Primer 7

Question 1

7 Primary symptoms of parasympathetic/ ach inhibition

Answer 1

HOT as a hare–> anhydrosis
RED as a beet–> flushing
BLIND as a bat–> STOP cycloplegia + mydriasis
DRY as a bone–> STOP salivation
MAD as a hatter–> CNS disturbance (low central Ach)
BLOATED as a toad–> constipation + urinary retention
FAST and Furious–> Tachy

Question 2

Anticholinergics used to treat urinary incontinence:

Answer 2

"On The Darn Toilet, Son!" 
Oxybutynin 
Tolterodine 
Darnifenacin (+ Solifenacin) 
Trospium

Question 3

5 patient populations for which atropine is CI:

Answer 3

1: Acute angle glaucoma

2. BPH
3. Hyperthermia
4. Elderly (delirium, watch for diphenhydramine too!)
5. GI obstrxn/ ilius

Question 4

4 meds with anticholinergic effects that are not “anticholinergics”

Answer 4

1. First gen H1 blockers (diphenhydramine ,doxylamine)
   * DELERIUM IN ELDERLY!*
2. Neuroleptics (first gen antipsychotics)
3. TCAs
4. Amantadine

Question 5

Current clinical indications for atropine use (2)

MOA

Answer 5

Antimuscarinic

1. Bradycardia
2. Organophosphate poisoning (w/ Pralidoxime)
   * also ^ pupil dilation, enuresis

Question 6

3 antimuscarinics used for pupil dilation

Answer 6

1. Homatropine
2. Cyclopentomide
3. Tropicamide

Question 7

Antimuscarinic used to treat parkinsons?

Answer 7

Benztropine

Question 8

Antimuscarinic used to treat motion sickness and reduce secretions in ventilated patients?

Answer 8

Scopolamine

Question 9

Antimuscarinics used to treat COPD and Asthma (^FEV1)

Answer 9

Ipratropium, Tiotropium

Question 10

Some high yield AchEi’s (5)

Answer 10

1. Physostigmine
2. Neostigmine
3. Erdrophonium
4. Rivastigmine
5. Pyridostigmine
6. Donepizil

Question 11

Direct Muscarinic Agonists (3)

Answer 11

1. Pilocarpine
2. Carbachol
3. Bethanechol

Question 12

Cholinesterase regenerator?

Answer 12

Pralidoxime