Indirect acting (ACHE blocker) cholinoreceptor agonists

Question 1

Edrophonium

Answer 1

Short acting

Dx – myasthenia; used to differentiate myasthenia from cholinergic crisis

Question 2

Neostigmine, Pyridostigmine

Answer 2

Rx – ileus, urinary retention, myasthenia, reversal of non-depolarizing NM blockers
Quarternary amines (no CNS entry), intermediate-acting

Question 3

Donepezil

Tacrine

Answer 3

Rx – Alzheimer disease

Lipid-soluble (CNS entry)

Question 4

Organophosphates

Answer 4

Rx – glaucoma (echothiophosphate)
Insecticides: malathion, parathion
Nerve gas: sarin
Lipid-soluble,
Long-acting
Irreversible inhibitors of AChE

Question 5

Physostigmine

Answer 5

Tertiary amine 
enters CNS,
intermediate-acting

Rx – glaucoma;
antidote in atropine overdose