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Medical Pharmacology Exam 1 > Cholinergics II > Flashcards

Cholinergics II Flashcards

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USMLE® Step 1 flashcards
1
Q

Among anticholinergics, Parkinson’s disease is treated using _ (2)

A

Trihexyphenidyl

Atropine

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2
Q

Among anticholinergics, motion sickness can be treated using _(2)

A

Atropine

Scopolamine

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3
Q

For induction of amnesia before surgery, _ is used

A

Scopolamine

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4
Q

Atropine, homatropine and tropicamide are used to elicit what 2 occular conditions?

A

Mydriasis

Cycloplegia

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5
Q

What 2 anticholinergics are used to decrease respiratory tract secretions?

A

Ipratropium

Tiotropium

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6
Q

Hyperactive GI and genitourinary tract muscle can be treated using (4)

A

Atropine
Methscopolamine
Oxybutynin
Solifenacin

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7
Q

Excessive bradycardia and hypotension can be treated with which anticholinergic drug?

A

Atropine

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8
Q

Poisoning with organophosphates or muscarine containing mushrooms can be treated using _

A

Atropine

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9
Q

Two anticholinergics used as pre-anesthetic medications are _

A

Atropine

Scopolamine

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10
Q

[Teritary/Quaternary] anticholinergics are most likely to produce CNS toxicities. What are 3 examples provided?

A

Tertiary
Atropine
Scopolamine
Trihexyphenidyl

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11
Q

Excess mydiasis, urinary retention, dry mouth and reduced sweating can be expected following overdose with _

A

Anticholinergics, PNS effects

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12
Q

The expected effector sites of antimuscarinic agents include _ (3). What can extremely high doses of antimuscarinic agents do?

A

smooth muscle, cardiac muscle, gland cells

Can potentially block nicotinic receptors in neuromuscular junctions

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13
Q

Tertiary muscarinic antagonists are used for the treatment of occular or CNS maladies. The 2 examples specifically provided are _. What was the example of the quaternary antimuscarinic agent?

A

Atropine and scopolamine

Methscopolamine

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14
Q

Loss of accomodation reflex is referred to as _. When mydriasis and cycloplegia are required, what are 3 topical agents used?

A

Cycloplegia
Atropine
Homatropine
Tropicamide

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15
Q

5 drugs used in ophthalmology for mydriasis and cycloplegia are atropine, homatropine, tropicamide, scopolamine and cyclopentolate. Arrange them in order of longest acting to shortest

A

ASHCT

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16
Q

During myocardial infarct, vagal reflexes can result in depression of SA (and AV) node activity, leading to bradycardia. What is the effect of atropine under these conditions?

A

Can be used to block muscarinic receptors in SA and AV node, leading to tachycardia. Too much atropine can be damaging though, needs to be dosed carefully

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17
Q

What class of drugs can be administed to patients before using inhaled anesthetics to prevent bronchospasm / laryngospasm?

A

Antimuscarinics

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18
Q

What is the effect of antimuscarinics of bronchial diameter and bronchial secretions?

A

Caused bronchodialation and decreases bronchial secretions

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19
Q

Antimuscarinics can be used for the treatment of patients with what 2 airway diseases? What is the first line treatment for these conditions?

A

Bronchitis and COPD (emphesema)

beta adrenergic agonists

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20
Q

How are tiotropium and ipratropium related to atropine? What are they used for?

A

Ipratropium - synthetic atropine analog
Tiotropium - Long lasting analog
Used for non-systemic treatment of bronchial hypersecretion

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21
Q

Systemic treatment of bronchial hypersecretion results in decreased fluidity. What results from decreased fluidity?

A

Airflow obstruction and increased infection

22
Q

What are the effects of antimuscarinics of GI motility?

A

The reduce motility.

23
Q

GI hypermotility caused by parasympathomimetics and antihypertensives can be counteracted using what class of drugs?

A

Antimuscarinics

24
Q

What do Parkinson’s disease, heavy metal poisoning and difficulties swallowing have in common? How can this be alleviated?

A

All cause excessive salivation

Can be treated using antimuscarinics

25
Q

What is xerostomia? What class of drug is expected to cause it?

A

Dry mouth

Antimuscarinics

26
Q

How do antimuscarinics affect eccrine sweat glands? What branch of NS usually innervates these types of sweat glands?

