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Pharmacology 3rd Exam > Parasympathetic / Cholinergic > Flashcards

Parasympathetic / Cholinergic Flashcards

1
Q

Cholinergic transmission steps

A 
Synthesis 
Storage in vesicles 
Release 
Binding to receptor 
Degradation of acetylcholine 
Recycling of choline
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2
Q

Carries choline from extracellular to pre-synaptic region

A

Na-dependent transporter

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3
Q

Process in synthesis
Enzyme
Product

A

Acetylation
Choline acetyltransferase
Acetylcholine

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4
Q

Inhibits transporter, uptake of acetylcholine

A

Vesamicol

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5
Q

Inhibits transport of choline to the pre-synaptic region

A

Hemicholinum

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6
Q

Blocks release of acetylcholine
Decreased neurotransmitter
Decreased muscle contraction
Paralysis

A

Botulinum toxin

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7
Q

Cholinoceptors

A

Muscarinic

Nicotinic

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8
Q

M1

A

E - exocrine glands
A - autonomic glands
C - CNS

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9
Q

M2

A 
HCSP
Heart
CNS
Smooth muscle 
Peripheral nerve
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10
Q

M3

A 
ESEBC
Exocrine glands 
Smooth muscle 
Eye 
Blood vessel 
CNS
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11
Q

M4

A

CNS

Enhanced locomotion

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12
Q

M5

A

CSI
CNS
Salivary glands
Iris

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13
Q

NN

A

Ganglion - stimulation

CNS - neurotransmisson

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14
Q

NM

A

Skeletal muscle - contraction

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15
Q

Subtypes of cholinergic agonists

A

DIRECT

Indirect

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16
Q

DIRECT acting cholinergic agonists

A

Choline esters

Alkaloids

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17
Q

Choline esters

A

Acetylcholine
Bethanechol
Carbachol
Methacholine / provocholine

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18
Q

Most potent cholinergic agonist
Cause 10-Min miosis during cataract surgery
Lack of selectivity

A

Acetylcholine

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19
Q

Strong muscarinic activity

Increase intestinal motility after surgery

A

Bethanechol

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20
Q

Ester of carbamic acid

A

Carbachol

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21
Q

For open angle glaucoma that is resistant to pilocarpine

A

Carbachol

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22
Q

Weak nicotinic activity

Diagnosis of asthma

A

Methacholine

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23
Q

What should be given after the methacholine test

A

Rapid-acting bronchodilator

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24
Q

DOC for glaucoma

Can Cross blood brain barrier

A

Pilocarpine

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25
Q

No therapeutic use

A

Muscarine

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26
Q

Has muscarinic and nicotinic activity

Potential for Alzheimer’s

A

Arecholine

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27
Q

Indirect-acting cholinergic agonists /

Cholinesterase inhibitors

A

Organophosphates
Carbamates
Quaternary amines

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28
Q

DFP Keana

A

Diisopropylfluorophosphate

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29
Q

Organophosphates

A

Isofluorophate
Echothiophate
Malathion, parathion
Tabon, sarin, soman

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30
Q

Chronic treatment of open-angle glaucoma

Duration 1 week

A

Isofluorophate

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31
Q

Open angle glaucoma

3-7 days

A

Echothiophate

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32
Q

Insecticides / Pesticides
No clinical use
Active metabolites: malaoxon, paraoxon

A

Malathion, parathion

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33
Q

Phospholine Iodide

A

Echothiophate

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34
Q

Placed on soldiers to combat the spread of life threatening diseases on the Front lines typhus and Malaria

A

DDT

dichlrorodiphenyltrichloroethane

35
Q

Nerve gases

A

Tabun
Sarin
Soman

36
Q

Organophosphate toxicity

A

Cholinergic Crisis

37
Q

Antidote for cholinergic Crisis

A

Pralidoxine chloride 2 PAM

Atropine

38
Q

Carbamates

A

Physostigmine eserine
Neostigmine prostigmin
Pyridostigmine mestinon

39
Q

Intestinal and bladder atony
Miotic agent for open angle glaucoma
6-12 hrs

A

Physostigmine

40
Q

Treats MYASTHENIA GRAVIS
Paralytic ileus or atony of the urinary bladder
Antidote for TUBOCURARINE POISONING
3-6 hrs

