Muscarinic Agonists Flashcards
Major clinical manifestations of neuropathy?
Other stuff – but they mention autonomic dysfunction.
Ok fine – this is a shitty flashcard.
Most important clinical form of autonomic neuropathy?
Cardiovascular autonomic neuropathy
Effects of alcoholism/chronic liver disease on ANS?
Autonomic, mainly vagal dysfunction
Peripheral arterial vasodilation and increased plasma catecholamine concentrations.
How do people get botulism toxin poisoning?
Food contaminated with toxin, open wound (IV injection site), botox injection
Botulinum toxin interacts with _________ proteins.
This causes what effects?
SNARE proteins.
No vesicle Ach release
T or F. Hyperthyroidism is a contraindication for the use of murcarinic agonists.
T
Most common cause of hyperthyroidism?
Grave’s Disease
Common symptoms of Grave’s Disease
Looks like hyperadrenergic state Hot/Sweating Irregular heartbeat Diarrhea Weightloss HTN
Treatment for Grave’s Disease?
beta blockers
Relationship between the thyroid and ANS?
- Adrenal glucocorticoids inhibit T3 formation
- Common unction to maintain energy expenditure homeo.
- Adrenergic desensitization can cause hypothyroidism (also, the opposite with sensitization)
Main causes of hypothyroidism?
Iodine deficiency (in foreign countries) or Hashimoto’s
Muscarinic receptors are named after…
Muscarine, the first parasympathomimetic
When would you clinically use muscarine?
Don’t.
It’ll cross yo blood brain barrier and give you the shakes.
(in medical world…convulsions)
Wait…if muscarine gets all up in your brain, why can we take other muscarinic drugs?
Add in a quartanary ammonum to limit the distribution in the CNS
What’s the downside to the ammonium present on muscarinic meds?
Low GI absorption means it usually have to be injected or in a topical cream
Acetylcholine. Selectivity? Hydrolysis by AChE?
Nicotinic or Muscarinic
Yep
Carbachol. Selectivity? Hydrolysis by AChE?
Hits both, not broken down
Methacholine. Selectivity? Hydrolysis by AChE?
Mostly just muscarinic. Hydrolyzed.
Bethanechol, Muscarine, and Pilocarpine. Selectivity? Hydrolysis by AChE?
Only Murcarinic.
Not hydrolyzed
Whats the problem with muscarinic agonists that hit nicotinic receptors?
Nicotinic receptor affinity increases the risk of fatal muscle weakness
What is Methacholine used for?
Diagnosis of bronchial hyperactivity (Ashthma, COPD)
Bronchial Challenge Test
Why use Methacholine to test bronchial hypersensitivity?
Short duration of action (because of AChE)
What do you see in a methacholine bronchial hypersensitivity test?
When given increasing doses, people with hyperreactivity will show signs of respiratory insufficiency at a dose below the level healthy patients will.
Two causes of glaucoma
Increase in Aq humor production or loss of drainage
How do glaucoma drainage problems happen?
Open Angle – Clogged or Obstructed Canal of Schlemm
Narrow/Closed Angle – Drainage blocked by iris muscles
Open and Closed glaucoma – who should scare you more.
Closed – More acute and more severe
How to treat open angle glaucoma? (nonspecific)
M3 muscarinic agonisits – stretch the trabecular network/reduce clotting.
How to treat closed angle glaucoma? (Nonspecific)
M3 muscarinic agonisits – hit the receptor on the sphincter muscles.
Specific muscarinic agents used for treatment of Glaucoma?
Carbachol and Pilocarpine
Carbachol and Pilocarpine. Who is shorter acting? Less headache?
Pilocarine for both.
Important medical details to keep in mind for pilocarpine?
Can enter the CNS and cause epilepsy
What is Bethanechol used for?
Urinary Retention Problems
Post-operative Ileus
Potential treatments for Sjogren’s Synrome?
Cevimeline and Pilocarpine
How does varenacline work?
Partial agonist of nicotinic receptor
Activates enough to block withdrawl, while slowing onset of cigarette use.
What does Timolol do?
Its a beta blocker that decreases the formation of aqueous humor
