) Partial agonist at the α4β2 neuronal nicotinic receptors
2. ) Smoking Cessation

Question 15

Bupropion

1. ) Indication?
2. )MOA?
3. )ADR?

Answer 15

1. ) Primarily used as an anti-depressant; also can be used for smoking cessation
2. ) inhibits DA and NE reuptake pumps
3. )Can lower the seizure threshold

Question 16

1. ) What drugs are Alzheimers AChI’s

2. ) Dose limiting ADR?

Answer 16

1. )
   - Donepezil
   - Rivastigmine
   - Galantamine

2.) Bradycardia

Question 17

Edrophonium

1. ) Drug class?
2. ) Indication?

Answer 17

1. ) Non- AD ACHI

2. ) Myasthenia gravis diagnosis

Question 18

Neostigmine

1. ) Drug class?
2. ) Indication?

Answer 18

1. ) Non- AD ACHI

2. ) Myasthenia gravis treatment

Question 19

Pyridostigmine

1. ) Drug class?
2. ) Indication?

Answer 19

1. ) Non- AD ACHI

2. ) Myasthenia gravis treatment

Question 20

Physostigmine

1. ) Drug class?
2. ) Indication?

Answer 20

1. ) Non- AD ACHI

2. ) ***Anticholinergic toxidrome

Question 21

Ambenonium

1. ) Drug class?
2. ) Indication?

Answer 21

1. ) Non- AD ACHI

2. ) Myasthenia gravis treatment

Question 22

“C holinergic crisis” vs. “Myasthenic c risis”

Answer 22

• “ Cholinergic crisis” = too much ACh in NMJ (need less)

- “Myasthenic c risis” = not enough ACh in NMJ (need more)

Question 23

Malathion/Parathion

1. ) Drug Class
2. ) MOA

Answer 23

1. ) irreversible AChI’s (pesticides)

2. )Covalent* binding to enzyme active site leading to irreversible inhibition of AChesterase→ Cholinergic toxidrome

Question 24

Sarin

1. ) Drug Class
2. ) MOA

Answer 24

1. ) irreversible AChI’s

2. )Covalent* binding to enzyme active site leading to irreversible inhibition of AChesterase→ Cholinergic toxidrome

Question 25

What are the ADR’s of Cholinergic Toxidrome/Crisis

Answer 25

Salviation/SWEATING
Lacrimation
Urination
Diarrhea
GI upset
Emesis

Bronchospasm
Bradycardia
Bronchorrhea (excessive sputum)

Question 26

Treatment of Organophosphate Toxicity

Answer 26

-Pralidoxime (2-PAM) (prior to aging of enzyme)
AND
-Atropine (antimuscarinic )