Indirect Acting Cholinomimetics Flashcards

1
Q

What is the mechanism of action of acetylcholinesterase inhibitors?

A

Reversible inhibition of acetylcholinesterase, causing ACh to accumulate in the synapse and enhance cholinergic function

They actually bind to AChase and take longer to be hydrolyzed than Ach so they just let more of the natural ligand be around to activate the receptor

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2
Q

What type of drug is neostigmine?

A

ACHase inhibitor

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3
Q

What is the primary clinical use of neostigmine?

A

Treats GI and urinary bladder paralysis, glaucoma, myasthenia gravis, and anticholinergic effects caused by some drugs like phenothiazides

Neostigmine does not pass the blood-brain barrier (BBB).

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4
Q

What type of drug is donepezil?

A

ACHase inhibitor

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5
Q

What condition is donepezil primarily used to treat?

A

Alzheimer’s disease associated with loss of cholinergic control of short-term memory

Donepezil passes the BBB and can cause dizziness and headaches but is not curative.

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6
Q

What is sarin classified as?

A

An irreversible acetylcholinesterase inhibitor and nerve gas

Sarin covalently binds and inactivates AChE, leading to excessive acetylcholine and cholinergic crisis.

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7
Q

What is the treatment required for life-threatening cholinergic crisis caused by sarin or parathione?

A

pralidoxime (PAM) - breaks chemical bonds between drugs and ACHase

Sarin is not used therapeutically and is a chemical warfare nerve agent.

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8
Q

What type of substance is parathione?

A

An irreversible acetylcholinesterase inhibitor and insecticide

Exposure can lead to severe cholinergic toxicity, and an antidote with pralidoxime is required.

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9
Q

True or False: Neostigmine can pass the blood-brain barrier.

A

False

Neostigmine does not have central effects due to its inability to pass the BBB.

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10
Q

Fill in the blank: Donepezil is used to treat _______.

A

Alzheimer’s disease

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11
Q

What are the potential effects of donepezil due to its ability to pass the BBB?

A

Can cause dizziness and headaches

Donepezil produces central effects but is not curative.

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12
Q

What is the antidote for parathione poisoning?

A

Pralidoxime

breaks chemical bonds between drugs and ACHase

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