Muscarinic Agonists Flashcards

1
Q

Major clinical manifestations of neuropathy?

A

Other stuff – but they mention autonomic dysfunction.

Ok fine – this is a shitty flashcard.

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2
Q

Most important clinical form of autonomic neuropathy?

A

Cardiovascular autonomic neuropathy

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3
Q

Effects of alcoholism/chronic liver disease on ANS?

A

Autonomic, mainly vagal dysfunction

Peripheral arterial vasodilation and increased plasma catecholamine concentrations.

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4
Q

How do people get botulism toxin poisoning?

A

Food contaminated with toxin, open wound (IV injection site), botox injection

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5
Q

Botulinum toxin interacts with _________ proteins.

This causes what effects?

A

SNARE proteins.

No vesicle Ach release

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6
Q

T or F. Hyperthyroidism is a contraindication for the use of murcarinic agonists.

A

T

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7
Q

Most common cause of hyperthyroidism?

A

Grave’s Disease

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8
Q

Common symptoms of Grave’s Disease

A
Looks like hyperadrenergic state
Hot/Sweating
Irregular heartbeat
Diarrhea
Weightloss
HTN
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9
Q

Treatment for Grave’s Disease?

A

beta blockers

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10
Q

Relationship between the thyroid and ANS?

A
  1. Adrenal glucocorticoids inhibit T3 formation
  2. Common unction to maintain energy expenditure homeo.
  3. Adrenergic desensitization can cause hypothyroidism (also, the opposite with sensitization)
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11
Q

Main causes of hypothyroidism?

A

Iodine deficiency (in foreign countries) or Hashimoto’s

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12
Q

Muscarinic receptors are named after…

A

Muscarine, the first parasympathomimetic

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13
Q

When would you clinically use muscarine?

A

Don’t.
It’ll cross yo blood brain barrier and give you the shakes.
(in medical world…convulsions)

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14
Q

Wait…if muscarine gets all up in your brain, why can we take other muscarinic drugs?

A

Add in a quartanary ammonum to limit the distribution in the CNS

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15
Q

What’s the downside to the ammonium present on muscarinic meds?

A

Low GI absorption means it usually have to be injected or in a topical cream

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16
Q

Acetylcholine. Selectivity? Hydrolysis by AChE?

A

Nicotinic or Muscarinic

Yep

17
Q

Carbachol. Selectivity? Hydrolysis by AChE?

A

Hits both, not broken down

18
Q

Methacholine. Selectivity? Hydrolysis by AChE?

A

Mostly just muscarinic. Hydrolyzed.

19
Q

Bethanechol, Muscarine, and Pilocarpine. Selectivity? Hydrolysis by AChE?

A

Only Murcarinic.

Not hydrolyzed

20
Q

Whats the problem with muscarinic agonists that hit nicotinic receptors?

A

Nicotinic receptor affinity increases the risk of fatal muscle weakness

21
Q

What is Methacholine used for?

A

Diagnosis of bronchial hyperactivity (Ashthma, COPD)

Bronchial Challenge Test

22
Q

Why use Methacholine to test bronchial hypersensitivity?

A

Short duration of action (because of AChE)

23
Q

What do you see in a methacholine bronchial hypersensitivity test?

A

When given increasing doses, people with hyperreactivity will show signs of respiratory insufficiency at a dose below the level healthy patients will.

24
Q

Two causes of glaucoma

A

Increase in Aq humor production or loss of drainage

25
Q

How do glaucoma drainage problems happen?

A

Open Angle – Clogged or Obstructed Canal of Schlemm

Narrow/Closed Angle – Drainage blocked by iris muscles

26
Q

Open and Closed glaucoma – who should scare you more.

A

Closed – More acute and more severe

27
Q

How to treat open angle glaucoma? (nonspecific)

A

M3 muscarinic agonisits – stretch the trabecular network/reduce clotting.

28
Q

How to treat closed angle glaucoma? (Nonspecific)

A

M3 muscarinic agonisits – hit the receptor on the sphincter muscles.

29
Q

Specific muscarinic agents used for treatment of Glaucoma?

A

Carbachol and Pilocarpine

30
Q

Carbachol and Pilocarpine. Who is shorter acting? Less headache?

A

Pilocarine for both.

31
Q

Important medical details to keep in mind for pilocarpine?

A

Can enter the CNS and cause epilepsy

32
Q

What is Bethanechol used for?

A

Urinary Retention Problems

Post-operative Ileus

33
Q

Potential treatments for Sjogren’s Synrome?

A

Cevimeline and Pilocarpine

34
Q

How does varenacline work?

A

Partial agonist of nicotinic receptor

Activates enough to block withdrawl, while slowing onset of cigarette use.

35
Q

What does Timolol do?

A

Its a beta blocker that decreases the formation of aqueous humor