Prototype drugs exam 2

Question 1

Anticholinergic Agents/ Parasympatholytics

Answer 1

atropine

Question 2

Indications for atropine

Answer 2

Decrease secretions, bradycardia, pylorospasm, ureteral colic, relaxing of bladder, emotional lability with head injuries, antidote for cholinergic drugs, pupil dilation

Question 3

Actions of atropine

Answer 3

competitively blocks acetylcholine muscarinic receptor sites, blocking the effects of the parasympathetic nervous system.

Question 4

Pharmacokinetics of atropine

Answer 4

Route- IM
Onset-10-15min
peak- 30min
Duration 4h

Route- IV
Onset- stat
Peak- 2-4 min
Duration- 4h

Route- SQ
Onset- varies
Peak- 1-2h
Duration- 4h

Route- topical
Onset- 5-10 min
Peak- 30-40 min
Duration- 7-14 day

Question 5

Half-life of atropine

Answer 5

2.5 h, with metabolism in the liver and excretion in the urine

Question 6

Adverse effects of atropine

Answer 6

blurred vision, mydriasis, cycloplegia, photophobia, palpitations, bradycardia, dry mouth, altered taste perception, urinary hesitancy &retention, decreased sweating, predisposition to heat prostration, (Flushed, hot, dry, mad as the hatter)

Question 7

Direct-Acting cholinergic agonists

Answer 7

bethanechol (Duvoid, Urecholine)

Question 8

Indications for bethanechol

Answer 8

Treatment of nonobstructive postoperative and postpartum urinary retention, neurogenic bladder atony in adults and children >8y; diagnosis and treatment of reflux esophagitis in adults and used orally in infants and children for treatment of esophageal reflux.

Question 9

Action of bethanechol

Answer 9

Acts directly on cholinergic receptors to mimic the effects of Ach, increase tone of detrusor muscles and causes emptying of the bladder.

Question 10

Pharmacokinetics of bethanechol

Answer 10

Route - oral
onset- 30-90min
peak- 60-90 min
duration- 1-6 h

Question 11

half-life of bethanechol

Answer 11

metabolism and excretion unkonwn, though to be synaptic.

Question 12

adverse effects of bethanechol

Answer 12

abdominal discomfort, salivation, nausea, vomiting, sweating, flushing.

Question 13

Indirect-acting cholinergic agonists

Answer 13

pyridostigmine (Mestinon) & donezpezil (Aricept)

Question 14

Indications for pyridostigmine

Answer 14

managment of myasthenia gravis; antidote to neuromuscular junction blockers; increases survival after exposure to nerve gas.

Question 15

Indications for donepezil

Answer 15

management of Alzheimer’s dementia, including severe dementia.

Question 16

Actions of pyridostigmine

Answer 16

reversible cholinesterase inhibitor that increases the levels of Ach, facilitating transmission at the neuromuscular junction.

Question 17

Pharmacokinetics of pyridostigmine

Answer 17

Route oral IM IV
Onset 35-45min 15min 5min
Duration 3-6h 3-6 h 3-6 h

Question 18

Half-life of pyrdostigmine

Answer 18

1.9 to 3.7 hours, metabolized in the liver and tissue and excretion is in the urine.

Question 19

Adverse effects of pyrdostigmine

Answer 19

bradycardia, cardiac arrest, tearing, miosis, salivation, dysphagia, nausea, vomiting, increased bronchial secretions, urinary frequencty and incontinence.

Question 20

Actions of donepezil

Answer 20

reversible cholinesterase inhibitor that causes elevation ACh levels in the cortex, which slows the neuronal degradation of Alzheimer’s disease.

Question 21

Pharmacokinetics of donepezil

Answer 21

Route- oral
Onset- varies
Peak- 2-4 h

Question 22

Half-life of donepezil

Answer 22

70 hrs; metabolism is in the liver and excretion is in the urine.

Question 23

Adverse effects of donepezil

Answer 23

Insomnia, fatigue, rash, nausea, vomiting, diarrhea, dyspepsia, abdominal pain, muscle cramps.

Question 24

Known effects of pilocarpine

Answer 24

Increased secretions in the GI tract and relieve the symptoms of dry mouth that are in seen in Sjogren’s syndrome. Treats glaucoma.

Question 25

tacrine (Cognex)

Answer 25

a cholinergic drug used to treat Alzheimer’s disease that and was the first drug used to treat Alzheimer’s dementia.

Question 26

galatmine (Razadyne)

Answer 26

a cholinergic drug used to treat Alzheimer’s disease that use to stop the progression of Alzheimer’s dementia.

Question 27

rivastigmine (Exelon)

Answer 27

a cholinergic drug used to treat Alzheimer’s disease that is a available in liquid form for easy swallowing.

Question 28

donepezil (Aricept)

Answer 28

a cholinergic drug used to treat Alzheimer’s disease that has a once a day dosing with a half life of 70 h.