Neuroscience Week 5: Cholinergic Pharmacology II

Question 1

preganglionic neurotransmitter for sympathetics and parasympathetics

Answer 1

Acetylcholine

Question 2

postganglionic receptor for sympathetics and parasympathetics

Answer 2

Acetylcholine Nicotinic receptors

Question 3

Nicotinic Acetylcholine Receptors mechanism

Answer 3

Ligand-gated ion channel - opens allowing Na+ and sometimes some Ca2+ leading to depolarization and activation

Question 4

Nicotinic Acetylcholine Receptors Action

Answer 4

Question 5

Receptors that mediate reflexes

Answer 5

Question 6

Nicotinic Receptors

Answer 6

Question 7

Location of nicotinic receptors

Answer 7

Question 8

Nicotine Effects in the ANS, skeletal muscle, CNS

Answer 8

Question 9

Nicotine Effects in the Skeletal NMJ

Answer 9

Question 10

Nicotine Effects in the CNS

Answer 10

Question 11

Some nicotine delivery systems

Answer 11

Question 12

Overdose of nicotine

Answer 12

• Induce vomiting - gastric lavage
• Respiratory assistance for diaphragm failure
• Treatment of shock

Question 13

Where will nicotinic antagnoists work and not work?

Answer 13

Works in the:

• brain
• sympathetic and parasympathetic ganglia
• NMJ

Doesn’t work at:

• muscarinic receptors

Question 14

Hexamethonium Pharmacological Properties

Answer 14

Question 15

What effects of a ganglionic blockade, on a resting patient in the exam room?

Answer 15

Question 16

Hexamethonium Therapeutic uses

Answer 16

Question 17

Hexamethonium Still used

Answer 17

• largely replaced by selective adrenergic receptor agents
• some specific uses in CV regulation

Question 18

Nicotinic Antagonists

Answer 18

Question 19

d-tubocurarine

Answer 19

Question 20

Succinylcholine

Answer 20

depolarizing blocker persistently activating and causes desensitization block

Question 21

Succinylcholine metabolizism

Answer 21

Rapid termination by Butyrylcholinesterase in plasma and liver once infusion is terminated

Question 22

BOTOX uses and mechanism

Answer 22

persistent inhibition: blocks release of acetylcholine from neurons indirectly

Question 23

Acetylcholinesterases density

Answer 23

high density at ganglionic

and

lower density at target organs

Question 24

Acetylcholinesterase Reaction

Answer 24

Very fast reaction

Question 25

Acetylcholinesterase Inhibitors: Classes 3 listed

Answer 25

* Quarternary Alcohols * Carbamide Esters * Organophosphates

Question 26

Acetylcholinesterase Inhibitors: quarternary alcohols

Answer 26

Edrophonium

Question 27

Acetylcholinesterase Inhibitors: Carbamate Esters

Answer 27

* Neostigmine * Physostigmine * Pyriodstigmine

Question 28

Acetylcholinesterase Inhibitors: Organophosphates

Answer 28

* Malathion * Parathion * Echothiophate

Question 29

Acetylcholinesterase inhibitors length of inhibition * Quarternary alcohols * Carbamate Esters * Organophosphates

Answer 29

Question 30

Organophosphate inhibition of Acetylcholinesterase

Answer 30

Question 31

Organophosphate inhibition of Acetylcholinesterase and Regeneration by \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 31

Pralidoxime

Question 32

Organophosphate circumvention

Answer 32

Pralidoxime

Question 33

Therapeutic uses of Acetylcholinesterase Agents

Answer 33

Question 34

Caveat of Myasthenia Gravis Diagnosis

Answer 34

Differentiate between myasthenic weakness and cholinergic crisis

Question 35

Myasthenia Gravis: Cholinergic Crisis or Myasthenia Gravis

Answer 35

Question 36

Question 1

Answer 36

C.

Question 37

Myasthenia Gravis Treatment

Answer 37

Question 38

Acetylcholinesterase Inhibitor Toxicity possible exposure sources and properties 3 listed

Answer 38

Question 39

Acetylcholinesterase inhibitors effect on organ systems (low exposure)

Answer 39

Question 40

Acetylcholinesterase inhibitors effect on organ systems (high exposure)

Answer 40

muscarinics keep increasing but nicotinic effects flip

Question 41

Prophylaxis and Treatment of Acetylcholinesterase inhibitor toxicity

Answer 41

Question 42

Prophylaxis and Treatment of Acetylcholinesterase inhibitor toxicity: Pyridostigmine

Answer 42

Question 43

Prophylaxis and Treatment of Acetylcholinesterase inhibitor toxicity: Heroic doses of atropine

Answer 43

Question 44

Prophylaxis and Treatment of Acetylcholinesterase inhibitor toxicity: Pralidoxime

Answer 44

Question 45

Prophylaxis and Treatment of Acetylcholinesterase inhibitor toxicity: Artificial respiration and anticonvulsants

Answer 45

Question 46

Summary

Answer 46