Direct-Acting Cholinergic Agonists

Question 1

involved in memory

Answer 1

M1

Question 2

cause coronary vasodilation by nitric oxide (seen when ACh is injected IV)

Answer 2

M3

Question 3

muscarinic agonist cardiovascular effects

Answer 3

blood vessels aren’t innervated by PNS, vagal stimulation isn’t much at therapeutic levels

Question 4

respiratory effects of muscarinic stimulation

Answer 4

bronchoconstriction –> contraindicated in asthma, COPD

Question 5

muscarinic agonist with the most GU and GI effects

Answer 5

Bethanechol

Question 6

muscarinic agonists GU/GI effects

Answer 6

relax all the sphincters for urination/defecation
stimulate bladder detrusor muscle (push out urine)
increased secretory activity and peristalsis

Question 7

muscarinic agonist that cause the most salivary secretion

Answer 7

pilocarpine**, cevimeline

Question 8

pilocarpine is used to treat

Answer 8

narrow angle glaucoma, xerostomia

Question 9

GI reasons not to give muscarinic agonists

Answer 9

peptic ulcer disease (increase secretions)
bowel obstruction (increased peristalsis)

Question 10

Side effects of pilocarpine

Answer 10

brow ache??
sweating
blurry vision

Question 11

2 alkaloid muscarinic agonists

Answer 11

pilocarpine, muscarine

Question 12

Xerostomia DOC and why

Answer 12

cevimeline
It’s selective for M1 receptors and therefore has fewer side effects
Longer lasting

Question 13

treatments (2) for muscarine poisoning (poison mushrooms)

Answer 13

atropine (muscarinic antagonist)

albuterol (bronchodilates)

Question 14

bethanechol is a

Answer 14

ester, quarternary ammonium compound (no CNS)

Question 15

if continuously stimulated, nicotinic receptors

Answer 15

desensitize rapidly since nicotine is not rapidly hydrolyzed

Question 16

low dose central effects of nicotinic stimulation

Answer 16

increases alertness/attention

dopamine release causes pleasure

Question 17

high dose central effects of nicotinic stimulation

Answer 17

tremor, vomiting, increased respiration

Question 18

peripheral effects of nicotinic stimulation

Answer 18

similar to discharge of both parasympathetic and sympathetic neurons

Question 19

cardiac peripheral effects of nicotinic stimulation

Answer 19

sympathetic tone prevails: HTN, increased HR (modulated by reflex bradycardia)

Question 20

GU/GU peripheral effects of nicotinic stimulation

Answer 20

parasympathetic tone prevails: N/V, urination

Question 21

NMJ peripheral effects of nicotinic stimulation

Answer 21

muscle contractions followed by receptor desensitization

flaccid paralysis

Question 22

treatment for nicotine poisoning

Answer 22

atropine (muscarinic antagonist)
anticonvulsants
mechanical respiration

Question 23

nicotine poisoning symptoms

Answer 23

Vomiting
convulsions
coma
respiratory arrest
paralysis
htn
cardiac arrhythmias

Question 24

partial agonist on Nn in brain

Answer 24

varenicline

Question 25

uses of varenicline

Answer 25

smoking cessation: provides some dopamine to block cravings yet as a partial agonist decreases the full effects of nicotine (if smoked)

Question 26

varencicline general side effects

Answer 26

N/V/C
HA
fatigue
flatulence

Question 27

varencicline CNS side effects

Answer 27

sleep disturbance 
vivid nightmares
psychosis
mania
anxiety 
suicide