Muscarinic Agonists

Question 1

Diabetes can affect which part of the nervous system?

Answer 1

Autonomic

Question 2

How does Diabetes cause neuropathy? (4)

Answer 2

Metabolic insult to nerve fibers
Neurovascular insufficiency
Autoimmune damage
Neurohormal growth factor

Question 3

Most clinically important form of Diabetes mellitus?

Answer 3

Cardiovascular autonomic neuropathy

Question 4

What does Diabetes M. increase risk of?

Answer 4

Silent myocardial ischemia/mortality

Question 5

Common nerve dysfunction in patients with liver diseases?

Answer 5

Autonomic, mainly vagal diseases

Question 6

What can exaggerate vagal nerve dysfunction?

Answer 6

Alcohol abuse

Question 7

Advanced chronic liver disease is characterized by what? (2)

Answer 7

Peripheral arterial vasodilation

Increased plasma catecholamine

Question 8

Botulism poisoning impacts what?

Answer 8

Parasympathetic nervous system

Question 9

What bacteria causes botulism?

Answer 9

Clostridium Botulinum

Question 10

Where is Clostridium Botulinum present? (3)

Answer 10

Soil/Water
Food borne
Wound borne (drug users)

Question 11

What does Botulism toxin inhibit?

Answer 11

Release of acetylcholine

Question 12

Symptoms of Botulism? (4)

Answer 12

Weakness
Trouble Seeing
Feeling tired
Trouble Speaking

Question 13

What adrenergic state does Hyperthyroidism mimic?

Answer 13

Hyperadrenergic

Question 14

What type of disease is Grave’s disease?

Answer 14

Autoimmune

Question 15

In grave’s disease what does thyroid stimulating immunoglobulin stimulate?

Answer 15

Secretion of Thyroxine (T4) and Triiodothyronine (T3)

Question 16

Symptoms of Hyperthyroidism? (7) (They all have to do with the body in overdrive mode)

Answer 16

Feeling hot
Excessive sweating
Tachycardia
Diarrhea
Dry eyes
Weight Loss
Hypertension

Question 17

How do you treat Grave’s disease?

Answer 17

B-blockers

Question 18

What do you not use for Grave’s disease?

Answer 18

Muscarinic agonists

Question 19

What happens when the adrenal gland is activated/stimulated?

Answer 19

Glucocorticoids are released

Question 20

What does glucocorticoid do?

Answer 20

Inhibits enzyme that converts T4 to T3

Question 21

Which is the active form of thyroid hormone?

Answer 21

T3

Question 22

What is the interaction between PANS, SANS, and Thyroid?

Answer 22

Energy expenditure

Question 23

What effects will a reduced body weight cause? (3)

Answer 23

T3 down
SANS down
PANS up

Question 24

What effect will an elevated body weight cause? (2)

Answer 24

T3 up

SANS up

Question 25

Desensitization of adrenergic receptors will cause what in the thyroid?

Answer 25

Hypothyroidism

Question 26

Sensitization of adrenergic receptors will cause what in the thyroid?

Answer 26

Hyperthyroidism

Question 27

Who is hypothyroidism more common in?

Answer 27

Women

Question 28

Hypothyroidism is cause by what?

Answer 28

Iodine deficiency

Question 29

What type of disease is Hashimoto's?

Answer 29

Autoimmune

Question 30

What cause Hashimoto's?

Answer 30

Antibodies attacking the thyroid

Question 31

What are the symptoms of Hashimoto's? (6) (It's like the body is slowing down)

Answer 31

``` Cold Dry skin Constipation Slowed heart rate Weight increase Hair loss ```

Question 32

Cholinergic stimulation can do what?

Answer 32

Reduce symptoms of neuropathic ANS disorders

Question 33

Aminita mascara known for what?

Answer 33

Killing flies

Question 34

Danger of Aminita mascara?

Answer 34

Can cross BBB and cause convulsions

Question 35

Absorption problem with Direct acting cholinergic receptor agonists (Esters)?

Answer 35

Their polarity causes limited CNS distribution and GI absorption. So they have to be given via IV or IM

Question 36

Muscarinic agonists are used for what? (2)

Answer 36

Asthma | COPD Diagnosis

Question 37

Which drug for diagnosis of bronchial hyperactivity?

Answer 37

Methacholine

Question 38

What type of agonists would you use for treatment of glaucoma?

Answer 38

Muscarinic

Question 39

Which version of glaucoma is fast and which is slow?

Answer 39

Open/narrow angle is slow | Closed angle is fast

Question 40

Go to muscarinic agonist for Glaucoma?

Answer 40

Carbachol because it is longer acting than pilocarpine

Question 41

If there is reduced BBB function why don't you want to give pilocarpine?

Answer 41

It can enter CNS and cause epilepsy

Question 42

When would you want to use the muscarinic agonist Bethanechol?

Answer 42

Urinary retention | Post operative ileus (GI Atony)

Question 43

When do you want to avoid Bethanechol?

Answer 43

When bladder is obstructed by stones, hyperplasia, or tumors

Question 44

When do you want to use muscarinic agonist Cevimeline?

Answer 44

Xerostomia (Dryness of the mouth) | Sjogren's disease

Question 45

When do you give nicotinic cholinergic agonists?

Answer 45

Smoking Cessation

Question 46

When would you avoid use of nicotine patches?

Answer 46

Patient has cardiovascular problems

Question 47

Difference between Nicotine and Varenicline?

Answer 47

Nicotine is full agonist while Varenicline is partial agonist

Question 48

What does Varenicline block?

Answer 48

Nicotine binding

Question 49

Timolol (B-blocker) used for what?

Answer 49

Chronic open angle glaucoma

Question 50

Why do you change location of nicotine patch?

Answer 50

Avoid skin irritation