Pharmacology - Anti-Muscarinic Drugs and Drugs Affecting Nicotinic Receptors (Exam 2)

Question 1

What are the effects of anti-cholinergic drugs (muscarinic antagonists)?

Answer 1

Opposite of SLUDGE

Decreased salivation, sweating
Decreased urination
Decreased defecation
Decreased GI motility

(anti-cholinergics BLOCK rest and digest)

Question 2

What are the physiological effects of anti-cholinergic (muscarinic antagonists) in the lungs and heart?

Answer 2

Bronchodilation
Increased HR

(CAN be used for asthma/COPD pts)

Question 3

What are the natural alkaloid anti-muscarinics?

Answer 3

Atropine
Scopolamine

Question 4

What are the anti-muscarinic drugs? (4)

Answer 4

Atropine
Benztropine
Ipratropium
Scopolamine

Question 5

Anti-cholinergic drugs are _________ agents

Answer 5

parasympatholytic

Question 6

What is a GI side effect of anti-cholinergic drugs?

Answer 6

Constipation

Question 7

What are the effects of anti-cholinergics in the eye?

Answer 7

Mydriasis (pupil dilation)
Cycloplegia (loss of accommodation)

Question 8

Anti-cholinergics can make _______ worse

Answer 8

Glaucoma

(you want to constrict the pupil in pts with glaucoma, not dilate)

Question 9

What else are anti-cholinergics used to treat?

Answer 9

Motion sickness (scopolamine)
Parkinson’s

Question 10

What are the adverse effects of anti-cholinergic drugs?

Answer 10

Xerostomia

Question 11

What are the contraindications of anti-cholinergics?

Answer 11

Glaucoma
Benign prostate hyperplasia
Urinary obstruction/retention
GI obstruction
Cardiovascular disease

Question 12

What is the antidote for anti-cholinergics?

Answer 12

Anti-cholinesterases (AChE inhibitor)

(and vice versa)

Question 13

Nicotinic receptor drugs work on which nervous systems?

Answer 13

Somatic (skeletal muscle)
Sympathetic
Parasympathetic

Question 14

Nicotinic receptors are _______ receptors that _______ selectively binds to

Answer 14

ACh
nicotine

Question 15

What drug is a competitive antagonist for muscle-type nicotinic receptors?

Answer 15

Curare

Question 16

What effect does Curare (competitive antagonist) have on muscles?

Answer 16

Paralysis

Question 17

Where are nicotinic receptors found in the somatic nervous system?

Answer 17

Neuromuscular junction

Question 18

Where are nicotinic receptors found in the SNS and PSNS?

Answer 18

Autonomic ganglia (postganglionic)

Adrenal medulla (for SNS only)

Question 19

What are the 2 types of nicotinic receptors?

Answer 19

Neuronal-type (NN)
Muscle-type (NM)

Question 20

Where are neuronal-type nicotinic receptors found?

Answer 20

SNS
PSNS

Question 21

Where are muscle-type nicotinic receptors found?

Answer 21

Somatic nervous system

Question 22

Nicotinic receptors are ligand-gated ___________ channels

Answer 22

Na+ (sodium)

Question 23

When ACh binds to the ligand-gated Na+ channels (nicotinic receptors), what happens?

Answer 23

Depolarization and action potential

Question 24

Nicotine causes ________ because it stimulates the _______ pathway in the brain to cause _______ and _________

Answer 24

addiction; reward; pleasure and euphoria

Question 25

What receptors do neuromuscular junctional blockers work on?

Answer 25

muscle-type nicotinic receptors (somatic nervous system)

Question 26

What are the 2 types of neuromuscular junctional blockers?

Answer 26

1. Non-depolarizing 2. Depolarizing

Question 27

Non-depolarizing neuromuscular junctional blockers work as ___________ _________

Answer 27

competitive antagonists (Ex: Curare)

Question 28

What is the effect of non-depolarizing neuromuscular junctional blockers?

Answer 28

No depolarization No muscle contraction You get flaccid paralysis

Question 29

Depolarizing neuromuscular junctional blockers work as __________

Answer 29

agonists

Question 30

What is the effect of depolarizing neuromuscular junctional blockers?

Answer 30

Depolarization Action potential Muscle contraction (initially)

Question 31

Too much depolarizing neuromuscular junctional blockers eventually causes...

Answer 31

Receptor inactivation Paralysis (Desensitization)

Question 32

Curare blocks _________ nicotinic receptors

Answer 32

muscle-type

Question 33

What drug is a depolarizing neuromuscular junctional blocker?

Answer 33

Succinylcholine

Question 34

Neuromuscular junctional blockers are frequently used in __________

Answer 34

anesthesia

Question 35

What is the adverse effect of neuromuscular junctional blockers?

Answer 35

Death from respiratory failure (due to paralysis of diaphragm)

Question 36

What are the 2 major types of cholinesterase?

Answer 36

AChE BChE (plasma)

Question 37

Which cholinesterase is critical for life?

Answer 37

AChE

Question 38

Which cholinesterase is NOT critical for life?

Answer 38

BChE

Question 39

Which cholinesterase plays a role in succinylcholine (aka hydrolyzes succinylcholine)?

Answer 39

BChE (also called psuedo-cholinesterase)

Question 40

What is an adverse effect of succinylcholine?

Answer 40

Prolonged duration of action (due to deficiency in BChE)