Pharmacology Unit 3

Question 1

Cholinergic Receptors are part of what system? What are they divided into?

Answer 1

Sympathetic (preganglionic) and parasympathetic system

Can be subdivided into:
- Muscarinic: Generally peripheral, post-ganglionic parasym., some CNS
- Nicotinic: Autonomic ganglia and neuromuscular junction

Question 2

What is the role of Cholinergic Stimulants?

Answer 2

Increase the activity at Ach synapse

Question 3

What are Direct Binding Cholinergic Stimulants?

Answer 3

• These bind directly to cholinergic receptors
  (prototypes= Bethanechol, Pilocarpine)

Question 4

What are Indirect acting Cholinergic Stimulants?

Answer 4

• These increase synaptic inactivity by inhibiting the acetylcholinesterase enzyme located in cholinergic synapses
• Cholinergic synapse
• Less specificity than direct acting - Neostigmine

Question 5

What are the Drug Effects of Cholinergic Agents?
Think SLUDGE

Answer 5

Salivation
Lacrimation
Urination
Diarrhea
GI Cramps
Emesis

Question 6

What is the Purpose of Cholinergic Drugs?

Answer 6

To stimulate the parasympathetic system to manage: Glaucoma, Dementia, Alzheimer’s, Myasthenia Gravis, Bladder Atony

Question 7

Why do Cholinergic Drugs have few therapeutic uses? What are their Side affects?

Answer 7

Cholinergic have fewer therapeutic uses because of their numerous side effects
- Primarily because of their potential to adversely slow heart rate and constrict the respiratory passages

Side Affects:
- Bradycardia
- SOB
- Dyspnea
- Wheezing (bronchoconstriction)

Question 8

What are Anticholinergics?

Answer 8

These decrease stimulations of the of the parasympathetic system to manage peptic ulcer, IBS, neurogenic/overactive bladder, motion sickness, PD, hyperhidrosis, COPD
- This causes symptoms of “fight or flight”

Inhibit cholinergic activity by acting as competitive agonist, they bind to cholinergic receptor but dont activate it

Question 9

What are Major Side Effects of Anticholinergic Drugs?

Answer 9

Tachycardia, Confusion, Dizziness

Question 10

What are Anticholinergic (Blocker) Reactions?

Answer 10

• Hot as hell- Decreased sweat
• Blind as bat- blurred vision
• Dry as bone- Dry mouth
• Red as a beet- direct vasodilation
• Mad as a hatter- CNS, delirium

Question 11

What are the Indications of Adrenergic Drugs?

Answer 11

To stimulate the sympathetic nervous system to manage: Asthma, Cardiac Arrest, Hypotension, Anaphylaxis, Nasal Congestion

Question 12

What are the 2 Adrenergic Agonist?

Answer 12

Alpha 1 Selective Agonist
- Located primarily on vascular smooth muscle and lead to smooth muscle contraction and vasoconstriction

Alpha 2 Selective Agonist
- Stimulate Alpha 2 receptors in the brain and brainstem inhibiting sympathetic discharge thus reducing BP
- Stimulate interneurons in spinal cord causing interneuron inhibition and decrease excitability of motor neurons supplied by interneurons

Question 13

What are the Major Side Effects of Adrenergic Drugs?

Answer 13

• Tachycardia, Hypertension, Arrhythmias

Question 14

What are Adrenergic Antagonist (Blocking Agents)?

Answer 14

These bind to adrenergic receptors, but inhibit or block stimulation of the SNS to manage: Hypertension, Anxiety, Benign Prostatic Hyperplasia (BPH), Cardiac Arrhythmias

Question 15

What are the Major Side Effects of Adrenergic-Blocking Agents (Antiadrenergic drugs)?

Answer 15

Hypotension, Bradycardia, Drowsiness, Fatigue