A

Neostigmine

41
Q

Carbamate insecticides

A

Carbaryl
Propoxur
Aldicarb

42
Q

For tensilon test - diagnosis of myasthenia gravis

A

Edrophonium

43
Q

Cholinergic antagonists

A

Muscarinic blockers
Ganglion blockers
Neuromuscular blockers

44
Q

Prevents motion sickness

Blocks short-term memory

A

Scopolamine

45
Q

Scopolamine, when given with atropine produces

A

Twilight sleep

46
Q

Produce mydriasis and cycloplegia for ophthalmoscopic examination

A

Homatropine
Cyclopentolate
Tropicamide

47
Q

For ASTHMA and COPD chronic obstructive pulmonary disease

More peripheral effects less CNS effects

A

Ipratropium bromide

48
Q

Treatment for COPD

A

Tiotropium

49
Q

For peptic ulcer

Selective for muscarinic receptor in the stomach

A

Pirenzepine

50
Q

Pirenzepine decreases secretion of

A

Acid and pepsin

51
Q

Parkinson’s disease

Extrapyramidal disorders

A

Benztropine
Trihexyphenidyl
Oxybutynin

52
Q

Hypermotility of the bowel

A

Dicyclomine

53
Q

Reduces GI smooth muscle spasms

Adjunct for peptic ulcer

A

Propantheline

54
Q

Other drugs that have anticholinergic effects

A

Antihistamines
Antipsychotics
TCAs
Opioids

55
Q

Block nicotinic receptors causing paralysis

A

Neuromuscular blockers /

Skeletal muscle relaxants

56
Q

Subtypes of neuromuscular blockers

A

Competitive non-depolarizing

Competitive depolarizing

57
Q

Compete with acetylcholine at nicotinic receptors
Prevent depolarization
Inhibit muscular contraction

A

Nondepolarizing blockers

58
Q

Adjunct to anesthesia
For short surgical operations
Very little histamine release

A

Vecuronium

59
Q

Mechanical ventilation for critically ill patients

Ideal for patients with kidney and liver failure

A

Atracurium

Cisatracurium

60
Q

No histamine release

A

Cisatracurium

61
Q

Has vagolytic actions

Used when elevated heart rate is desired

A

Pancuronium

62
Q

Increase heart rate

No histamine release

A

Pancuronium

63
Q

Prevents fasciculation associated with succinyl choline

A

Tubocurarine

64
Q

Tubocurarine adverse effects
Hypotension:________
Bronchospasm:_________

A

Histamine

Ganglionic blockade

65
Q

For short surgical procedures

A

Mivacurium

66
Q

Mivacurium is hydrolyzed by

A

Plasma cholinesterase

67
Q

Useful for tracheal intubation in patients with gastric contents

A

Rocuronium

68
Q

Adjunct to anesthesia in long surgery cases

Long duration in patients with renal dysfunction

A

Pipecuronium

Doxacurium

69
Q

DRUG INTERACTIONS of Nondepolarizing neuromuscular blockers

A

Cholinesterase inhibitors
Halogenated hydrocarbon anesthetics
Aminoglycoside antibiotics
Calcium channel blockers

70
Q

Can overcome the action of nondepolarizing blockers

A

Cholinesterase inhibitors

Neostigmine, physostigmine, edrophonium

71
Q

Enhance neuromuscular blockade by exerting a stabilizing action of nondepolarizing blockers

A

Halogenated hydrocarbon anesthetics

72
Q

Inhibit ACh release from cholinergic nerves by competing with calcium ions

A

Aminoglycoside antibiotics

73
Q

May increase the neuromuscular block of nondepolarizing and dep blockers

A

Calcium channel blockers

74
Q

Muscle regidity and hyperpyrexia

A

Malignant hyperthermia

75
Q

Treatment for malignant hyperthermia

A

DANTROLENE
- blocks release of calcium from the sarcoplasmic reticulum of muscle cells

Rapidly cooling the patient

76
Q

Pre-reversal

A

Atropine

Glycopyrrolate

77
Q

Reversal

A

Cholinesterase inhibitors

78
Q

Block nicotinic receptors in both sympathetic and parasympathetic ganglia

A

Ganglionic blockers

79
Q

Ganglionic blockers

A

Hexamethonium
Trimethaphan
Mecamylamine
Nicotine

80
Q

First drug effective for hypertension

A

Hexamethonium

81
Q

Treatment of hypertensive emergencies caused by pulmonary edema or dissecting aortic aneurysm

A

Trimethaphan

82
Q

Treats moderately severe to severe hypertension

A

Mecamylamine

83
Q

Nicotine
Low dose: _______
High dose: _______

A

Ganglionic stimulation

Ganglionic blockade

Pharmacology 3rd Exam (2 decks)

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