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Pha :Cholinergic System > Introduction > Flashcards

Introduction Flashcards

1
Q

What are the two main divisions of the Nervous System?

A

The two main divisions of the Nervous System are the
Central Nervous System (CNS) and Peripheral Nervous System (PNS)

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2
Q

What is the function of the Autonomic Nervous System (ANS)?

A

The function of the Autonomic Nervous System (ANS) is to control involuntary autonomic functions.

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3
Q

What neurotransmitter is used by the Parasympathetic Nervous System?

A

The Parasympathetic Nervous System uses Acetylcholine (ACh) as its primary neurotransmitter.

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4
Q

What enzyme catalyzes ACh synthesis?

A

Choline Acetyltransferase (ChAT) is the enzyme that catalyzes Acetylcholine (ACh) synthesis.

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5
Q

Where is ACh stored?

A

Acetylcholine (ACh) is stored in synaptic vesicles.

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6
Q

What triggers ACh release?

A

The release of Acetylcholine (ACh) is triggered by an action potential.

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7
Q

What breaks down ACh?

A

Acetylcholinesterase (AChE) breaks down Acetylcholine (ACh).

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8
Q

What are the two types of receptors for ACh?

A

The two types of receptors for Acetylcholine (ACh) are Nicotinic and Muscarinic receptors.

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9
Q

What is the role of Choline Acetyltransferase (ChAT)?

A

Choline Acetyltransferase (ChAT) catalyzes the synthesis of Acetylcholine (ACh).

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10
Q

What is the outcome of Acetylcholinesterase (AChE) action?

A

The outcome of Acetylcholinesterase (AChE) action is the breakdown of Acetylcholine (ACh) into choline and acetate.

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11
Q

What is the “fight or flight” response associated with?

A

The Sympathetic Nervous System is associated with the “fight or flight” response.

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12
Q

What system promotes “rest and digest”?

A

The Parasympathetic Nervous System promotes “rest and digest”.

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13
Q

What is the primary neurotransmitter of the Sympathetic Nervous System?

A

The primary neurotransmitter of the Sympathetic Nervous System is Noradrenaline (NA).

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14
Q

What transports choline into neurons?

A

Choline is transported into neurons through a sodium-dependent transporter.

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15
Q

What produces Acetyl-CoA (AcCoA)?

A

Acetyl-CoA (AcCoA) is produced from glucose metabolism.

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16
Q
  1. The Central Nervous System (CNS) consists of the:
    A) Brain and spinal cord
    B) Nerves outside the CNS
    C) Somatic and Autonomic Nervous Systems
    D) Sympathetic and Parasympathetic Nervous Systems
  2. Which system promotes the “fight or flight” response?
    A) Parasympathetic Nervous System
    B) Sympathetic Nervous System
    C) Somatic Nervous System
    D) Central Nervous System
  3. What is the primary neurotransmitter of the Parasympathetic Nervous System?
    A) Acetylcholine (ACh)
    B) Noradrenaline (NA)
    C) Dopamine
    D) Serotonin
  4. What enzyme catalyzes Acetylcholine (ACh) synthesis?
    A) Acetylcholinesterase (AChE)
    B) Choline Acetyltransferase (ChAT)
    C) Monoamine Oxidase (MAO)
    D) Tyrosine Hydroxylase
A
  1. A) Brain and spinal cord
  2. B) Sympathetic Nervous System
  3. A) Acetylcholine (ACh)
  4. B) Choline Acetyltransferase (ChAT)
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17
Q

1.Where is Acetylcholine (ACh) stored?
A) Synaptic cleft
B) Synaptic vesicles
C) Mitochondria
D) Endoplasmic reticulum

2.What triggers the release of Acetylcholine (ACh)?
A) Action potential
B) Calcium influx
C) Sodium-dependent transporter
D) Potassium channel

3.What breaks down Acetylcholine (ACh)?
A) Acetylcholinesterase (AChE)
B) Choline Acetyltransferase (ChAT)
C) Butyrylcholinesterase (BChE)
D) Monoamine Oxidase (MAO)

4.What type of receptors does Acetylcholine (ACh) bind to?
A) Nicotinic and Muscarinic
B) Adrenergic and Dopaminergic
C) Serotonergic and GABAergic
D) Glutamatergic and GABAergic

A

1.B) Synaptic vesicles

2.A) Action potential

3.A) Acetylcholinesterase (AChE)

4.A) Nicotinic and Muscarinic

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18
Q
  1. The Central Nervous System (CNS) includes nerves outside the brain and spinal cord. (True/False)
  2. The Autonomic Nervous System (ANS) controls voluntary functions. (True/False)
A
  1. False
  2. False
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19
Q

1.Acetylcholine (ACh) is the primary neurotransmitter of the Sympathetic Nervous System. (True/False)

2.Choline Acetyltransferase (ChAT) breaks down Acetylcholine (ACh). (True/False)

3.Acetylcholinesterase (AChE) synthesizes Acetylcholine (ACh). (True/False)

4.The Parasympathetic Nervous System promotes the “fight or flight” response. (True/False)

A

1.False

2.False

3.False

4.False

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20
Q

1.Noradrenaline (NA) is the primary neurotransmitter of the Parasympathetic Nervous System. (True/False)

2.Synaptic vesicles store Acetylcholine (ACh). (True/False)

3.Action potential triggers the release of Acetylcholine (ACh). (True/False)

4.Muscarinic and Nicotinic receptors are types of Adrenergic receptors. (True/False)

A
  1. False
  2. True
  3. True
  4. False
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21
Q
  1. The two main divisions of the Nervous System are the _______________________ and Peripheral Nervous System (PNS).
  2. The Autonomic Nervous System (ANS) controls _______________________ functions.
  3. The primary neurotransmitter of the Parasympathetic Nervous System is _______________________.
  4. _______________________ catalyzes the synthesis of Acetylcholine (ACh).
  5. Acetylcholine (ACh) is stored in _______________________.
A
  1. Central Nervous System (CNS)
  2. involuntary
  3. Acetylcholine (ACh)

4.Choline Acetyltransferase (ChAT)

5.synaptic vesicles

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22
Q

1.The release of Acetylcholine (ACh) is triggered by an _______________________.

