Neuropharmacology

Question 1

what are cholinergic drugs?

Answer 1

drugs that mimic the action of acetylcholine

Question 2

what are adrenergic drugs?

Answer 2

drugs that mimic the action of epinephrine and norepinephrine

Question 3

what are the general functions of the sympathetic and parasympathetic systems?

Answer 3

oppose each other
discrete vs diffuse action
both excitatory and inhibitory
maintain homeostasis
one may directly inhibit other

Question 4

what are the events involved in a cholinergic response?

Answer 4

synthesis of acetylcholine
storage of acetylcholine in vesicles
arrival of impulse and calcium uptake
release of acetylcholine into synaptic cleft
interaction of acetylcholine with receptor
hydrolysis of acetylcholine by esterase
reuptake of choline

Question 5

what are the agonist and antagonist of muscarinic receptors (subtype of cholinergic)?

Answer 5

muscarine is agonist
atropine is antagonist

Question 6

what are the agonist and antagonist of nicotinic receptors (subtype of cholinergic)?

Answer 6

nicotine is agonist
curare is antagonist

Question 7

nicotinic receptor is the _________________ and is activated by _____________________________________

Answer 7

sodium channel
2 acetylcholine binding to the 2 alpha subunits

Question 8

what are the subclasses of muscarinic receptors?

Answer 8

M1
M2
M3

Question 9

where are M2 receptors located?

Answer 9

heart

Question 10

where are M3 receptors located?

Answer 10

smooth muscle
secretory glands

Question 11

what is the receptor action of M1 and M3?

Answer 11

M1: close potassium channel
M3: increased contraction, increased secretion
depolarization

Question 12

what is the M2 receptor action?

Answer 12

open potassium channels and decrease cAMP to decrease heart rate

Question 13

if a cholinergic drug’s mechanism of action is at M1, what does it do?

Answer 13

excitatory
close potassium channel
activate phospholipase C

Question 14

if a cholinergic drug’s mechanism of action is at M2, what does it do?

Answer 14

inhibitory
open potassium channel
inhibit adenylate cyclase

Question 15

if a cholinergic drug’s mechanism of action is at M3, what does it do?

Answer 15

excitatory
activate phospholipase C
increase ionized calcium concentration

Question 16

where are cholinergic actions in the body?

Answer 16

cardiovascular system
respiratory system
gastrointestinal system
urinary bladder
eye
skeletal and smooth muscles

Question 17

what are cholinergic actions in the cardiovascular system?

Answer 17

decrease heart rate
decrease atrial contractility
decrease AV conduction
decrease blood pressure

Question 18

what are cholinergic actions in the respiratory system?

Answer 18

bronchoconstriction
increase bronchial secretion

Question 19

what are cholinergic actions in the gastrointestinal system?

Answer 19

increase motility
increase secretion
relax sphincters

Question 20

what are cholinergic actions in the urinary bladder?

Answer 20

contract detrusor muscle
relax internal sphincter

Question 21

what are cholinergic actions in the eye?

Answer 21

contract sphincter muscles and iris
contract ciliary muscle

Question 22

what are cholinergic actions in skeletal and smooth muscles?

Answer 22

contraction: muscle spasms

Question 23

what are some direct acting cholinomimetics?

Answer 23

natural alkaloids- muscarinic receptor
synthetic- choline esters

Question 24

what are some natural alkaloids?

Answer 24

muscarine
pilocarpine
arecoline

Question 25

what are some synthetic cholinomimetics?

Answer 25

choline esters: carbachol bethanechol methacholine

Question 26

how do indirect acting cholinomimetics work?

Answer 26

inhibit acetylcholinesterase

Question 27

what are some reversible indirect acting cholinomimetics?

Answer 27

physostigmine neostigmine pyridostigmine edrophonium

Question 28

what are some irreversible indirect acting cholinomimetics?

Answer 28

echothiophate malathion

Question 29

what can organophosphate poisoning be treated with and why?

Answer 29

atropine antagonist: blocks acetylcholine until can make more acetylcholinesterase proteins

Question 30

what are the clinical applications of cholinomimetics?

Answer 30

glaucoma ileus and urinary bladder atony myasthenia gravis edrophonium test and atropine curareform toxicity anticholinergic toxicity alzheimer's disease

Question 31

what blocks choline uptake and acetylcholine synthesis?

Answer 31

hemicholinium

Question 32

what blocks release of acetylcholine?

Answer 32

low calcium excess magnesium botulinum toxicity aminoglycosides local anesthetics

Question 33

what inhibits acetylcholine-receptor interaction?