A

Decrease sweat production

Sympathetic cholinergics

27
Q

What is atropine fever? Who is most suceptible: children, adults, elderly?

A

Atropine blocks sweating, increase body temp

Children and infants

28
Q

What is the effect of antimuscarinics on the muscles of the urinary bladder? [contract/relax] How does this affect urination?

A 
Relax the muscles
Reduce urination (Used to treat urgency, reduce bladder spasm following urologic surgery)
29
Q

4 drugs were provided as examples of M3 selective muscarinic antagonists. What are they? Which 3 are long acting?

A

Oxybutinin (Short acting)
Darifenacin
Solifenacin
Tolterodine

30
Q

How is cholinergic activity related to Parkinson’s disease? What is lost in Parkinsons that usually balanced out cholinergic input? How can this affect treatment for affected patients?

A

Too much cholinergic stimulation leads to tremor and rigidity
Dopaminergic neurotransmission
Combined levodopa and anticholinergics may be better

31
Q

What is the most effective drug for the treatment of motion sickness? What are significant side effects (2)?

A

Scopolamine

Sedation and dry mouth

32
Q

Prior to surgery, what class of drug can be used to cause amnesia?

A

Antimuscarinics

33
Q

Among antimuscarinics, how are tertiary and quaternary compounds different? Which would you use to treat eye or CNS symptoms or be expected to cross mucus membranes?

A

Tertiary cross BBB, quarternary don’t.

Tertiary

34
Q

Why is ipratropium better than atropine for the treatment of brochial symptoms? What specific disease is it good for?

A

Ipratropium is quaternary derivative of atropine, wont cross mucus membranes, doesn’t impair mucociliary clearance like a systemic atropine.
COPD

35
Q

How are methscopolamine and scopolamine related? What is methscopolamine used for?

A

Quaternary deriv. of scopolamine. Used for GI problems (slows the GI)

36
Q

What are the 4 tertiary antimuscarinics most likely to cause CNS side effects?

A

Atropine, scopolamine, homatropine and trihexiphenidyl

37
Q

Regarding Atropine, True or False

  • Binds to both nicotinic and muscarinic receptors
  • Crosses the BBB, limiting the dosages used
  • Salivary, sweat and bronchial glands insentitive to atropine
  • Causes mydriasis and cycloplegia
A

False - only muscarinic
True
False - most sensitives glands listed
True

38
Q

Drowsiness, amnesia, fatigue, dreamless sleep, euphoria are all possible side effects of antimuscarinics. True or false

A

True

39
Q

The major use of scopolamine is _. It is also used preanesthetically to produce _

A

Prevent motion sickness

Amnesia

40
Q

What is the major use of methscopolamine?

A

GI maladies, doesn’t cross mucus membranes

41
Q

What is homatropine used for? How is it related to atropine?

A

Used topically to elicit mydriasis and cycloplegia

Very short acting relative to atropine

42
Q

What is triheyphenidyl used for? (2)

A

Used to reduce uncoordinated movements assoc with Parkinsons

Reduce extrapyramidal side effects of anti-psychotics

43
Q

What is tropicamide used for? Shorter or longer acting than homatropine?

A

Used topically to elicit mydriasis and cycloplegia

Shorter

44
Q

Under what conditions will atropine be able to reduce GI secretions?

A

Really high doses with toxic effects

45
Q

How may muscarinic antagonists affect men with prostatic hyperplasia (undesired side effect)?

A

Worsen urinary retention

46
Q

Improved treatment of Parkinsons symptoms can be improved by combining what 2 (classes) of drug?

A

LEvodopa and muscarinic antagonist

47
Q

How are quaternary compounds absorbed?

A

Not well or reliably

48
Q

Atropine, scopolamine and methscopolamine affects both the nicotinic and muscarinic receptors equally. True or false.

A

False, those are 3 mainly muscarinic selective antagonists

49
Q

What are the major glands that are most sensitive to atropine? What is a major use of this drug?

A

salivary, bronchial, and sweat glands

Overcome organophosphate poisoning

50
Q

Scopolamine vs Methscopolamine: Which is used mainly for its CNS effects?

A

Scopolamine to prevent motion sickness

51
Q

What are the 2 antimuscarinics used topically in the eye? Which is lionger lasting?

A

Tropicamide and Homatropine

Homatropine acts for longer

Medical Pharmacology Exam 1 (15 decks)

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