Cholinomimetic agents

Question 1

Bethanechol

Answer 1

Clinical applications: Postop ileus, neurogenic ileus, urinary retention

Action: activates bowel and bladder smooth muscle; resistant to AChE

Question 2

Carbachol

Answer 2

Clinical applications: glaucoma, pupillary contraction, relief of intraocular pressure

Action: carbon copy or acetylcholine

Question 3

Pilocarpine

Answer 3

Clinical applications: potent stimular of sweat, tears, saliva; open-angle and closed-angle glaucoma

Action: contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed-angle glaucoma); resistant to AChE

Question 4

Methacholine

Answer 4

Clinical applications: Challenge test for diagnosis of asthma

Action: Stimulates muscarinic receptors in airway when inhaled

Question 5

Neostigmine

Answer 5

Clinical applications: Postop ileus, neurogenic ileus, urinary retention, mysthenia gravis, reversal of neuromuscular junction block (postop)

Action: increases endogenous ACh (no CNS penetration)

Question 6

Pyridostigmine

Answer 6

Clinical applications: myasthenia gravis (long acting); does not penetrate CNS

Action: increases endogenous ACh; increases strength

Question 7

Edrophonium

Answer 7

Clinical applications: Diagnosis of mysthenia gravis (extremely short acting)

Action: increases endogenous ACh

Question 8

Physostigmine

Answer 8

Clinical applications: Anticholinergic toxicity (crosses BBB)

Action: increases endogenous ACh

Question 9

Donepezil

Answer 9

Clinical applications: Alzheimer’s disease

Action: increases endogenous ACh