Parasym Indirect Agonist

Question 1

Indirect agonists for Alzheimer’s disease

Answer 1

Donepezil, rivastigmine, galantamine

Ist line for Alzheimer disease (Don Riva forgot the gala).

Question 2

Indirect agonists for myasthenia gravis

Answer 2

Neostigmine, Pyridostigmine, Physostigmine

Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative).

Question 3

Neostigmine

Answer 3

1 ACh. Does not penetrate CNS.

Postoperative and neurogenic ileus and urinary retention, myasthenia gravis,
reversal of neuromuscular junction blockade
(postoperative).

Neo CNS = no CNS penetration due to positive charge.

Question 4

Pyridostigmine

Answer 4

1 ACh. Gets rid of myasthenia gravis.

Myasthenia gravis (long acting). Used with glycopyrrolate or hyoscyamine to control pyridostigmine adverse effects.

1 ACh. Phreely (freely) crosses blood-brain barrier as not charged → CNS.

Question 5

Physostigmine

Answer 5

1 ACh. Antidote for anticholinergic toxicity.

Antidote for anticholinergic toxicity; physostigmine “phyxes” atropine overdose.