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Pharm - Autonomics > Muscarinic Agonist > Flashcards

Muscarinic Agonist Flashcards

1
Q

Diabetic autonomic neuropathy

A
  • metabolic insult to nerve fibers
  • neurovascular insufficiency
  • autoimmune damage
  • neurohormonal growth factor deficiency
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2
Q

Cardiovascular autonomic neuropathy

A
  • clinically most important form

- increased risk of silent myocardial ischemia/mortality

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3
Q

Autonomic dysfunction with alcoholism + chronic liver disease

A
  • autonomic, mainly vagal, nerve dysfunction is common with these two conditions
  • advanced chronic liver disease characterized by peripheral arterial vasodilation + increased plasma [catecholamine].
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4
Q

Organism responsible for botulism poisoning

A

Clostridium botulinum, present in soil and water

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5
Q

Source of botulism poisoning

A

foodborne, wound borne

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6
Q

Action of botulism

A
  • inhibits the release of acetylcholine

- cleaves SNARE proteins including synaptobrevin

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7
Q

Symptoms of botulism

A

weakness, trouble seeing, fatigue, trouble speaking

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8
Q

Graves disease description

A
  • autoimmune disease
  • thyroid stimulating Ig
  • stimulate secretion of Thyroxine(T4) and Triiodothyronine(T3)
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9
Q

Symptoms of Grave’s disease

A
  • mimic hyperadrenergic state
  • feeling hot
  • excessive sweating
  • irregular heartbeat/tachycardia
  • diarrhea/hyperdefecation
  • dry eyes
  • weight loss
  • hypertension
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10
Q

Treatment of Grave’s disease

A
  • treatment with Beta-blocker

- contraindication for use of muscarinic agonists

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11
Q

Relationship between thyroid and adrenal

A
  • adrenal gland activation(stress) => glucocorticoids inhibit enzyme that converts T4 to T3.
  • interaction between PANS, SANS, and Thyroid function
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12
Q

Reduced body weight and its action on thyroid and adrenal

A
  • T3 decrease
  • SANS decrease
  • PANS increase
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13
Q

Elevated body weight and its action on thyroid and adrenal

A
  • T3 increase

- SANS increase

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14
Q

Hypothyroidism

A
  • desensitization of adrenergic receptors
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15
Q

Hyperthyroidism

A
  • sensitization of adrenergic receptors
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16
Q

Undiagnosed hypothyroidism

A
  • iodine deficiency
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17
Q

Hashimoto’s disease

A
  • autoimmune disease

- Abs attacks thyroid

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18
Q

Symptoms of hypothyroidism

A
  • cold
  • dry skin
  • constipation
  • slowed heart rate
  • weight increase
  • hair loss
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19
Q

Cholinergic stimulation on Urinary tract

A
  • increase ureteral peristalsis
  • decrease bladder capacity
  • increase voiding pressure
20
Q

Cholinergic stimulation on Blood pressure

A
  • increase blood pressure
21
Q

Cholinergic stimulation on GI

A
  • increase GI tone
  • contractility
  • increased secretory activity
22
Q

Cholinergic stimulation on Respiratory

A
  • bronchoconstriction
  • mucus secretion
  • increase secretion from all glands including salivation, sweat, lacrimal, digestive, tracheobronchial
23
Q

Cholinergic stimulation on Eye

A
  • miosis

- drainage of anterior chamber

24
Q

Cholinergic stimulation basic two drugs

A
  • acetylcholinesterase inhibitors

- muscarinic agonists

25
Q

Muscarine and muscarinic receptors

A
  • aminita muscaria : kills flies
  • contains alkaloid muscarine
  • first parasympathomimetic
  • can cross BBB and cause convulsions
26
Q

Direct acting cholinergic receptor agonists are?

A

Esters

27
Q

Molecular description of cholinergic receptor agonist

A
  • polarity(quartanary ammonium)

- limited CNS distribution, and GI absorption

28
Q

4 drugs of the direct acting cholinergic receptor agonist

A 
acetylcholine
carbachol
methacoline(provocholine)
bethanechol(urecholine)
muscarine
pilocarpine
29
Q

Cholinergic agonist OD risk by acting on nicotinic receptors

A

acetylcholine
carbachol
methacholine

30
Q

Short acting cholinergic agonist

A

acetylcholine

methacholine

31
Q

Methacholine and Asthma/COPD diagnosis

A
  • use to diagnose bronchial hyperreactivity
  • bronchial challenge test
  • respond to lower drug dose
32
Q

Open/narrow angle glaucoma

A
  • clogged trabecular meshwork

- slow progression

33
Q

Closed-angle glaucoma

A
  • iris and ciliary body block the canal of schemm and trabecular network
  • fast progression
34
Q

Treatment for open/narrow angle glaucoma

A

Tinolol (Beta-blocker)

-stretch open meshwork

35
Q

Action on closed angle glaucoma

A

M3 contraction to pull ciliary body away

36
Q

Muscarinic agonists for treatment of glaucoma

A

Carbachol

Pilocarpine

37
Q

Carbachol description

A
  • primarily used for glaucoma
  • 2 to 5min onset, 4-8hr duration
  • longer acting than pilocarpine
38
Q

Pilocarpine description

A
  • relieves block of canal of schlemm

- partial agonist (less headache)

39
Q

Adverse effects of pilocarpine

A
  • sweating, salivation, diarrhea, bronchial mucus secretion
  • bronchospasm, bradycardia, vasodilation
  • miosis; blurred vision, impaired night vision
  • reduced BBB function; epilepsy
40
Q

Bethanechol description

A
  • muscarinic selective

- orally or subQ

41
Q

Contraindications of Bethanechol

A
  • urinary retention; avoid use in bladder outlet obstruction(bladder stone, prostate hyper. tumor)
  • post operative ileus(GI atony)
42
Q

Cevimeline and pilocarpine description

A
  • xerostomia(dryness of mouth)
  • following head/neck irradiation
  • sjogren’s disease/syndrome
43
Q

Nicotine description

A
  • full agonist
  • protonated at acidic pH
  • absorbed in mouth and lung
44
Q

Side effects of nicotine

A
  • irritation at site
  • fast/irregular heart beat
  • difficulty breathing
45
Q

Contraindication of nicotine

A

cardiovascular disease

46
Q

Varenicline(chantix) description

A
  • alpha4beta2 nicotinic receptor partial agonist
  • activates nicotine receptor much less than nicotine
  • blocks nicotine from binding
  • well tolerated
47
Q

Side effects of varenicline

A
  • GI related
  • nausea, constipation, gas, vomiting
  • altered dreams

Pharm - Autonomics (3 decks)

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