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Pharm Spring 2023 > Drugs That Affect Acetylcholine > Flashcards

Drugs That Affect Acetylcholine Flashcards

1
Q

Are there any therapeutic applications for acetylcholine? why or why not?

A

no, effects would be widespread and the metabolism of Ach by acetylcholinesterase happens rapidly

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2
Q

What is the acronym to remember Ach cholinergic agonist effects?

A

DUMBBELLS
- Diarrhea
- Urination
- Miosis/muscle weakness
- Bradycardia
- Bronchoconstriction
- Excitation or emesis
- Lacrimation
- Lethargy
- Salivation

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3
Q

What are the side effects of anticholinergic antagonists?

A

anti-DUMBBELLS (side effect in the (parentheses)
- Diarrhea (Constipation)
- Urination (Urinary retention)
- Miosis (Mydriasis/blurry vision)
- Bradycardia (Tachycardia)
- Bronchoconstriction (Bronchodilation)
- Excitation (Paralysis)
- Lacrimation (Dry eyes)
- Lethargy (Stimulated)
- Salivation (Dry mouth)

can’t see, can’t pee, can’t spit, can’t shit

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4
Q

What do M1 receptors do?

A

found in CNS and GI tract

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5
Q

what do M2 receptors do?

A

decreased heart rate and decreased atrial contraction

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6
Q

what do M3 receptors do?

A
  1. activates sweat glands
  2. increases GI motility
  3. increases bladder contraction
  4. bronchoconstriction
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7
Q

what drugs are muscarinic agonists that are choline esters?

A
  • Acetylcholine
  • Methacholine
  • Carbachol
  • Bethanechol
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8
Q

what drugs are muscarinic agonist that are naturally occurring cholinomimetic alkaloids?

A
  • Pilocarpine
  • Cevimeline
  • Adenosine
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9
Q

what are therapeutic uses of muscarinic agonists?

A
  • urinary bladder disorders
  • xerostomia
  • ophthalmology: miotic agents and glaucoma
  • supraventricular tachycardia (SVT) - adenosine - stops heart and resets
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10
Q

when is Pilocarpine indicated? What is the SE

A

I:xerostomia, topically for glaucoma
SE: sweating (DUMBBELLS)

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11
Q

what is the advantage of cevimeline?

A
  1. longer acting than pilocarpine
    *stimulates the salivary gland longer than pilocarpine
    *less side effects than pilocarpine
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12
Q

what does cevimeline activate?

A
  1. Preferentially activates M1 and M3 receptors on lacrimal and salivary gland epithelia so also used for xerostomia
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13
Q

what does adenosine do?

A

Slows and “stops” conduction through the AV node

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14
Q

when is adenosine indicated?

A

treatment of SVT

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15
Q

what is the dosing of adenosine?

A

6 mg push, then 12 mg push x2
*half life is less then 10 secs

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16
Q

what do acetylcholinesterase inhibitors do?

A

prevent breakdown of acetylcholine

17
Q

what are the acetylcholinesterase inhibitors?

A
  • Donepezil (alz)
  • Galantamine (alz)
  • Physostigmine (myasethenia gravis)
  • Neostigmine (Mg)
  • Pyridostigmine (Mg)
  • Rivastigmine (alz)
18
Q

what is Donepezil used for?

A

approved for clinical use and treatment of Alzheimer’s disease
*Primary agent

19
Q

what is the SE of Donepezil

A

DUMBBELLS

20
Q

what is Rivastigmine used for?

A
  • Indicated for treatment of Alzheimer’s disease
  • Much more lipophilic and has longer duration of action
21
Q

what IS Pyridostigmine used for

A

myasthenia gravis
* less lipophilic than Alzheimer’s drugs

22
Q

when is atropine indicated?

A

Symptomatic bradycardia in the ACLS algorithm

23
Q

What is the SE of atropine

A

ANTI-DUMBBELLS

24
Q

what is a use of muscarinic antagonist?

A

COPD/asthma

25
Q

how are muscarinic antagonists used for COPD/asthma?

A
  1. inhalation
    *Will limit side effects
26
Q

what drugs are a short acting muscarinic antagonist?

A

Ipratropium (Atrovent)

27
Q

what drugs are a long acting muscarinic antagonist?

A

Tiotropium (Spiriva)

28
Q

how are muscarinic antagonists used in overactive bladder?

A

block muscarinic receptors in the urinary tract leading to decreased bladder contraction and a decrease in urination
- more selectivity and few side effects

29
Q

what muscarinic antagonists are used in overactive bladder?

A

Oxybutynin (Ditropan)

30
Q

what muscarinic antagonists are used for motion sickness, post-op n/v?

A

Scopolamine

31
Q

what are the depolarizing neuromuscular agents?

A

Succinylcholine

32
Q

what are the nondepolarizing neuromuscular agents?

A
  • Rocuronium
  • Vecuronium
  • Cisatracurium
33
Q

What are the indications for neuromuscular blockers

A
  1. Muscle relaxation in rapid sequential/endotracheal tube
  2. Muscle relaxation during surgery
  3. Control of muscle tone following cardiac arrest
34
Q

what drug is used for nicotine replacement therapy?

A

Varenicline (Chantix)
*partial nicotinic agonist

35
Q

what are contraindications of atropine?

A

Tachycardia

36
Q

what are contraindications of amitriptyline?

A

patients with urinary retention issues

Pharm Spring 2023 (27 decks)

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