2.Acetylcholinesterase (AChE) breaks down Acetylcholine (ACh) into _______________________.

3.Acetylcholine (ACh) binds to _______________________ and Muscarinic receptors.

4.The Sympathetic Nervous System promotes the _______________________ response.

5.The Parasympathetic Nervous System promotes the _______________________ response.

A

1.action potential

2.choline and acetate

3.Nicotinic

4.”fight or flight”

5.”rest and digest”

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23
Q

Compare and contrast the Sympathetic and Parasympathetic Nervous Systems, including their effects on the body, neurotransmitters, and receptor types.

A

The Sympathetic and Parasympathetic Nervous Systems (SNS and PNS) are two branches of the Autonomic Nervous System (ANS), which regulates involuntary functions.

Similarities:

  1. Both SNS and PNS are automatic, controlling involuntary functions.
  2. Both use neurotransmitters to transmit signals.
  3. Both have sensory and motor components.

Differences:

Sympathetic Nervous System (SNS):

  1. “Fight or Flight” response
  2. Increases heart rate, blood pressure, and respiration
  3. Prepares body for stress, energy, and action
  4. Neurotransmitter: Noradrenaline (NA)
  5. Receptor types: Alpha (α) and Beta (β) adrenergic receptors

Parasympathetic Nervous System (PNS):

  1. “Rest and Digest” response
  2. Decreases heart rate, blood pressure, and respiration
  3. Promotes relaxation, digestion, and energy conservation
  4. Neurotransmitters: Acetylcholine (ACh)
  5. Receptor types: Muscarinic and Nicotinic receptors

Effects on the Body:

SNS:

  • Increases pupil dilation
  • Increases glucose release
  • Suppresses digestion

PNS:

  • Decreases pupil dilation
  • Decreases glucose release
  • Stimulates digestion

Key Contrast:

SNS prepares the body for stress and action, while PNS promotes relaxation and recovery.

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24
Q
  1. Cholinergic drugs can act as _______________________ agonists.
  2. Anticholinesterases are an example of _______________________ acting cholinergic drugs.
  3. Muscarinic receptors in smooth muscles cause _______________________ and sphincter relaxation.
  4. Muscarinic receptors in the urinary bladder cause contraction of the _______________________ muscle.
  5. Muscarinic receptors in the lungs cause _______________________.
A

1.cholinergic receptor
2.indirectly
3.contraction
4.detrusor
5.bronchoconstriction

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25
Q
  1. Muscarinic receptors in the eyes (M1) cause contraction of the _______________________ muscles.
  2. Muscarinic receptors in the heart (M2) cause a _____________ in heart rate.
  3. Muscarinic receptors in glands (M3) stimulate _______________________ and lacrimation.
  4. Nicotinic receptors in autonomic ganglia (Nn) stimulate both _______________________ and ______________ ganglia.
  5. Nicotinic receptors in skeletal muscle (Nm) cause _______________________ of skeletal muscle.

What is lacrimation

A
  1. ciliary
  2. reduction
  3. salivation
  4. sympathetic and parasympathetic
  5. contraction

Lacrimation: Excessive tear production and secretion.

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26
Q
  1. What type of receptors are involved in the contraction of ciliary muscles in the eyes?
    A) Nicotinic
    B) Muscarinic
    C) Adrenergic
    D) Dopaminergic
  2. Which type of nicotinic receptors is responsible for skeletal muscle contraction?
    A) Nn
    B) Nm
    C) M1
    D) M2
  3. What is the effect of muscarinic receptors on the heart rate?
    A) Increase
    B) Decrease
    C) No effect
    D) Variable
  4. Which type of cholinergic drugs acts as receptor agonists?
    A) Directly acting
    B) Indirectly acting
    C) Anticholinesterases
    D) Muscarinic antagonists
  5. What is the effect of muscarinic receptors on the urinary bladder?
    A) Relaxation
    B) Contraction
    C) No effect
    D) Variable
A
  1. B) Muscarinic
  2. B) Nm
  3. B) Decrease
  4. A) Directly acting
  5. B) Contraction
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27
Q

1.Which type of receptors is involved in the stimulation of salivation and lacrimation?
A) Nicotinic
B) Muscarinic
C) Adrenergic
D) Dopaminergic

2.What is the effect of nicotinic receptors on autonomic ganglia?
A) Stimulation of sympathetic ganglia only
B) Stimulation of parasympathetic ganglia only
C) Stimulation of both sympathetic and parasympathetic ganglia
D) Inhibition of both sympathetic and parasympathetic ganglia

3.Which type of cholinergic drugs inhibits the breakdown of acetylcholine?
A) Directly acting
B) Indirectly acting
C) Anticholinesterases
D) Muscarinic antagonists

4.What is the effect of muscarinic receptors on the lungs?
A) Bronchodilation
B) Bronchoconstriction
C) No effect
D) Variable

5.Which type of receptors is involved in the contraction of smooth muscles?
A) Nicotinic
B) Muscarinic
C) Adrenergic
D) Dopaminergic

A

1.B) Muscarinic
2.C) Stimulation of both sympathetic and parasympathetic ganglia
3.C) Anticholinesterases
4.B) Bronchoconstriction
5.B) Muscarinic

28
Q
  1. What is the primary function of muscarinic receptors in the eyes?
    A) Pupil dilation
    B) Ciliary muscle contraction
    C) Lacrimation
    D) Eyelid closure
  2. Which type of nicotinic receptors is responsible for stimulation of autonomic ganglia?
    A) Nn
    B) Nm
    C) M1
    D) M2