Answer 33

curare atropine hexamethonium

Question 34

what inhibits acetylcholine hydrolysis by esterase?

Answer 34

neostigmine organophosphate

Question 35

what is atropine's mechanism of action?

Answer 35

prevents acetylcholine from binding and inducing its effects by interacting with muscarinic acetylcholine receptors attenuates parasympathetic nerve impulses

Question 36

what are the actions of muscarinic antagonists on the cardiovascular system?

Answer 36

increase heart rate increase intranodal conduction slight increase or no change in blood pressure (dose dependent decrease in heart rate and second degree AV block can occur)

Question 37

what are the actions of muscarinic antagonists on the respiratory system?

Answer 37

produce bronchodilation decrease bronchial secretion

Question 38

what are the actions of muscarinic antagonists on the gastrointestinal system?

Answer 38

relaxation of GI smooth muscle decreased secretions decreased salivation

Question 39

what are the actions of muscarinic antagonists on the urinary bladder?

Answer 39

relaxes smooth muscle of urinary tract urinary retention

Question 40

what are the actions of muscarinic antagonists on the eye?

Answer 40

relax sphincter muscle and iris, dilated pupil

Question 41

what are some antimuscarinic drugs?

Answer 41

atropine glycopyrrolate homatropine propantheline ipratropium

Question 42

what is one autonomic ganglion blocker?

Answer 42

hexamethonium

Question 43

what are some neuromuscular blockers?

Answer 43

curure succinylcholine

Question 44

what are some clinical applications of anticholinergics in the GI?

Answer 44

spasmolytic peptic ulcer colic in horses

Question 45

what are some results of cholinergic drug toxicity?

Answer 45

severe colic and diarrhea increased exocrine secretion dyspnea hypotension, cardiac slowing death if not treated

Question 46

when should you be careful while using anti-cholinesterases?

Answer 46

liver disease respiratory disease late pregnancy

Question 47

when should you avoid using anti-cholinesterases?

Answer 47

other anti-cholinesterase drugs metabolized by cholinesterase phenothiozines

Question 48

when should you be careful with anti-muscarinic drugs?

Answer 48

glaucoma gastric ulcer

Question 49

what are some competitive non-depolarizing blockers?

Answer 49

D-tubocurarine gallamine pancuronium

Question 50

what are some depolarizing blockers?

Answer 50

succinyl choline decamethonium

Question 51

what is the mechanism of action for competitive/non-depolarizing blockers?

Answer 51

bind to receptors no depolarization block access of agonist to receptors action can be reversed

Question 52

what is the mechanism of action for non-competive/depolarizing blockers?

Answer 52

bind to receptors cause depolarization membrane remains depolarized cannot be reversed with acetylcholinesterase inhibitor

Question 53

how are D-tubocurarine and pancuronium metabolizd?

Answer 53

liver excreted in bile and urine

Question 54

how are gallamine and decamethonium metabolized?

Answer 54

excreted unchanged in urine minimal tissue distribution

Question 55

how is succinylcholine metabolized?

Answer 55

hydrolyzed by serum psuedo cholinesterase

Question 56

what is the order for muscles being relaxed?

Answer 56

toes, ears, eyes head and neck limbs respiratory muscles

Question 57

what are some pharmacological actions of blockers?

Answer 57

central autonomic effect contracture of ocular muscles hypotension cardiac arrhythmia

Question 58

what are the clinical applications of blockers?

Answer 58

major and minor surgery chemical restraint strychnine poisoning muscle disorders

Question 59

how do you treat blocker toxicosis?

Answer 59

artificial respiration anticholinesterase and atropine

Question 60

what are some ways that the junctional events in cholinergic junctions can be blocked?

Answer 60

choline uptake and acetylcholine synthesis release of acetylcholine inhibition of acetylcholine-receptor interaction acetylcholine hydrolysis by esterase

Question 61

what are some clinical applications of anticholinergics in ophthalmology?

Answer 61

mydriasis cycloplegia

Question 62

what is a clinical application of anticholinergics in respiratory?

Answer 62

bronchodilator

Question 63

what is a clinical application of anticholinergics in the cardiovascular system?

Answer 63

sinus bradycardia

Question 64

what is a clinical application of anticholinergics using no system in particular?

Answer 64

pre-anesthetic anti-cholinesterase toxicity

Question 65

what do anti-nicotinic drugs do?

Answer 65

muscle relaxants neuromuscular blocking agents

Question 66

how do anti-nicotinic drugs cause hypotension?

Answer 66

blockade of ganglion histamine release

Question 67

which anti-nicotinic drug can cause cardiac arrhythmia at high doses?

Answer 67

succinylcholine