Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology > Pharmacology Class 2020 :Cholinergics > Flashcards

Pharmacology Class 2020 :Cholinergics Flashcards

1
Q

What are the two components of the Peripheral nervous system?

A

Central which includes brain and brainstem

Peripheral which includes Autonomic and Somatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The autonomic nervous system is split into two parts

A

Sympathetic

Parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Almost all efferent fibers leaving the CNS are cholinergic

True or False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What neurotransmitter do all preganglionic neurons release?

A

ACH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which part of the nervous system has the most cholinergic fibers?

A

Parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where are nicotinic acetylcholine receptors located?

A

skeletal muscles or somatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where are muscarinic ACH receptors found?

A

Cardiac
Smooth muscle
Neuron endings
Sweat glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What two neurons are required within the autonomic nervous system reach a target organ?

A

preganglionic

postganglionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do cholinergics drugs do?

A

Mimic or block the actions of chemical transmitters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Are parasympathetic nerve fibers long or short?

A

short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

All receptors at the neuromuscular junction have what type of receptors?

A

nicotinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

All target organs of the parasympathetics have what type of receptor?

A

Muscarinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

All autonomic ganglia have nicotinic receptors

True or False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What major neurotransmitter is stored in vesicles?

A

ACH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What enzyme synthesizes ACH?

A

ACH is derived from Actyl coenzyme A by Choline or CHAT acetyltransferase preganglionic nerve terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What releases ACH?

A

Calcium dependent exocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does ACH bind?

A

Nicotinic receptors on postganglionic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which enzyme hydrolyzes ACH?

A

Acetylcholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where is acetylcholinesterase found?

A

neuronal membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What blocks the calcium dependent exocytosis of ACH?

A

Botullinum toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where is ACH degraded?

A

By acetylcholinesterase in the post synaptic cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are cholinergic receptors?

A

ACH receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the location and function of the M1 receptor?

A

Location:
CNS neurons, sympathetic
postganglionic neurons

Function:
Increased intracellular Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the location and function of M2 receptor?

A

Location:
Myocardium, smooth muscle, CNS
neurons

Function:
Opening of K channels, inhibition of
adenylyl cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the location and function of M3?

A

Location:
Exocrine glands, vessels, CNS neurons

Function: Increase intracellular calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the location and function of M4?

A

Location:
CNS neurons

Functions:
opening of potassium channels
Inhibition of adenyl cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the location and function of M5?

A

Location:
Vascular endothelium

Function:
Increased intracellular calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What effects does cholinergics have upon the eyes?

A

Miosis or contraction of the pupil for accomodation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the affect of a cholinergic on the heart?

A

Decrease HR and BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the affect of a cholinergic on respiratory?

A

Bronchial constrictions

Increased secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the affect of a cholinergic upon the GI?

A

Increased motility
Relax sphincters
Stimulates secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the affect of cholinergics on GU?

A

Relaxes sphincters

Bladder wall contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the affect of cholinergics on sweat glands?

A

Increase secretions such as tears, sweats, salivary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the two types of cholinergic drugs?

A

Direct Acting which directly act on ACH receptors

Indirect Acting which increases ACH through inhibition of acetylchoinesterase which allows more ACH to float around longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the two types of direct cholinergic agonist?

A

Esters and Alkaloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the ester form agonist?

A

Bethanechol
Carbechol
Methacholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the alkaloid form of agonist?

A

Pilocarpine

Muscarine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the indirect and reversible cholinergic agonist?

A 
Edrophonium
Neostigmine
Pyridostigmine
Physostigmine
Galantamine
Donepezil
Rivastigmine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the indirect and irreversible cholinergic agonist?

A

Malathion
Parathion
Sarin
Saron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

The reversible indirect agonist are lipid soluble

True or False

A

False

Water Soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The irreversible indirect agonist are water soluble

True or False

A

False

Lipid Soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the characteristics of the reversible cholinergic indirect agonist?

A

Alcohols and carbamates
Shorter duration of action
minutes to hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the characteristics of the irreversible cholinergic agonist?

A

Nerve gases and insecticides

Long duration of action due to covalent bonds between phosphorous enzyme complex

Some compounds last more than 100 hours

Cross BBB due to lipophilicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the reversible agents of indirect irreversible cholenergic?

A

Atropine which blocks ACH binding to the receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What cholinergic agents are used to treat open angle acute glaucoma?

A

Pilocarpine by causing contraction of the iris and ciliay muscle which leads to aqueous humor outflow and decreases intraocular pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What can be used in the place of pilocarpine if the cholinergic is not effective in treating glaucoma?

A

Carbachol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the effect of cholinergics on the cardiovascular system?