3.What is the effect of muscarinic receptors on the gastrointestinal tract?
A) Increased peristalsis
B) Decreased peristalsis
C) No effect
D) Variable

4.Which type of cholinergic drugs is used to treat glaucoma?
A) Directly acting
B) Indirectly acting
C) Anticholinesterases
D) Muscarinic antagonists

5.What is the effect of nicotinic receptors on skeletal muscle?
A) Relaxation
B) Contraction
C) No effect
D) Variable

A

Here are the answers:

  1. B) Ciliary muscle contraction
  2. A) Nn
  3. A) Increased peristalsis
  4. A) Directly acting
  5. B) Contraction
29
Q

1.Which type of cholinergic drugs is used to treat myasthenia gravis?
A) Directly acting
B) Indirectly acting
C) Anticholinesterases
D) Muscarinic antagonists

2.What is the effect of nicotinic receptors on autonomic ganglia?
A) Stimulation of sympathetic ganglia only
B) Stimulation of parasympathetic ganglia only
C) Stimulation of both sympathetic and parasympathetic ganglia
D) Inhibition of both sympathetic and parasympathetic ganglia

3.Which type of receptors is involved in the regulation of smooth muscle tone?
A) Nicotinic
B) Muscarinic
C) Adrenergic
D) Dopaminergic

  1. Which type of receptors is involved in the regulation of heart rate?
    A) Nicotinic
    B) Muscarinic
    C) Adrenergic
    D) Dopaminergic
  2. What is the effect of muscarinic receptors on the urinary bladder?
    A) Relaxation
    B) Contraction
    C) No effect
    D) Variable
A

Here are the answers:

  1. C) Anticholinesterases
  2. C) Stimulation of both sympathetic and parasympathetic ganglia
  3. B) Muscarinic
  4. B) Muscarinic
  5. B) Contraction
30
Q
  1. True or False: Muscarinic receptors in the eyes cause contraction of the ciliary muscles leading to mydriasis (large pupil).
  2. True or False: Muscarinic receptors in the heart increase heart rate.
  3. True or False: Nicotinic receptors in autonomic ganglia stimulate only sympathetic ganglia.
  4. True or False: Cholinergic drugs that act as receptor agonists are classified as indirectly acting.
  5. True or False: Anticholinesterases are an example of directly acting cholinergic drugs.
  6. True or False: Muscarinic receptors in the urinary bladder cause relaxation of the detrusor muscle.
A
  1. False
  2. False
  3. False
  4. False
31
Q

1.True or False: Nicotinic receptors in skeletal muscle cause relaxation.

2.True or False: Muscarinic receptors in the lungs cause bronchodilation.

3.True or False: Muscarinic receptors in the gastrointestinal tract decrease peristalsis.

4.True or False: Cholinergic drugs that inhibit the breakdown of acetylcholine are classified as directly acting.

A
  1. False
  2. False
  3. False
  4. False
32
Q
  1. What is the primary function of muscarinic receptors in the eyes?
  2. Which type of nicotinic receptors is responsible for skeletal muscle contraction?
A
  1. The primary function of muscarinic receptors in the eyes is to cause contraction of the ciliary muscles, leading to miosis (pupil constriction).
  2. Nm (Nicotinic muscular receptors) are responsible for skeletal muscle contraction.
33
Q
  1. What is the effect of muscarinic receptors on the heart rate?
  2. Which type of cholinergic drugs is used to treat myasthenia gravis?
A
  1. The effect of muscarinic receptors on the heart rate is to decrease it.
  2. Anticholinesterases (a type of indirectly acting cholinergic drug) are used to treat myasthenia gravis.
34
Q
  1. What is the effect of nicotinic receptors on autonomic ganglia?
  2. Which type of receptors is involved in the regulation of smooth muscle tone?
  3. What is the effect of muscarinic receptors on the urinary bladder?
  4. Which type of cholinergic drugs acts as receptor agonists?
A
  1. The effect of nicotinic receptors on autonomic ganglia is stimulation of both sympathetic and parasympathetic ganglia.
  2. Muscarinic receptors are involved in the regulation of smooth muscle tone.
  3. The effect of muscarinic receptors on the urinary bladder is contraction of the detrusor muscle.
  4. Directly acting cholinergic drugs act as receptor agonists.
35
Q
  1. Which type of cholinergic drugs is used to treat Alzheimer’s disease?
  2. What is the role of nicotinic receptors in the regulation of autonomic ganglia?
  3. Which type of receptors is involved in the regulation of lacrimation?
A
  1. Cholinesterase inhibitors (a type of indirectly acting cholinergic drug) are used to treat Alzheimer’s disease.
  2. The role of nicotinic receptors in the regulation of autonomic ganglia is to stimulate both sympathetic and parasympathetic ganglia.
  3. Muscarinic receptors are involved in the regulation of lacrimation.
36
Q

1.What is the effect of nicotinic receptors on skeletal muscle?

2.Which type of receptors is involved in the regulation of heart rate?

3.What is the role of muscarinic receptors in the regulation of gastrointestinal motility?

A
  1. The effect of nicotinic receptors on skeletal muscle is contraction.
  2. Muscarinic receptors (M2) are involved in the regulation of heart rate.
  3. The role of muscarinic receptors in the regulation of gastrointestinal motility is to increase peristalsis and promote bowel evacuation.
37
Q

1.Which type of nicotinic receptors is involved in the stimulation of autonomic ganglia?

2.What is the effect of muscarinic receptors on the lungs?

3.Which type of cholinergic drugs is used to treat glaucoma?

A
  1. Nn (Nicotinic receptors) are involved in the stimulation of autonomic ganglia.
  2. The effect of muscarinic receptors on the lungs is bronchoconstriction.
  3. Directly acting cholinergic drugs (such as pilocarpine) are used to treat glaucoma.
38
Q

1.What is the role of nicotinic receptors in the regulation of skeletal muscle contraction?

