direct cholinomimmetics

Question 1

what are the types of cholinergic receptors?

Answer 1

nicotinic receptors (“smoker”)

muscarinic receptors (“motorcycle parking spots”)

Question 2

where are n-ACHR found ?

Answer 2

-autonomic ganglia
(“ganglia like transformers”)

-skeletal muscle motor end plate
(“electric outlet near smoker”)

-adrenal glands
(“adrenal beanie on smoker”)

Question 3

what type of receptor is n-ACHR ?

Answer 3

act as ion channels where influx of + ions occur

(“ion channel news behind smoker”)

Question 4

What type of receptor is m-ACHR ? what are the subtypes ? where are they found ?

Answer 4

G-coupled receptors

M1 (Gq) - nerves , CNS
(“Brain helmet on 1st rider” , “3 DAGS”)

M2 (Gi) - SA node , AV node , atria
(“2nd rider shirt showing heart with jewels”)

M3 (Gq) - found on glands and smooth muscle (“glandular sponge with 3rd rider “ “3 DAGS”)

Question 5

M3 stimulation effect on vessels ?

Answer 5

M3→ Gq→ IP3/DAG→ Ca+2 increase→ NO release → cGMP increase → VASODILATION →drop in BP

(“Dilated NO Exhaust on 3rd motorcycle”)

Question 6

Name the Direct Cholinomimetics

Answer 6

Bethanecol (“Beth with Cola”)

Pilocarpine (“Pile of Carps”)

Carbachol (“constricted hood blocking carbon”)

Methacholine (“Marathon challenge”)

Varenicline
(“1-800 very-clean sign on pole next to smoker” )

Question 7

Bethanecol (“Beth with Cola”)

Answer 7

-increases secretions and gastric motility
(“cement pouring out from colon”)

-to treat neurogenic ileus/bladder due to spinal cord injury / post operation/ post pregnancy
*non obstructive*

(“Beth holding Bladder hose”)

Question 8

Pilocarpine

(“Pile of Carps”)

Answer 8

-increase Salivation -treat sjorgen
(“dripping carps mouths”)

-meiosis -activates sphincter pupilae muscle
(“constricted hood”)

• for treatment of acute angle Glaucoma
• contracts cilliary muscle (“smooth muscle crane”) causing accomodation and relaxation of zonular fibers (“fish net zonules”) as well as increasing the outflow of AQ.H
• treatment of Glaucoma

Question 9

Carbachol

(“constricted hood blocking carbon fumes”)

Answer 9

-agonist of both muscarinic and nicotinic receptors
(“carbon fumes from smoker”)

-causes pupillary constriction
(“constricted hood”)

• to treat acute angle glaucoma

Question 10

Methacholine

(“marathon challenge”)

Answer 10

• induce bronchoconstriction and may worsen asthma / COPD (“Wheezing Man”)
• may be used to intiate asthma for pulmonary testing

*Bronchial challenge test* Asthmatics react to lower doses .. then give Bronchodilator as a “reversibility test” to distinguish between ASTHMA/ COPD

Question 11

Varenicline

(“1800-Very-clean sign on pole”)

Answer 11

-nicotinic **partial agonist

-**
for smoking cessation

(“smoking cessation hotline 1800-Very-clean” sign on pole)