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M4: Pharmacology-Pharmacokinetics > Parasympathetic Agents > Flashcards

Parasympathetic Agents Flashcards

1
Q

What Type of Nervous System is;

▪️Biosynthesis: Metyrosine
▪️Storage: Reserpine
RELEASE (Exocyte)
□ Stimulators: TEAM
□ Inhibitors: GGB
TERMINATION
□ Reuptake: RIs
□ Metabolism: MAOs, COMT Inh.

A

Sympathetic

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2
Q

What Type of Nervous System is;

▪️Biosynthesis: Hemicholium (rate-limiting step)
▪️Storage: Vesamicol
RELEASE (Exocyte)
□ Stimulators: alpha-latrotoxin
□ Inhibitors: Botolinum toxin
TERMINATION
□ Reuptake: N/A
□ Metabolism: AChaE Inh.

A

Parasympathetic

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3
Q

What type of cholinoceptors

▪️GIT
▪️Parietal cells
▪️(+) Proton Pump=HCl production

A

M1 (Muscarinic)

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4
Q

What type of cholinoceptors

▪️Heart (atria)
▪️↓ cAMP
▪️Bradycardia, Dromotropic

A

M2 (Muscarinic)

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5
Q

What type of cholinoceptors

▪️Organs & Glands
▪️Exocrine Glands: (Wetness) Salivation, Lacrimation, Sweating
▪️Smooth Muscles: Qontraction
• Eyes: Circular (pupils) & Ciliary=Contraction Miosis
• Bronchi: Bronchoconstriction
• GIT: Tae= Bowel Mvmt.
• Urinary Bladder: Ihi=Urination

A

M3 (Muscarinic)

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6
Q

What type of cholinoceptors

▪️Ganglion=Synaptic Neurotransmission
▪️Adrenal Medulla=Epi release
▪️Stimulation

A

Nn (neural)

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7
Q

What type of cholinoceptors

▪️Nueromuscular End Plates
▪️Skeletal Muscle: Contraction

A

Nm (muscular)

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8
Q

Parasympathomimetics Agonist

Drug use for Mgt. of Glaucoma (CDE)

A

Carbachol - (Direct Acting)
Demecarium - (Indirect Acting)
Echothiopate - (Indirect Acting)

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9
Q

Direct Acting Cholinergic Agonist (Parasympathomimetics)

Drug use for Mgt. of Atropine Toxicity

A

Neostigmine

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10
Q

Direct Acting Cholinergic Agonist (Parasympathomimetics)

Drug use for Mgt. of Non-Obstructive Ileus (reduced peristalsis)

A

Physostigmine, Pilocarpine

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11
Q

Direct Acting Cholinergic Agonist (Parasympathomimetics)

Drug use for Smoking Cessation

A

Varenicline
Nicotine

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12
Q

Direct Acting Cholinergic Agonist (Parasympathomimetics)

Drug use for Pulmonary Challenge Test

A

Methacholine (bronconstrictor)

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13
Q

DIRECT ACTING or INDIRECT ACTING

Agonists: Cholinomimetics
▪️bind to stimulate receptors (M,N)
▪️cholinoceptors activation (Drug)

A

Direct Acting

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14
Q

DIRECT ACTING or INDIRECT ACTING

Agonists: Cholinomimetics
▪️inhibit ACh metabolism =↑ ACh
▪️Aka: Anticholinesterases

A

Indirect Acting Cholinergic Agonist

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15
Q

What Drug are under;

Parasympathetic Direct Agonist
a. Choline Esters
• Non-Selective: M & N

Mnemonics: ABCM

A

Acetylcholine
Bethanechol - M Selective
Carbachol
Methacholine

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16
Q

Parasympathetic Direct Agonist
a. Choline Esters
▪️Mgt. of Urine Retention

A

Bethanechol (urecholine)

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17
Q

What Drug are under;

Parasympathetic Direct Agonist
a. Cholinergic Alkaloids
• Non-Selective: binds to M&N (A)
• M-Selective: (PM)
• N-Selective: (LVN)

A

• Non-Selective: Arecoline
• M-Selective: Pilocarpine, Muscarine
• N-Selective: Lobeline, Varenicline, Nicotine

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18
Q

Areca Catechu; betel nut, nga nga

A

Arecoline (Non-Selective)

19
Q

Parasympathetic Direct Agonist
a. Cholinergic Alkaloids
▪️Mgt. of Glaucoma & GI Atony

A

Pilocarpine (M-Selective)

20
Q

Parasympathetic Drug
Indirect Acting Cholinergic Agonist
▪︎ Classes
1. Reversible: (?)
2. Irreversible: (?)
3. CNS-acting: (?)