A

Reduces peripheral vascular resistance and slows HR

Cholinergic Agents are not usually used to treat heart problems due to adverse effects of decreased inotrophy, decreased chronotropy and decreased vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What affects do cholinergic have on respiratory?

A

contraction of the bronchial smooth muscle and stimulates secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What agent is used to help diagnose asthma?

A

Methacholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Cholinergics should be avoided when treating asthma

True or False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What affect does cholinergics have on GI?

A

Increased motility, secretion and relaxes sphincters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What cholinergic drugs treat postoperative ileus?

A

Neostigmine and bethanecol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What cholinergic drugs treat dry mouth?

A

Pilocarpine

Cevimeline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What cholinergic drugs treat genitourinary?

A

Neostigmine by releasing post operative bladder retention through bladder contraction

Bethanechol which relieves urinary retention and neurogenic bladder by making bladder lose its tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the medical condition myasthenia gravis?

A

Edrophonium is used as a diagnostic agent but not available in the US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the agent used to treat myasthenia gravis?

A

Pyridostigmine and neostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What cholinergic drugs are used in the reversal of NMB?

A

pyridostigmine and neostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Physostigmine

A

Inhibits the enzyme acetylcholinesterase and has a tertiary amine that allows it to cross the BBB in the unionized form.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the antidote to reverse toxic effects caused by pure anticholinergics?

A 
Atropine
Benztropine
Scopolamine
Atropa
Belladonna
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the adverse effects of physostigmine?

A

Seizures
Hallucinations
Arrythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What cholinergic agents treat alzheimer disease?

A

Donepezil
Galantamine
Rivastigmine

These drugs inhibit acetylcholinesterase which increases ACH in the CNS for synaptic transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is alzheimers disease?

A

Characterized by the cholinergic deficiency in the cortex and basal forebrain

63
Q

What are the adverse effects and toxicity of the cholinergics?

A 
Nausea
Vomit
Salivation
Sweat
Bronchial constrict
decreased cardiac output
decreased inotropy
decreased chronotrophy
Muscle Weakness
Urinary urgency
64
Q

Do not use cholinergics if you have

A 
COPD
Asthma
Urinary tract obstruction
Acid peptic disease
hypotension
hyperthyroid
65
Q

Why are organophosphate cholinesterase inhibitors dangerous?

A

They allow too much ACH to accumulate

66
Q

What is a valuble decontamination method when poisoned by insecticide or organophosphate?

A

2 PAM which is used to knock of the organophosphate off the cholinesterase inhibitor which allow the break down of ACH

67
Q

What are the main muscarinic cholinergic receptor antagonist?

A

atropine
ipratropium
glycopyrrolate

68
Q

What are the anticholinergic effects of the eyes?

A

Mydriasis or

Cyclopegia which is blurred vision from dilated pupil paralysis

69
Q

What are the anticholinergic effects upon the skin?

A

dry skin and reduced sweating

70
Q

What are the affects of anticholinergics on the GI?

A

less motility

less gastric emptying

71
Q

What is the anticholinergic effect upon the heart?

A

increased heart rate

72
Q

what is the anticholinergic effect upon the respiratory?

A

bronchial dilation and decreased secretion

73
Q

What is the anticholinergic effects upon the genitourinary?

A

urinary retention

74
Q

What is the anticholinergic effect on the CNS?

A

Drowsiness
Hallucinations
Coma

75
Q

What are the muscarinic anatagonist?

A 
Atropine
Ipratropium
Scopolamine
Benztropine
Cyclopentolate
Darifenacin
Dicycloamine
Festoterodine
Glycopyrrolate
Oxybutynin
Pirenzepine
Propantheline
Solifenancin
Tolterodine
Trihexyphenidyl
Tropicamide
Trospium
76
Q

Where does atropine come from?

A

Belladonna plant and it is a competitive antagonist at the muscarinic receptors

77
Q

What are the therapeutic uses of atropine?

A

To treat bradycardia by blocking cholinergics which reduce HR

Decrease salivation/ secretions
Dilate pupil in opthamology for exam
Treat muscarinic mushroom poison
Organophosphate poison

78
Q

What are the effects of atropine on the CNS?

A

Hallucination

Disorientation

Irritability

Restlessness

All of this at toxic dose because ACH is needed by the brain in a certain amount

79
Q

What receptor does atropine target within the heart?

A

It blocks the M2 receptors on the SA nodal pacemaker to antagonize the parasympathetic tone of the heart which can lead to tachycardia if atropine is at toxic level

80
Q

What is the effects of atropine on skin at toxic level?

A

Dry skin

Anihidrosis

81
Q

What effects does atropine have on the respiratory system?