  1. Which type of receptors is involved in the regulation of salivation?
  2. What is the effect of muscarinic receptors on the skin?
A
  1. The role of nicotinic receptors in the regulation of skeletal muscle contraction is to stimulate muscle contraction.
  2. Muscarinic receptors are involved in the regulation of salivation.
  3. The effect of muscarinic receptors on the skin is to cause sweating.
39
Q
  1. What is the primary mechanism of action of cholinergic agonists?
    A) Inhibition of acetylcholinesterase
    B) Stimulation of muscarinic receptors
    C) Mimicry of acetylcholine
    D) Blockade of nicotinic receptors
  2. Which of the following is a choline ester?
    A) Muscarine
    B) Pilocarpine
    C) Acetylcholine
    D) Arecoline
  3. What is the primary use of pilocarpine?
    A) Treatment of open-angle glaucoma
    B) Treatment of closed-angle glaucoma
    C) Treatment of dry mouth
    D) Treatment of myasthenia gravis
  4. What is the mechanism of action of pilocarpine in treating glaucoma?
    A) Decrease in intraocular pressure (IOP) due to increased outflow of aqueous humor
    B) Increase in IOP due to decreased outflow of aqueous humor
    C) Constriction of the pupil
    D) Dilatation of the pupil
  5. Which of the following is a side effect of pilocarpine?
    A) Stinging sensation in the eye
    B) Blurred vision
    C) Headache
    D) All of the above
  6. What is the definition of anticholinesterases?
    A) Medications that stimulate muscarinic receptors
    B) Medications that inhibit acetylcholinesterase
    C) Medications that mimic acetylcholine
    D) Medications that block nicotinic receptors
  7. What is the mechanism of action of anticholinesterases?
    A) Increase in acetylcholine concentration due to inhibition of acetylcholinesterase
    B) Decrease in acetylcholine concentration due to stimulation of acetylcholinesterase
    C) Blockade of muscarinic receptors
    D) Stimulation of nicotinic receptors
  8. Which of the following is a reversible anticholinesterase?
    A) Organophosphate
    B) Neostigmine
    C) Physostigmine
    D) All of the above except A
  9. Which of the following is an irreversible anticholinesterase?
    A) Neostigmine
    B) Physostigmine
    C) Organophosphate
    D) Rivastigmine
  10. What is the primary difference between lipid-soluble and lipid-insoluble anticholinesterases?
    A) Mechanism of action
    B) Duration of action
    C) Distribution in the body
    D) Effects on the central nervous system (CNS)
A
  1. C) Mimicry of acetylcholine
  2. C) Acetylcholine
  3. A) Treatment of open-angle glaucoma
  4. A) Decrease in intraocular pressure (IOP) due to increased outflow of aqueous humor
  5. D) All of the above
  6. B) Medications that inhibit acetylcholinesterase
  7. A) Increase in acetylcholine concentration due to inhibition of acetylcholinesterase
  8. D) All of the above except A
  9. C) Organophosphate
  10. C) Distribution in the body
40
Q
  1. Which of the following anticholinesterases has muscarinic and CNS effects?
    A) Neostigmine
    B) Physostigmine
    C) Organophosphate
    D) Rivastigmine
  2. Which of the following anticholinesterases has skeletal muscle effects and stimulates ganglia?
    A) Neostigmine
    B) Physostigmine
    C) Organophosphate
    D) Rivastigmine
  3. What is the primary use of neostigmine?
    A) Treatment of myasthenia gravis
    B) Treatment of glaucoma
    C) Treatment of dry mouth
    D) Treatment of Alzheimer’s disease
  4. What is the primary mechanism of action of neostigmine?
    A) Inhibition of acetylcholinesterase
    B) Stimulation of muscarinic receptors
    C) Blockade of nicotinic receptors
    D) Increase in acetylcholine concentration
  5. Which of the following is a side effect of neostigmine?
    A) Nausea and vomiting
    B) Abdominal cramps
    C) Diarrhea
    D) All of the above
A
  1. B) Physostigmine

Physostigmine is a reversible anticholinesterase that has muscarinic and CNS effects.

2.A) Neostigmine

Neostigmine is a reversible anticholinesterase that has skeletal muscle effects and stimulates ganglia.

3.A) Treatment of myasthenia gravis

Neostigmine is primarily used to treat myasthenia gravis, a neuromuscular disorder.

4.A) Inhibition of acetylcholinesterase

Neostigmine works by inhibiting the enzyme acetylcholinesterase, which breaks down acetylcholine.

5.D) All of the above

Neostigmine can cause several side effects, including nausea and vomiting, abdominal cramps, and diarrhea.

41
Q
  1. What is the primary mechanism of action of cholinergic agonists?
    A) Inhibition of acetylcholinesterase
    B) Stimulation of muscarinic receptors
    C) Mimicry of acetylcholine
    D) Blockade of nicotinic receptors
  2. Which of the following is a choline alkaloid?
    A) Acetylcholine
    B) Methacholine
    C) Muscarine
    D) Bethanechol
  3. What is the primary use of pilocarpine?
    A) Treatment of open-angle glaucoma
    B) Treatment of closed-angle glaucoma
    C) Treatment of dry mouth
    D) Treatment of myasthenia gravis
  4. What is the mechanism of action of pilocarpine in treating glaucoma?
    A) Increase in intraocular pressure (IOP) due to decreased outflow of aqueous humor
    B) Decrease in IOP due to increased outflow of aqueous humor
    C) Constriction of the pupil
    D) Dilatation of the pupil
  5. Which of the following is a side effect of pilocarpine?
    A) Stinging sensation in the eye
    B) Blurred vision
    C) Headache
    D) All of the above
  6. What is the definition of anticholinesterases?
    A) Medications that stimulate muscarinic receptors
    B) Medications that inhibit acetylcholinesterase
    C) Medications that mimic acetylcholine
    D) Medications that block nicotinic receptors
  7. Which of the following is a reversible anticholinesterase?
    A) Organophosphate
    B) Neostigmine
    C) Physostigmine
    D) All of the above except A
  8. What is the primary difference between lipid-soluble and lipid-insoluble anticholinesterases?
    A) Mechanism of action
    B) Duration of action
    C) Distribution in the body
    D) Effects on the central nervous system (CNS)
  9. Which of the following anticholinesterases has muscarinic and CNS effects?
    A) Neostigmine
    B) Physostigmine
    C) Organophosphate
    D) Rivastigmine
  10. What is the primary use of neostigmine?
    A) Treatment of myasthenia gravis
    B) Treatment of glaucoma
    C) Treatment of dry mouth
    D) Treatment of Alzheimer’s disease
A

Here are the answers to the 10 multiple-choice questions:

  1. C) Mimicry of acetylcholine
  2. D) Bethanechol
  3. A) Treatment of open-angle glaucoma
  4. B) Decrease in IOP due to increased outflow of aqueous humor
  5. D) All of the above
  6. B) Medications that inhibit acetylcholinesterase
  7. D) All of the above except A
  8. C) Distribution in the body
  9. B) Physostigmine
  10. A) Treatment of myasthenia gravis
42
Q
  1. By inhibiting acetylcholinesterase, anticholinesterases increase the concentration of _______________________ in the synaptic cleft.
  2. Anticholinesterases can be classified into two main categories: _______________________ and irreversible.
  3. Physostigmine and organophosphates are examples of _______________________ agents.
  4. Neostigmine is an example of a _______________________ agent.
  5. Anticholinesterases with muscarinic and CNS effects stimulate _______________________.
A
  1. By inhibiting acetylcholinesterase, anticholinesterases increase the concentration of acetylcholine in the synaptic cleft.
  2. Anticholinesterases can be classified into two main categories: reversible and irreversible.
  3. Physostigmine and organophosphates are examples of irreversible agents.
  4. Neostigmine is an example of a reversible agent.
  5. Anticholinesterases with muscarinic and CNS effects stimulate muscarinic receptors.
43
Q
  1. Cholinergic agonists are medications that _______________________ the action of the neurotransmitter acetylcholine.
  2. Cholinergic agonists can be classified into two main categories: _______________________ and choline alkaloids.
  3. Pilocarpine is used in eye medications to treat _______________________.
  4. Pilocarpine penetrates the cornea, causing _______________________, ciliary muscle contraction, and a decrease in intraocular pressure (IOP).
  5. Anticholinesterases are medications that inhibit the enzyme _______________________.
A

Here are the answers to the 5 fill-in-the-blank questions:

  1. Cholinergic agonists are medications that mimic the action of the neurotransmitter acetylcholine.
  2. Cholinergic agonists can be classified into two main categories: muscarinic agonists and choline alkaloids.
  3. Pilocarpine is used in eye medications to treat glaucoma.
  4. Pilocarpine penetrates the cornea, causing pupillary constriction, ciliary muscle contraction, and a decrease in intraocular pressure (IOP).
  5. Anticholinesterases are medications that inhibit the enzyme acetylcholinesterase.
44
Q
  1. Cholinergic agonists can be classified into two main categories: choline esters and _______________________.
  2. Pilocarpine is used in eye medications to treat _______________________.
  3. Pilocarpine penetrates the cornea, causing _______________________, ciliary muscle contraction, and a decrease in intraocular pressure (IOP).
  4. Anticholinesterases are medications that inhibit the enzyme _______________________.
  5. By inhibiting acetylcholinesterase, anticholinesterases increase the concentration of _______________________ in the synaptic cleft.
  6. Anticholinesterases can be classified into two main categories: _______________________ and irreversible.
  7. Physostigmine and organophosphates are examples of _______________________ agents.
  8. Neostigmine is an example of a _______________________ agent.
  9. Anticholinesterases with muscarinic and CNS effects stimulate _______________________.
  10. Organophosphates are an example of _______________________ anticholinesterases.
A

Here are the answers to the 10 fill-in-the-blank questions:

  1. Cholinergic agonists can be classified into two main categories: choline esters and choline alkaloids.
  2. Pilocarpine is used in eye medications to treat glaucoma.
  3. Pilocarpine penetrates the cornea, causing pupillary constriction, ciliary muscle contraction, and a decrease in intraocular pressure (IOP).
  4. Anticholinesterases are medications that inhibit the enzyme acetylcholinesterase.
  5. By inhibiting acetylcholinesterase, anticholinesterases increase the concentration of acetylcholine in the synaptic cleft.
  6. Anticholinesterases can be classified into two main categories: reversible and irreversible.
  7. Physostigmine and organophosphates are examples of irreversible agents.
  8. Neostigmine is an example of a reversible agent.
  9. Anticholinesterases with muscarinic and CNS effects stimulate muscarinic receptors.
  10. Organophosphates are an example of irreversible anticholinesterases.
45
Q
  1. True or False: Organophosphates are examples of reversible anticholinesterases.
  2. True or False: Pilocarpine penetrates the cornea, causing mydriasis (dilation of the pupil).
  3. True or False: Anticholinesterases can be classified into two main categories: reversible and irreversible.
  4. True or False: Lipid-soluble agents have skeletal muscle effects and stimulate ganglia.
  5. True or False: Cholinergic agonists can be classified into two main categories: choline esters and choline alkaloids.
A

Here are the answers to the 5 true/false questions:

  1. False: Organophosphates are examples of irreversible anticholinesterases.
  2. False: Pilocarpine penetrates the cornea, causing miosis (constriction of the pupil), not mydriasis.
  3. True: Anticholinesterases can be classified into two main categories: reversible and irreversible.
  4. False: Lipid-insoluble agents (such as neostigmine) have skeletal muscle effects and stimulate ganglia, while lipid-soluble agents (such as physostigmine) have more CNS effects.
  5. True: Cholinergic agonists can be classified into two main categories: choline esters and choline alkaloids.
46
Q
  1. True or False: Cholinergic agonists are medications that inhibit the action of the neurotransmitter acetylcholine.
  2. True or False: Pilocarpine is used in eye medications to treat closed-angle glaucoma.
  3. True or False: Anticholinesterases increase the concentration of acetylcholine in the synaptic cleft.
  4. True or False: Neostigmine is an example of an irreversible anticholinesterase.
  5. True or False: Physostigmine has muscarinic and CNS effects.
A

Here are the answers to the 5 true/false questions:

  1. False: Cholinergic agonists are medications that mimic the action of the neurotransmitter acetylcholine.
  2. False: Pilocarpine is used in eye medications to treat open-angle glaucoma.
  3. True: Anticholinesterases increase the concentration of acetylcholine in the synaptic cleft.
  4. False: Neostigmine is an example of a reversible anticholinesterase.
  5. True: Physostigmine has muscarinic and CNS effects.
47
Q

1.Describe the pharmacokinetics of lipid-soluble and lipid-insoluble anticholinesterases.

2.. What are the effects of anticholinesterases on the central nervous system (CNS)?

A

Here are the answers to the two questions:

  1. Describe the pharmacokinetics of lipid-soluble and lipid-insoluble anticholinesterases:

Lipid-soluble anticholinesterases (e.g., physostigmine):

  • Cross the blood-brain barrier (BBB) easily due to their lipid solubility
  • Have a faster onset of action and a shorter duration of action
  • Are distributed throughout the body, including the CNS
  • Are metabolized by the liver and excreted in the urine

Lipid-insoluble anticholinesterases (e.g., neostigmine):

  • Do not cross the BBB easily due to their lipid insolubility
  • Have a slower onset of action and a longer duration of action
  • Are primarily distributed in the peripheral nervous system (PNS) and not in the CNS
  • Are metabolized by the liver and excreted in the urine
  1. What are the effects of anticholinesterases on the central nervous system (CNS)?

Anticholinesterases can have various effects on the CNS, including:

  • Stimulation of muscarinic receptors, leading to increased activity in the CNS
  • Increased release of acetylcholine, leading to increased cholinergic activity in the CNS
  • Effects on cognitive function, including improved memory and learning
  • Effects on mood, including reduced anxiety and depression
  • Potential for toxicity, including seizures and coma, at high doses

Note: The effects of anticholinesterases on the CNS can vary depending on the specific agent, dose, and individual response.

48
Q

1.Classify anticholinesterases into two main categories and provide examples.

2.What is the difference between reversible and irreversible anticholinesterases?

A

1.
Anticholinesterases can be classified into two main categories:

Reversible Anticholinesterases

  • Examples: Neostigmine, Pyridostigmine, Edrophonium
  • Mechanism: Reversibly bind to the active site of acetylcholinesterase, increasing the concentration of acetylcholine in the synaptic cleft.

Irreversible Anticholinesterases

  • Examples: Physostigmine, Organophosphates (e.g., Sarin, Tabun)
  • Mechanism: Irreversibly bind to the active site of acetylcholinesterase, permanently inactivating the enzyme and increasing the concentration of acetylcholine in the synaptic cleft.
  1. The main difference between reversible and irreversible anticholinesterases is the duration of their action and the mechanism by which they inhibit acetylcholinesterase.

Reversible anticholinesterases:

  • Bind reversibly to the active site of acetylcholinesterase
  • Increase the concentration of acetylcholine in the synaptic cleft for a short period
  • Are generally used for the treatment of myasthenia gravis, glaucoma, and other conditions.

Irreversible anticholinesterases:

  • Bind irreversibly to the active site of acetylcholinesterase
  • Permanently inactivate the enzyme, leading to a prolonged increase in the concentration of acetylcholine in the synaptic cleft
  • Are generally used for the treatment of conditions such as glaucoma, and are also used as insecticides and nerve agents.
49
Q

1.What are the common side effects of pilocarpine?

2.Define anticholinesterases and describe their mechanism of action

A

1.
Common side effects of pilocarpine include:

  • Stinging sensation in the eye
  • Blurred vision
  • Headache
  • Eye irritation
  • Lacrimation (tearing)
  • Miosis (pupillary constriction)
  • Nausea and vomiting

2.
Anticholinesterases are medications that inhibit the enzyme acetylcholinesterase, which breaks down the neurotransmitter acetylcholine.

Mechanism of action:

Anticholinesterases work by:

  • Binding to the active site of acetylcholinesterase
  • Inhibiting the breakdown of acetylcholine
  • Increasing the concentration of acetylcholine in the synaptic cleft
  • Enhancing cholinergic transmission and increasing the activity of acetylcholine at muscarinic and nicotinic receptors.
50
Q

1.What is the primary use of pilocarpine?

2.Describe the mechanism of action of pilocarpine in treating glaucoma.

A

1.
The primary use of pilocarpine is to treat glaucoma, specifically open-angle glaucoma. It is used to reduce intraocular pressure (IOP) and prevent damage to the optic nerve.

2.
Pilocarpine works by:

  • Stimulating muscarinic receptors in the eye
  • Causing contraction of the ciliary muscle
  • Increasing the outflow of aqueous humor from the eye
  • Reducing intraocular pressure (IOP)

By reducing IOP, pilocarpine helps to prevent damage to the optic nerve and slow the progression of glaucoma.

51
Q
  1. What is the definition of cholinergic agonists?
  2. Classify cholinergic agonists into two main categories and provide examples.
A

1.
Cholinergic agonists are medications that mimic the action of the neurotransmitter acetylcholine by stimulating cholinergic receptors (muscarinic and/or nicotinic) in the central and peripheral nervous systems.

2.
Cholinergic agonists can be classified into two main categories:

  • Choline Esters

Examples: Acetylcholine, Bethanechol, Carbachol

These agents are structurally similar to acetylcholine and work by directly stimulating cholinergic receptors.

  • Choline Alkaloids

Examples: Pilocarpine, Muscarine, Arecoline

These agents are naturally occurring compounds that stimulate cholinergic receptors, often with greater selectivity for muscarinic receptors.

52
Q

What are the examples of cholinergic agonist ( in ester and alkaloid)

A

Cholinergic Agonists:

  1. Choline esters:
    • Acetylcholine
    • Methacholine
    • Carbachol
    • Bethanechol
  2. Choline alkaloids:
    • Muscarine
    • Pilocarpine
    • Arecoline
53
Q

Example of anticholinesterases
( reversible and irreversible)

A

Anticholinesterases:

  1. Reversible:
    • Neostigmine
    • Physostigmine
    • Pyridostigmine
    • Edrophonium
    • Rivastigmine
    • Donepezil
    • Galantamine
  2. Irreversible:
    • Organophosphates (e.g., Baygon)
54
Q

Anti-cholinesterase example into lipid soluble and lipid insoluble

A

Lipid-soluble agents:

  1. Physostigmine
  2. Organophosphates (e.g., Baygon)

Lipid-insoluble agents:

  1. Neostigmine
55
Q
  1. What is the effect of anticholinesterases on intraocular pressure?
    A) Increase
    B) Decrease
    C) No effect
    D) Variable effect
  2. Which of the following is a CNS effect of anticholinesterase poisoning?
    A) Excitement
    B) Ataxia
    C) Coma
    D) All of the above
  3. What is the primary mechanism of action of anticholinesterases?
    A) Inhibition of acetylcholine release
    B) Stimulation of nicotinic receptors
    C) Inhibition of acetylcholinesterase
    D) Stimulation of muscarinic receptors
  4. Which of the following is a treatment option for anticholinesterase poisoning?
    A) Atropine
    B) Pralidoxime
    C) Both A and B
    D) Neither A nor B
  5. What is the effect of anticholinesterases on the circular muscle of the iris?
    A) Constriction
    B) Relaxation
    C) Increased contraction
    D) Decreased contraction
A
  1. B) Decrease
  2. D) All of the above
  3. C) Inhibition of acetylcholinesterase
  4. C) Both A and B
  5. A) Constriction
56
Q
  1. What is the primary use of pilocarpine?
    A) Treating myasthenia gravis
    B) Treating glaucoma
    C) Treating Alzheimer’s disease
    D) Treating cobra bites
  2. Which of the following is a muscarinic effect of anticholinesterase poisoning?
    A) Fall in blood pressure
    B) Excessive sweating
    C) Respiratory paralysis
    D) Coma
  3. What is the mechanism of action of anticholinesterases in treating glaucoma?
    A) Increasing intraocular pressure
    B) Reducing intraocular pressure
    C) Constricting the pupil
    D) Dilating the pupil
  4. Which of the following is an example of a reversible anticholinesterase?
    A) Physostigmine
    B) Neostigmine
    C) Organophosphate
    D) Pilocarpine
  5. What is the primary cause of muscle weakness in myasthenia gravis?
    A) Autoantibodies against acetylcholine receptors
    B) Deficiency of acetylcholine
    C) Excess of acetylcholine
    D) Blockage of nicotinic receptors
  6. Which of the following is a treatment option for myasthenia gravis?
    A) Thymectomy
    B) Plasmapheresis
    C) Corticosteroids
    D) All of the above
  7. What is the effect of anticholinesterases on the ciliary body?
    A) Constriction
    B) Relaxation
    C) Increased production of aqueous humor
    D) Decreased production of aqueous humor
  8. Which of the following is a nicotinic effect of anticholinesterase poisoning?
    A) Excessive sweating
    B) Fall in blood pressure
    C) Respiratory paralysis
    D) Coma
  9. What is the primary use of neostigmine?
    A) Treating glaucoma
    B) Treating myasthenia gravis
    C) Treating Alzheimer’s disease
    D) Treating cobra bites
  10. Which of the following is an example of an irreversible anticholinesterase?
    A) Physostigmine
    B) Neostigmine
    C) Organophosphate
    D) Pilocarpine
A
  1. B) Treating glaucoma
  2. B) Excessive sweating
  3. B) Reducing intraocular pressure
  4. B) Neostigmine
  5. A) Autoantibodies against acetylcholine receptors
  6. D) All of the above
  7. D) Decreased production of aqueous humor
  8. C) Respiratory paralysis
  9. B) Treating myasthenia gravis
  10. C) Organophosphate
57
Q
  1. What is the primary mechanism by which anticholinesterases reduce intraocular pressure (IOP) in glaucoma patients?

A) Constriction of the ciliary body
B) Relaxation of the circular muscle of the iris
C) Increased production of aqueous humor
D) Drainage of aqueous humor through Schlemm’s canal

A

D) Drainage of aqueous humor through Schlemm’s canal

Anticholinesterases, such as pilocarpine, reduce intraocular pressure (IOP) in glaucoma patients by increasing the drainage of aqueous humor through Schlemm’s canal. This is achieved by:

  1. Constricting the circular muscle of the iris, which opens the Schlemm’s canal.
  2. Increasing the permeability of the trabecular meshwork, allowing more aqueous humor to drain.

By enhancing the drainage of aqueous humor, anticholinesterases reduce IOP, providing relief from glaucoma.

58
Q
  1. Which of the following is a characteristic of myasthenia gravis?

A) Excessive acetylcholine release
B) Autoantibodies against nicotinic receptors
C) Muscle weakness and impaired muscle contractions
D) Increased intraocular pressure

A

C) Muscle weakness and impaired muscle contractions

Myasthenia gravis is a chronic autoimmune disorder characterized by muscle weakness and impaired muscle contractions. The symptoms of myasthenia gravis include:

  • Muscle weakness, especially in the face, arms, and legs
  • Impaired muscle contractions, leading to drooping eyelids, difficulty swallowing, and shortness of breath
  • Muscle fatigue, which worsens with activity and improves with rest
59
Q
  1. What is the primary use of anticholinesterases in the treatment of myasthenia gravis?

A) To increase acetylcholine release
B) To inhibit acetylcholinesterase
C) To stimulate nicotinic receptors
D) To relax the circular muscle of the iris

2.Which of the following anticholinesterases is commonly used to treat Alzheimer’s disease?

A) Neostigmine
B) Rivastigmine
C) Physostigmine
D) Pilocarpine

3.What is the effect of anticholinesterases on the ciliary body in glaucoma patients?

A) Constriction
B) Relaxation
C) Increased production of aqueous humor
D) Decreased production of aqueous humor

A

Here are the answers with proper numbering:

  1. B) To inhibit acetylcholinesterase
  2. B) Rivastigmine
  3. D) Decreased production of aqueous humor
60
Q
  1. True or False: Anticholinesterases are used to treat hypertension.
  2. True or False: Pilocarpine is used to treat open-angle glaucoma.
  3. True or False: Anticholinesterases can be used to reverse the effects of depolarizing muscle relaxants.
  4. True or False: Myasthenia gravis is an autoimmune disorder characterized by muscle weakness and impaired muscle contractions.
  5. True or False: Anticholinesterases, such as neostigmine, can be used to treat muscle weakness and impaired muscle contractions in patients with myasthenia gravis.
  6. True or False: Anticholinesterases can be used to treat cobra bites.
  7. True or False: Rivastigmine is an anticholinesterase used to treat Alzheimer’s disease.
  8. True or False: Anticholinesterases can be used to treat paralytic ileus after surgery.
  9. True or False: Anticholinesterases, such as physostigmine, can be used to treat glaucoma.
  10. True or False: Anticholinesterases can be used to reverse the effects of non-depolarizing muscle relaxants after surgery.
A

Here are the answers:

  1. False: Anticholinesterases are not typically used to treat hypertension.
  2. True: Pilocarpine is used to treat open-angle glaucoma.
  3. True: Anticholinesterases can be used to reverse the effects of depolarizing muscle relaxants.
  4. True: Myasthenia gravis is an autoimmune disorder characterized by muscle weakness and impaired muscle contractions.
  5. True: Anticholinesterases, such as neostigmine, can be used to treat muscle weakness and impaired muscle contractions in patients with myasthenia gravis.
  6. True: Anticholinesterases can be used to treat cobra bites.
  7. True: Rivastigmine is an anticholinesterase used to treat Alzheimer’s disease.
  8. True: Anticholinesterases can be used to treat paralytic ileus after surgery.
  9. True: Anticholinesterases, such as physostigmine, can be used to treat glaucoma.
  10. True: Anticholinesterases can be used to reverse the effects of non-depolarizing muscle relaxants after surgery.
61
Q
  1. Anticholinesterases can be used to treat _______________________ by reducing intraocular pressure.
  2. Myasthenia gravis is an _______________________ disorder characterized by muscle weakness and impaired muscle contractions.
  3. Anticholinesterases, such as _______________________, can be used to treat muscle weakness and impaired muscle contractions in patients with myasthenia gravis.
  4. Anticholinesterases can be used to reverse the effects of _______________________ muscle relaxants after surgery.
  5. Anticholinesterases, such as _______________________, can be used to treat Alzheimer’s disease.
  6. The constriction of the circular muscle of the iris causes the _______________________ canal to open, allowing the aqueous humor to drain.
  7. Anticholinesterases can be used to treat _______________________ bites.
  8. Anticholinesterases can be used to treat _______________________ poisoning.
  9. Anticholinesterases can be used to prevent the formation or breakdown of _______________________.
  10. Anticholinesterases, such as neostigmine, work by inhibiting the enzyme _______________________.
A

Fill-in-the-blank answers

  1. glaucoma
  2. autoimmune
  3. neostigmine
  4. non-depolarizing
  5. rivastigmine
  6. Schlemm’s
  7. cobra
  8. organophosphate
  9. acetylcholine
  10. acetylcholinesterase
62
Q

Describe the role of anticholinesterases in the treatment of Alzheimer’s disease.

A
63
Q

Explain the difference between the muscarinic and nicotinic effects of anticholinesterases.

A
64
Q
  1. What are the primary symptoms of myasthenia gravis, and how do anticholinesterases help alleviate these symptoms?
A

Primary Symptoms of Myasthenia Gravis and the Role of Anticholinesterases

Primary Symptoms:

  1. Muscle weakness, especially in the face, arms, and legs
  2. Impaired muscle contractions, leading to:
    1. Drooping eyelids (ptosis)
    2. Difficulty swallowing (dysphagia)
    3. Shortness of breath

How Anticholinesterases Help:

  1. Inhibit acetylcholinesterase, increasing acetylcholine levels
  2. Enhance nerve-muscle transmission, improving muscle strength and contractions

By increasing acetylcholine levels, anticholinesterases improve muscle function, reducing weakness and impaired contractions in myasthenia gravis patients.

65
Q
  1. Describe the mechanism of action of anticholinesterases in treating glaucoma.
A

Mechanism of Action of Anticholinesterases in Treating Glaucoma

Anticholinesterases treat glaucoma by:

  1. Inhibiting acetylcholinesterase, increasing acetylcholine levels.
  2. Stimulating muscarinic receptors, constricting the circular muscle of the iris.
  3. Opening Schlemm’s canal, allowing aqueous humor to drain.
  4. Constricting the ciliary body, reducing aqueous humor production.

This decreases intraocular pressure (IOP), relieving glaucoma.

Pha :Cholinergic System (1 decks)

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