A
  1. Reversible: safer
  2. Irreversible: toxic
  3. CNS-acting: Anti-Alzheimer’s
21
Q

What Classes belongs the ff. drugs?
[Reversible, Irrreversible, CNS-acting]

▪️Aminialcohol: Edrophonium (Tensilon)

▪️Carbamates: (-stigmine)
▪︎ Physostigmine
▪︎ Pyridostigmine
▪︎ Neostigmine
▪️Others:
▪︎ Ambenonium
▪︎ Demecarium

A

Reversible

22
Q

What Classes belongs the ff. drugs?
[Reversible, Irrreversible, CNS-acting]

▪️Organophosphate
▪️Agricultural Poisons: Malathion, Parathion
▪️Nerve Gases: (Soman Tabun, Sarin)
▪️Echothiophate: medically useful

A

Irreversible (Long-Acting)

23
Q

Parasympathetic (Indirect Acting Cholinergic Agonist)

  1. Diagnostic agent for Myasthenia Gravis
  2. Treatment for Myasthenia Gravis
A
  1. Dx: Edrophonium (Tensilon Test)
  2. Tx: Carbamates (Neostigmine, Pyridostigmine, Ambenonium)
24
Q

Drugs for Alzheimer’s Disease (CNS -acting: ↑ ACh effects)

Mnemonics:
TAClesa at GALANTe si DONya RIVA

A

Tacrine
Galantamine
Donepezil
Rivastigmine

25
Q

Parasympathetic
(Indirect-Acting Cholinergic Agonist)

Side effects/Toxicity [DUMBBELSS]

A

Diarrhea
Urination
Miosis
Bradycardia
Bronchoconstriction
Emesis
Lacrimation
Sweating
Salivation

26
Q

Management of Cholinergic Toxicities:

Tx:
▪️Early (short): cholinesterase reactivators
▪️Late (long):

A

▪️Early (short): Pralidoxime,, Diacetylmonoxime (DAM)
▪️Late (long): Atropine

27
Q

Cholinergic Antagonist
[Antimuscarinic/Aka: Anticholinergics]

▪️Prototype: (?)

A

Atropine - inhibits M1, M2, M3

28
Q

What Drug is:

Effects: Peripheral
▪️M1: block HCl production ( ↓acid secretion)
▪️M2: tachycardia
▪️M3: Mydriasis, Cyclopegia

Uses:
▪️Tx. Symptomatic bradycardia
▪️Tx. Cholinometic Poisoning - Organophosphate: DUMBBELSS
▪️Given with Diphenoxylate as anti-diarrheal [Atropine + Diphenoxylate (Lomotil) ]

A

Atropine

29
Q

Parasympathetic Antagonist
(Anticholinergics)

▪️CNS Acting
- Mgt. of Extrapyramidal Syndrome Parkinsonism

Mnemonics: BBT

A

Benztropine
Biperiden
Trihexyphenidyl

30
Q

Parasympathetic Antagonist
(Anticholinergics)

▪️CNS Acting
- Mgt. of motion sickness

A

Scopolamine

31
Q

Parasympathetic Antagonist
(Anticholinergics)

▪️Mydriatics-for eye exam
▪️Cycloplegics-tx of pain (eye injury)

What drug are under these? (ATCH)

A

Mydriatics/Cycloplegics
▪️ Anistropine
▪️ Tropicamide
▪️ Cyclopentolate
▪️ Homotropine

32
Q

Parasympathetic Antagonist
(Anticholinergics)

▪️Bronchodilators (-tropium)
- Mgt. of BA & COPD

A

SAMA: Ipatropium, Oxytropium
LAMA: Tiotropium (1st Line Reliever in COPD)

33
Q

▪️1st line reliever for BA
▪️1st line reliever in COPD

A

▪️SAMA
▪️LAMA (Tiotropium)

34
Q

Parasympathetic Antagonist
(Anticholinergics)

▪️Selective M1-Blocker (-zepine)
- (-) HCl production
- Mgt. of hyperacidity

A

Pirenzepine
Telenzepine

35
Q

Parasympathetic Antagonist
(Anticholinergics)

▪️Selective M3-Blocker
- act as GIT & urinary bladder
- For Urine incontinence & Hypermotility D/O

A

HNBB
Dicycloverine
Glycopyrrolate
Oxybutinin

36
Q

Antinicotinics = Nn & Nm

What is Nn Blockers:

A

Nn Blockers: Ganglionic

37
Q

Antinicotinics = Nn & Nm

What is Nm Blockers:

A

Nm Blockers: Nueromuscular Blockers

38
Q

What drug belongs to:
▪️Nn Blockers: Ganglionic Blockers
- obsolete antiHTNsive

A

Hexamethonium
Trimethaphan
Mecamylamine

39
Q

What are the 2 types lf Antinicotinics?

A
  1. Nn
  2. Nm
40
Q

Use of each Antinicotinics
1. Nn
2. Nm

A
  1. For obsolete antihypertensive
  2. Skeletal muscle-Relaxants , anesthetic adjuncts, spastic D/O
41
Q

2 Classes of Nm Blockers

A
  1. Depolarizing/Irreversible/Non-Comp.
  2. Non-depolarizing/Reversible/Competitive
42
Q

What drug under?

Parasympathetic Antagonist
[Nm Blocker-Depolarizing]

A

Succinylcholine
-MOA: Irrevesible Nm activation

43
Q

What drug under?

Parasympathetic Antagonist
[Nm Blocker-Non-Depolarizing]

-curare derivatives (2)

A

Isoquinolones (-curium) Tubocurarine
▪️Atracurium
▪️Cistracurium

Steroidal (-curonium)
▪️Pancuronium
▪️Vecuronium

M4: Pharmacology-Pharmacokinetics (50 decks)

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