A

promotes bronchodilation and decreases secretion

Inhibits bronchoconstriction caused by histamine , bradykinin

82
Q

What is the affect on the eye of atropine?

A

Cause unopposed sympathetic dilator activity and mydriasis by blocking the cholinergic responss on the pupillary sphincter muscle of the iris which leads to cycloplegia and photophobia

83
Q

What are the effects of atropine on GU?

A

Relaxes smooth muscle of the ureters and bladder wall to inhibit bladder contraction

84
Q

What are the effects of the atropine on GI?

A

Decreases motility by blocking the muscarinic receptors of the GI which cause a prolonged gastric emptying time and therefore vulnerabilty to ulcers

85
Q

Scopolamine

A

Prevention of motion sickness treatment

Treats postoperative vomit

86
Q

What is the MOA of scopolamine?

A

Blocks neural pathways from vestibular apparatus in the inner ear to the emetic center in the brainstem

87
Q

Why does scopolamine have a more significant effect on CNS than atropine?

A

It can pass BBB easily because of its lipophillic nature and therefore at toxic levels cause drowsiness, amnesia, fatigue and dreamless sleep

88
Q

Which anticholinergics treat overactive bladder?

A 
Oxybutynin
Trospium
Solifenancin
Darifenancin
Tolterodine
Festoerodine
89
Q

What is the MOA of anticholinergics used to treat overactive bladder?

A

Target M3 receptors in the bladder to relieve spasm

90
Q

Anticholinergics used to treat an overactive bladder has 1/5 the anticholinergic activity of atropine , but 4 to 10 times the antispasmodic activity

True or False

A

True

91
Q

What MOA does atropine use to treat bradycardia?

A

Block M2 receptors on the SA nodal pacemaker cells

92
Q

Which anticholinergics treat parkinson?

A

Benztropine and Trihexyphenidyl by antagonizing ACH

93
Q

What treats IBS?

A

Dicyclomine and Hyoscyamine by reducing the spasmotic effects on the smooth muscle GI tract

94
Q

What are the anticholinergics that treat drooling?

A

Glycopyrrolate and Atropine by inhibiting salivation and secretion as well as causing bronchodilation

95
Q

Ipratropium is a treatment for what medical condition?

A

COPD by blocking ACH in the bronchial smooth muscle to cause bronchodilation

96
Q

Xerostomia

A

Dry mouth

97
Q

What are the adverse effects of ipratropium?

A

xerostomia
cough
blurred vision

98
Q

What are the effects of anticholinergics on ophthalmology?

A

Mydriasis and cyclopegia

99
Q

What are the specific names of the anticholinergics used in opthamology exams?

A

Homatropine
Atropine
Tropicamide

100
Q

Anticholinergic adverse effects of eyes

A

increased angle closure pressure

101
Q

Anticholinergic adverse effects of the GI

A

slow motility which allows gastric ulcers

Peptic Ulcer disease

102
Q

Anticholinergic adverse effects of the GU

A

Prevents contraction

103
Q

Anticholinergic effects on Myasthenia Gravis

A

Worse symptoms

104
Q

Glycopyrrolate is used to treat which medical condition?

A

Duodenal ulcer

Sialorrhea

105
Q

Benzotropine is used to treat which medical condition?

A

Extrapyramidal symptoms and Parksonism

106
Q

Homatropine is used to treat which medical condition?

A

Opthamological examination

Myhidrasis and cycloplegia induction

107
Q

What is the clinical use of ipratropium?

A

Reduces or prevents bronchospasm

108
Q

What are the oxybutynin used for?

A

Reduces detrusor smooth muscle tone

109
Q

What is the clinical use of 2 PAM?

A

Regenerates active ACHE and can relieve skeletal muscle end plate block

110
Q

Histamine function

A

Neurotransmitter and Neuromodulator

Mediates allergic and inflammatory reaction with some role in anaphylatic reaction

Vasodilation
Release C reactive proteins

111
Q

Which cells release histamine?

A

Mast Cells

Basophils

112
Q

Where are the most abundant stores of histamine?

A

In mast cells of the nose, mouth, feet, blood vessels, internal body surfaces or places prone to injury

113
Q

Non mast cell histamine

A

Neuroendocrine control, cardiovascular regurgitation , thermal and body weight regulation, sleep and arousal

114
Q

Fundal Cells of the Stomach

A

Histamine release stimulates acid production

115
Q

When is histamine released ?

A

Allergic Type 1 hypersensitivity

116
Q

What are the four receptors that histamine binds to within the body?

A

H1 = smooth muscle, endothelium and brain

H2=Gastric Mucosa, cardiac muscle, mast cells and brain

H3=Presynaptic brain, Myenteric plexus

H4= Eosinophils, Neutrophils, CD4 t cells for immune response

117
Q

Which histamine receptor lowers BP?

A

H1

118
Q

Which histamine receptor reduces HR?

A

H2

119
Q

Which histamine receptor cause flushing?

A

H1

120
Q

Which histamine receptor gives a sense of warmth?

A

H1

121
Q

Which histamine receptor gives a headache?

A

H1

122
Q

Which histamine receptor causes edema?

A

H1

123
Q

What is the effect of histamine binding to H1 in the GI?

A

Contraction of intestinal smooth muscle

124
Q

Which histamine receptor stimulation results in acid secretion?

A

H2 causes secretion of acid from parietal cells

125
Q

What is the effect of H1 stimulation within the respiratory ?

A

Bronchoconstriction

126
Q

What affect does H1 stimulation have in CNS?

A

pain and itching

127
Q

What affect does histamine have on skin?

A

Wheal and flare

128
Q

What can happen GU from histamine?

A

Histamine induced contractions lead to abortion

129
Q

Which histamine receptor causes arousal in the circadian sleep/wake cyle?

A

H1

130
Q

What affects do Histamine have in CNS?

A

Memory and learning
Suppression of feeding
Body Temperature control

131
Q

What is the triple response?

A
  1. Red spot
  2. Flare Response
  3. Edema

All from an intradermal injection of histamine that causes a triple response

132
Q

What are the histamine antagonist?

A

Epi cause opposite effect on smooth muscle and anaphylaxis treatment.

The release inhibition of mast cells by Cromolyn and Nedocromil which stabilize mast cells

133
Q

What condition is a histamine anatgonist good to treat?

A

asthma

134
Q

What condition is a histamine antagonist good to treat?

A

asthma

135
Q

What are H1 antagonist?

A 
Allergy and cold medicine
Sleep aids
motion sickness
antientic
1st and 2nd generation H1 antagonist
136
Q

What are H2 antagonist?

A 
Pepti ulcer disease
GERD
Ulcer prophylaxis
Heartburn
Famotidine
Cimetidine
Rantidine
137
Q

H3 antagonism can help with what condition?

A

weight loss

138
Q

What are the effects of H4 antagonism?

A

Decrease pain and improve cognitive impairment

139
Q

What are the first generation antihistamines?

A

Diphenhydramine which is benadryl

Hydroxyzine 
Meclizine
Promethazine
Cyproheptadine
Bromopheniramine
Chlorpheniramine
140
Q

What are the second generation antihistamines?

A 
Fexofenadine
Loratadine
Cetrizine
Desloratadine
Levicetirizine
141
Q

What are the effects of first generation antihistamines?

A 
More sedation
More lipophillic
Well absorbed
Shorter acting 4-6 hours per dose
More side effects
Sedating
More Anti ACH effects
142
Q

What are effects of 2nd generation antihistamines?

A 
Much less sedation
Less lipophilic
Well absorbed
Longer Acting 12-24 hours
Less side effects
Little/no sedation
Much less anti ACH effects
143
Q

What does diphenhydramine treat?

A

anaphylaxis

allergic rhinitis, hay fever

144
Q

Hyroxyzine treats which condition?

A

Pruritus

145
Q

Why are second generation agents preferred to treat seasonal allergies?

A

Less drowsy
Antagonizes histamine effects on smooth muscle, blood vessels, immune cells
Also block muscarinic receptors

146
Q

Which drugs treat motion sickness and vestibular disturbances?

A

Diphenhydramine
Dimenhydrinate
Promethazine
Meclizine

147
Q

What are MOA of the antagonist that treat motion sickness?

A

Antimuscarinic effects by suppressing vestibular end organ receptors and inhibits activation of central cholinergic pathways.

148
Q

Which drug is used to treat nausea and vomiting in pregnant woman?

A

Doxylamine combined with B6

149
Q

What is a drug to treat generalized anxiety?

A

Hyroxyzine

150
Q

What are a drugs that are sleep aids?

A

Doxylamine

Diphenhyramine

151
Q

Cypropheptadine

A

Unique antihistamine because it has antiseronergic activity that is no longer used to treat allergies

152
Q

What are some antihistamine cough and cold products?

A

Chloropheniramine

Bromopheniramine

153
Q

What are the adverse anticholinergic affects and toxcity

A 
Sedation
Dry mouth
blurred vision
urine retention
GI upset
nausea

Excitation and convulsions in children
Postural hypotension

154
Q

Which two second generation antihistamines are isomers?

A

Loratadine and Desloratidine

Pathology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions