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Step 1 > Parasympathetic Activation / Cholinomimetic Agents > Flashcards

Parasympathetic Activation / Cholinomimetic Agents Flashcards

1
Q

4 CNs involved in parasympathetic NS

A
  1. CN III
  2. CN VII
  3. CN IX
  4. CN X
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2
Q

All preganglionic neurons use what NT and act on what receptor

A

ACh; act on nicotinic receptors

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3
Q

What is unique about parasympathetic preganglonics?

A

Ae very long and synapse in ganglia near target organs; this makes their actions more localized

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4
Q

Parasympathetic postganglionic neurons use what NT and what receptor

A

ACh–> on muscarinic receptors

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5
Q

What is the difference in nicotinic and muscarinic receptors in terms of how they produce their effects

A

Nicotinic–> open ligand gated Na/K channels

Muscarinic–> activate GPCRs and effect 2nd messenger systems

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6
Q

Other than autonomic ganglia, where else in the body are nicotinic receptors found?

A
  1. at the NMJ; part of somatic nervous system

2. adrenal medulla (sympathetic NS)

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7
Q

Other than CNs, where else are parasympathetic nerves found?

A

2nd and 3rd SACRAL spinal nerves (hence name craniosacral system)

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8
Q

parasympathetic action in GI

A

increased motility and tone–> increased digestion

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9
Q

parasympathetic action in bladder

A

relaxes sphincter, increases muscle tone of bladder wall

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10
Q

Parasym NS action in eye

A
  1. miosis

2. ciliary muscle contraction (accomodation)

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11
Q

Parasym NS action on lung

A

Contraction–> increased bronchial tone

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12
Q

Parasymp NS action on heart

A

decreased HR; some decrease in contractility

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13
Q

parasymp activity in lacrimal glands

A

stimulate tears

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14
Q

parasymp activity in salivary gland

A

watery secretion

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15
Q

parasymp effect on g.u.

A

erection (of penis or clitoris)

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16
Q

mnemonic for orhanophosphate poisoning/ cholinergic excess

A

DUMBELSS

Not specific for only parasympathetic action; nicotinic and muscarinic receptors are found elsewhere too

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17
Q

what does DUMBELSS stand for

A
  1. diarrhea
  2. urination
  3. miosis
  4. bronchospasm
  5. excitation of muscle/CNS (nicotinic @ NMJ)
  6. lacrimation
  7. salivation
  8. sweating
18
Q

other than parasympathetic post ganglionic nerve targets, where else in body are muscarinic receptors found

A

Sweat glands

19
Q

organophosphate mechanism of injury

A

inactivates acetylcholineesterase–> ACh excess–> excess cholinergic stimulation

20
Q

What two drugs are given for cholinergic excess/ organophosphate toxicity

A
  1. Atropine–> (blocks muscarinic rceptors)

2. Pralidoxime–> (regenerates acetylcholinesterase

21
Q

ptosis and diplopia that worsens throughout the day

A

Myasthenia gravis

22
Q

what drug is used to test for myasthenia gravis

A

edrophonium (Tensilon test)

23
Q

50% M.G. asociated with thymic ______

A

hyperplasia

24
Q

20% M.G. associated with thymic _____

A

atrophy

25
Q

15% M.G. associated with thymic ________

A

tumor (thymoma)

26
Q

What causes a Myasthenia crisis (symptom)

A

Rapidly progressing weakness in respiratory muscles

27
Q

4 treatments for myasthenia gravis

A
  1. immunotherapy (cyclosporine, immunotherapy)
  2. Plasmapheresis
  3. Indirect cholinergic agent
  4. thymectomy
28
Q

3 anticholinesterases useful for tx of Alzheimer’s

A
  1. Donepezil
  2. Galantamine
  3. Rivastigmine
29
Q

who gets poisoned by organophosphates

A

farmers

30
Q

4 direct cholinomimetic agonists

A
  1. Bethanecol
  2. Carbachol
  3. Pilocarpine
  4. Methacholine
31
Q

direct ACh agonist given for postoperative ileus, neurogenic ileus or urinary retention

A

Bethanecol

32
Q

direct ACh agonist given for glaucoma

A

Carbachol

33
Q

agonist that is an analoque of ACh

A

Carbachol

34
Q

agonist that is potent stimulator of sweat, tears, and saliva; given for glaucoma (both open and closed)

A

Pilocarpine

*cry, drool, sweat on your PILOw”

35
Q

direct agonist given as challenge test for asthma

A

Methacholine

*stimulates muscarinic receptor in lung to induce bronchspasm

36
Q

5 indirect agents (anticholinesterases)

A
  1. Neostigmine
  2. Pyridostigmine
  3. Edrophomium
  4. Physostigmine
  5. Donepezil
37
Q

indirect agent for short term tx of myasthenia gravis

A

Neostigmine

38
Q

indirect agent that reverses non-depolarizing NMJ blockers

A

Neostigmine

39
Q

indirect agent used for long term tx of myasthenia gravis

A

Pyridostigmine

40
Q

which indirect agent can cross the BBB

A

Physostigmine

41
Q

With all chlinomimetic agents, exacerbation of what three conditions can occur

A
  1. COPD
  2. Asthma
  3. Peptic Ulcer Disease
42
Q

indirect agent used for atropine overdose

A

Physostigmine

  • “Phyxes” atropin OD

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