Muscarinic Agonists Flashcards
Diabetes can affect which part of the nervous system?
Autonomic
How does Diabetes cause neuropathy? (4)
Metabolic insult to nerve fibers
Neurovascular insufficiency
Autoimmune damage
Neurohormal growth factor
Most clinically important form of Diabetes mellitus?
Cardiovascular autonomic neuropathy
What does Diabetes M. increase risk of?
Silent myocardial ischemia/mortality
Common nerve dysfunction in patients with liver diseases?
Autonomic, mainly vagal diseases
What can exaggerate vagal nerve dysfunction?
Alcohol abuse
Advanced chronic liver disease is characterized by what? (2)
Peripheral arterial vasodilation
Increased plasma catecholamine
Botulism poisoning impacts what?
Parasympathetic nervous system
What bacteria causes botulism?
Clostridium Botulinum
Where is Clostridium Botulinum present? (3)
Soil/Water
Food borne
Wound borne (drug users)
What does Botulism toxin inhibit?
Release of acetylcholine
Symptoms of Botulism? (4)
Weakness
Trouble Seeing
Feeling tired
Trouble Speaking
What adrenergic state does Hyperthyroidism mimic?
Hyperadrenergic
What type of disease is Grave’s disease?
Autoimmune
In grave’s disease what does thyroid stimulating immunoglobulin stimulate?
Secretion of Thyroxine (T4) and Triiodothyronine (T3)
Symptoms of Hyperthyroidism? (7) (They all have to do with the body in overdrive mode)
Feeling hot Excessive sweating Tachycardia Diarrhea Dry eyes Weight Loss Hypertension
How do you treat Grave’s disease?
B-blockers
What do you not use for Grave’s disease?
Muscarinic agonists
What happens when the adrenal gland is activated/stimulated?
Glucocorticoids are released
What does glucocorticoid do?
Inhibits enzyme that converts T4 to T3
Which is the active form of thyroid hormone?
T3
What is the interaction between PANS, SANS, and Thyroid?
Energy expenditure
What effects will a reduced body weight cause? (3)
T3 down
SANS down
PANS up
What effect will an elevated body weight cause? (2)
T3 up
SANS up
Desensitization of adrenergic receptors will cause what in the thyroid?
Hypothyroidism
Sensitization of adrenergic receptors will cause what in the thyroid?
Hyperthyroidism
Who is hypothyroidism more common in?
Women
Hypothyroidism is cause by what?
Iodine deficiency
What type of disease is Hashimoto’s?
Autoimmune
What cause Hashimoto’s?
Antibodies attacking the thyroid
What are the symptoms of Hashimoto’s? (6) (It’s like the body is slowing down)
Cold Dry skin Constipation Slowed heart rate Weight increase Hair loss
Cholinergic stimulation can do what?
Reduce symptoms of neuropathic ANS disorders
Aminita mascara known for what?
Killing flies
Danger of Aminita mascara?
Can cross BBB and cause convulsions
Absorption problem with Direct acting cholinergic receptor agonists (Esters)?
Their polarity causes limited CNS distribution and GI absorption. So they have to be given via IV or IM
Muscarinic agonists are used for what? (2)
Asthma
COPD Diagnosis
Which drug for diagnosis of bronchial hyperactivity?
Methacholine
What type of agonists would you use for treatment of glaucoma?
Muscarinic
Which version of glaucoma is fast and which is slow?
Open/narrow angle is slow
Closed angle is fast
Go to muscarinic agonist for Glaucoma?
Carbachol because it is longer acting than pilocarpine
If there is reduced BBB function why don’t you want to give pilocarpine?
It can enter CNS and cause epilepsy
When would you want to use the muscarinic agonist Bethanechol?
Urinary retention
Post operative ileus (GI Atony)
When do you want to avoid Bethanechol?
When bladder is obstructed by stones, hyperplasia, or tumors
When do you want to use muscarinic agonist Cevimeline?
Xerostomia (Dryness of the mouth)
Sjogren’s disease
When do you give nicotinic cholinergic agonists?
Smoking Cessation
When would you avoid use of nicotine patches?
Patient has cardiovascular problems
Difference between Nicotine and Varenicline?
Nicotine is full agonist while Varenicline is partial agonist
What does Varenicline block?
Nicotine binding
Timolol (B-blocker) used for what?
Chronic open angle glaucoma
Why do you change location of nicotine patch?
Avoid skin irritation
