Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology Exam 2 (by Richie) > Cholinergics - 8/21/15 (Scrogin) > Flashcards

Cholinergics - 8/21/15 (Scrogin) Flashcards

1
Q

Name 2 classes of cholinergic receptors

A
  1. Muscarinic (GPCR)

2. Nicotinic (ligand gated ion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many transmembrane polypeptides compose nicotinic receptors?

A

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nicotinic receptors are permeable to what ions?

A

K+ and Na+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nicotinic receptors are located on what cell types?

A

Nn type: POST-ganglionic cells

Nm type: skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which system, sympathetic or parasympathetic, is activated by nicotinic agonists?

A

Both, simultaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Nicotine stimulates what type of receptors, specifically

A

Nn in autonomic ganglia, and CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What’s nicotine used for

A

smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MOA of succinylcholine

A

Blocks Nm receptors in the NMJ, causing depolarization block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Succinylcholine - Rx?

A

relaxation for intubation or ECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Succinylcholine - 2 contraindications?

A

familial hyperthermia

skeletal muscle myopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name 4 quaternary nitrogen analogs

A

Acetylcholine
Methacholine
Carbachol
Bethanechol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acetylcholine - what receptors?

A

Nicotinic and muscarinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acetylcholine - clearance?

A

BOTH acetyl and plasma-cholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acetylcholine - Rx?

A

No therapeutic use - metabolized to fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Methacholine - clearance?

A

acetylcholinesterase, slowed hydrolysis (longer t1/2 than acetylcholine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Methacholine - receptors?

A

Muscarinic - smooth muscle, glands, heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Methacholine - Rx?

A

Diagnose asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Methacholine - Tx?

A

Bronchiolar constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Methacholine - contraindication?

A

B-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Carbachol - clearance?

A

More resistant to acetylcholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Carbachol - receptors?

A

Both muscarinic and nicotinic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Carbachol - Rx

A

miotic agent

Reduces intraocular pressure after cataract surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Carbachol - SE?

A

excessive muscarinic/nicotinic activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bethanochol - clearance

A

resistant to acetyl- and plasma cholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Bethanochol - receptor selectivity?

A

Muscarinic only (GI and urinary bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bethanochol - Rx?

A

Post-op urinary retention
Post-partum urinary retention
Neurogenic bladder atony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Can quaternary amine drugs cross the BBB

A

No they’re charged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Bethanochol - contra?

A

peptic ulcer
asthma
bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Muscarine poisoning causes profound

A

sympathetic activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Muscarine poisoning - antidote?

A

Atropine - muscarinic antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pilocarpine - receptor selectivity?

A

pure muscarinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pilocarpine - BBB?

A

Yes, crosses (tertiary amine). Appreciable CNS effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pilocarpine - Rx?

A

dry mouth (radiotherapy)
Sjogren’s syndrome
Open glaucoma
Closed-angle glaucoma

34
Q

Pilocarpine - Contra?

A

B-blockers (exacerbates slowed conduction)

35
Q

Cholinesterase inhibitors act INDIRECTLY as

A

cholinergic agonists

36
Q

2 types of endogenous cholinesterases:

A
  1. Acetylcholinesterase

2. Plasma-cholinesterase (aka butyryl-cholinesterase)

37
Q

Where is butyrylcholinesterase localized

A

plasma

38
Q

What hydrolyzes exogenous cholinergics?

A

butyrlcholinesterase (plasma cholinesterase)

39
Q

Name 3 reversible cholinesterase inhibitors

A
  1. Neostigmine
  2. Edrophonium
  3. Donepazil
40
Q

Neostigmine - BBB?

A

Poor penetration of BBB

41
Q

Neostigmine - MOA

A

inhibits acetylcholinesterase; stimulatory effect at Nm

42
Q

Neostigmine - Rx

A

Reverse neuromuscular blockade

eg. MS

43
Q

Neostigmine - SE

A

Excessive ACh stimulation at peripheral muscarinic and Nm

44
Q

Neostigmine - contra

A

intestinal obstruction

45
Q

Edrophonium - MOA?

A

Inhibits cholinesterases, stimulates nicotinic R

46
Q

Edrophonium - pharmakodynamics?

A

Rapid onset of action. Short duration of action.

47
Q

Edrophonium - Rx?

A
  1. Diagnosis of myasthenia gravis

2. Differential btwn myasthenia gravis progression and cholinergic crisis (excessive ACh)

48
Q

Edrophonium - SE?

A

Bradycardia

49
Q

Edrophonium - Tx?

A

Neuromuscular block promoting muscle weakness (mistaken for MS progression)

50
Q

Physostigmine - BBB?

A

Crosses it

51
Q

Physostigmine - clearance?

A

plasma cholinesterase (long time though)

52
Q

Physostigmine - Rx?

A

Counteract delirium via excess anticholinergic activation

53
Q

Physostigmine - SE?

A

too much ACh at N and M receptors

54
Q

Physostigmine - contra?

A

Asthma, cardiac insufficiency, gut obstruction

55
Q

Donepezil - Rx

A

Alzheimer’s

56
Q

Donepezil - MOA

A

Reversible inhibitor of acetylcholinesterase in CNS

57
Q

Donepezil - BBB?

A

Crosses BBB

58
Q

Found in insecticides and nerve gas

A

organophosphates

59
Q

Organophosphate - MOA

A

irreversible inhibitor of cholinesterase’s - the complex “becomes a stable complex with time”

60
Q

Two antidotes for organophosphate poisoning (cholinergic crisis)

A

Atropine

2-PAM

61
Q

Name an organophosphate that is used to produce long term mitosis for open angle glaucoma

A

Echothiophate

62
Q

What is a parsympatholytic agent?

A

Muscarinic antagonist

63
Q

At high doses, muscarinic antagonists can

A

block nicotinic cholinergic receptors at autonomic ganglia

64
Q

Atropine - name 5 Rx

A
  1. Allay the urgency and
    frequency of micturition
  2. relieve hypermotility of
    colon and hypertonicity of
    the small intestine
  3. organophosphate poisoning antidote
  4. indue mydriasis and cycloplegia (paralysis of ciliary muscle)
  5. reverse vagal bradycardia
65
Q

Scopalamine Rx?

A
  1. Minimize secretions before surgery

2. Treat chemo-induced nausea/emesis

66
Q

Glycopyrrolate Rx?

A

Prevents overstimulation of gut during reversal of neuromuscular blockade.

67
Q

Name 3 muscarinic antagonists

A

A. Atropine
B. Scopalamine
C. Glycopyrrolate

68
Q

How do Atropine poisoning patients present?

A

“Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone”

69
Q

Edrophonium half life?

A

10 minutes

70
Q

Pralidoxime (2-PAM) half life?

A

75 min

71
Q

Pralidoxime (2-PAM) - MOA?

A

PERIPHERAL AchE reactivator

72
Q

Pralidoxime (2-PAM) - Rx?

A

Resp. muscle weakness from organophosphate poisoning

73
Q

Physostigmine - MOA?

A

reversible AChE inhibitor

74
Q

What would you give for delirium from anticholinergic drugs, or glaucoma?

A

Physostigmine, a reversible AChE inhibitor

75
Q

What would you give to diagnose myasthenia gravis, or to reverse neuromuscular block?

A

Edrophonium, an AChE inhibitor

76
Q

What would you give for open angle glaucoma?

A

Echothiophate, an irreversible AChE inhibitor with a VERY LONG half life.

77
Q

What would you give for excessive secretions b4 surgery, hypertonic gut, organophosphate poisoning, bradycardia?

A

Atropine, a muscarinic antagonist

78
Q

What would you give, for motion sickness, or to reduce secretions during surgery?

A

Scopalamine, a muscarininc antagonist (like atropine, except longer T1/2)

79
Q

What drug would you give, with a shorter half-life than echothiophate, to reverse neuromuscular blockade and reduce secretions?

A

Glycopyrrolate, a muscarinic receptor antagonist

80
Q

Pilocarpine - half life?

A

1 hr

Pharmacology Exam 2 (by Richie) (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions