Cholinomimetics Therapeutics

Question 1

Bethanechol (Urecholine)

Answer 1

Post operative and neurogenic ileus; urinary retention (bowel and bladder smooth muscle ACh-innervated)

Question 2

Pilocarpine (Salagen)

Answer 2

Glaucoma (ACh activates sphincter and ciliary muscles of eye)

Question 3

Cevimeline (Evoxac)

Answer 3

Xerostomia/Dry mouth ( in eg. sjorgens, post radiation therapy; via increased salivation)

Question 4

Nicotine (NRT)

Answer 4

Smoking cessation (reduces cravings)

Question 5

Neostigmine (Prostigmin)

Answer 5

post operative neurogenic ileus; urinary retention; myasthenia gravis; reversal of neuromuscular blockade
lasts 0.5-2 hours

Question 6

Physostigmine (Eserine)

Answer 6

Glaucoma (ACh activates papillary sphincter and ciliary muscles of eye)
lasts 0.5-2 hours

Question 7

Donepazil (Aricept)

Answer 7

Alzheimers (amplifies endogenous ACh in brain)

Question 8

Edrophonium (enlon)

Answer 8

Myasthenia gravis (differentiating deficiency vs Ach crisis) ; ileus
lasts 5-15 min

Question 9

Echothiophate (Phospholine)

Answer 9

Glaucoma (ACh activate papillary sphincter and ciliary muscles of eye)
lasts >100 hrs

Question 10

Prolidoxime (protopam)

Answer 10

Poisoning by nerve gas or insecticide

Question 11

Sarin

Answer 11

Volatile nerve gas

treat with pralidoxime and atropine before aging.

Question 12

What are the main side effects of direct acting muscarinic cholinomimetics?

Answer 12

SLUDGE

Question 13

What are the side effects of AChE inhibitors?

Answer 13

SLUDGE + general increase in cholinergic neurotransmission; paralysis