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Drugs > FA Cholinomimetics > Flashcards

FA Cholinomimetics Flashcards

1
Q

Bethanechol

A

Direct muscarinic receptor agonist; activates bowel and bladder smooth muscle; resistant to AChE;

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2
Q

Carbachol

A

Carbon copy of ACh;

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3
Q

CU bethanechol

A

postoperative ileus, neurogenic ileus, urinary retention

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4
Q

CU carbechol

A

glaucoma, pupillary constriction, relief of IOP

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5
Q

CU pilocarpine

A

potent stimulator of sweat, tears and saliva; open and closed angle glaucoma

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6
Q

CU methacholine

A

challenge test for diagnosis of asthma

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7
Q

Pilocarpine

A

Contracts ciliary muscle of eye (open-angle glaucoma), contracts pupillary sphincter (closed-angle glaucoma);
“you cry, drool, and sweat on your pillow”

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8
Q

Methacholine

A

Stimulates muscarinic receptors in airway when inhaled

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9
Q

CU neostigmine

A

postoperative and neurogenic ileus and urinary retention, Myasthenia gravis, reversal of NMJ blockage (postoperative)

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10
Q

Neostigmine

A

anticholinesterase (neo CNS = no CNS)

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11
Q

CU pyridostigmine

A

Myasthenia gravis (long acting); does not penetrate CNS

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12
Q

Pyridostigmine

A

anticholinesterase –> inc ACh and strength; does not penetrate CNS

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13
Q

CU Physostigmine

A

anticholinergic toxicity (ie jimson weed, atropine overdose); crosses BBB –> CNS

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14
Q

physostigmine

A

anti cholinesterase that crosses BBB

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15
Q

Name three AChE inhibitors that work for Alzheimer’s

A

rivastigmine, galantamine, donepezil

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16
Q

Historically, dx of myasthenia gravis (extremely short acting). MG now diagnosed by anti-ChR aAB test.

A

Edrophonium

17
Q

General toxicities of all indirect and direct cholinomimetics

A

exacerbation of COPD, asthma, PUD

18
Q

4 direct cholinomimetics

A

bethanechol, carbachol, pilocarpine, methacholine

19
Q

7 indirect cholinomimetics

A

Neo-, pyrido-, physio- stigmine

rivastigmine, galantamine, donepezil

20
Q

Cholinesterase inhibitor poisoning (often due to organophosphates (parathion) that irreversibly inhibit AChE –> too much ACh)

A 
DUMBBELS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle and CNS
Lacrimation,
Sweating 
Salivation
21
Q

Antidote to organophosphate poisoning

A

atropine (competitive inhibitor) + pralidoximine (regenerates AChE if given early)

22
Q

Atropine, homatropine, tropic amide effect on eye

A

mydriasis (pupil dilation) and cycloplegia (paralysis of the ciliary muscle of the eye –> loss of accommodation)

23
Q

benztropine

A

muscarinic antagonist for Parkinson’s disease

24
Q

scopolamine

A

muscarinic antagonist for motion sickness

25
Q

ipratropium, tiotropium

A

muscarinic antagonist for COPD, asthma

26
Q

oxybutynin,
darifenacin,
solifenacin

A

reduce urgency in mild cystitis and reduce bladder spasms

Other agents: tolterodine, fesoterodine, trospium

27
Q

Glycopyrrolate

A

Affects GI and respiratory systems.
Parenteral: postoperative use to reduce airway secretions
Oral: drooling, peptic ulcer

28
Q

atropine effect on airway

A

decreases secretions

29
Q

atropine effect on stomach

A

decreases acid secretion

30
Q

atropine effect on gut motility

A

decreases

31
Q

atropine effect on bladder

A

decreases urgency in cystitis

32
Q

atropine effects

A

inc pupil dilation, cycloplegia

dec AW secretions, stomach acid, gut motility, urgency in cystitis

33
Q

Atropine toxicity

A

Hot as a hare (inc temp due to dec sweating)
Dry as a bone (dry mouth + skin)
Red as a beet (flushed skin)
Blind as a bat (cycloplegia, mydriasis)
mad as a hatter (disorientation… and constipation)

34
Q

special populations to worry about with atropine toxicity

A

acute angle-closure glaucoma in elderly (mydriasis),
urinary retention in men w/ BPH,
hyperthermia in infants

Drugs (21 decks)

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