Sketchy Cholinergic Flashcards

1
Q

Acetyl-Cola Sign

A

ACh receptor agonist

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2
Q

Mime drinking cola

A

Cholinomimetrics

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3
Q

Smoker

A

Nicotinc ACh receptor

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4
Q

Outlet near smoker

A

Nicotinic ACh receptors found on motor end plate on skeletal muscle NMJ

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5
Q

Transformers

A

Nicotinic ACh receptors found on autonomic ganglia

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6
Q

Beanie

A

Nicotinic ACh receptors found on adrenal gland

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7
Q

Motorcycle parking spots

A

Muscarinic ACh receptor

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8
Q

Ion channel news behind smoker

A

Nicotinic receptors are Na channels

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9
Q

QIQ Mart

A

M1-Gq ; M2-Gi; M3-Gq

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10
Q

Dogs in M1/M3 motorcycles

A

Gq activates IP3-DAG cascade - increased Ca

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11
Q

Packed up tent in M2 motorcycle

A

Gi decreases cAMP

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12
Q

Brain Helmet on M1

A

M1 receptors found in nerves/CNS

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13
Q

Top of Heart with Jewels on M2

A

M2 receptors found in atria, SA node, AV node

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14
Q

Glandular Sponge

A

M3 receptors on glands

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15
Q

Smooth muscle stripes

A

M3 receptors on smooth muscle

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16
Q

NO exhaust pipe

A

M3 activation leads to NO release, increased cGMP and vasodilation; opposite in damaged endothelial

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17
Q

Beth Construction worker with Cola

A

Bethanechol - cholinomimetric

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18
Q

Cement from colon spout

A

muscarinic agonists increase secretion/motor activity of gut

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19
Q

Do not obstruct sign

A

Bethanechol is used to treat non-obstructive GI dysmotility (post-op ileus, neurogenic ileus)

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20
Q

Water hose

A

Bethanechol treates urinary retention

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21
Q

Pile o’carp

A

Pilocarpine - cholinomimetric

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22
Q

Dripping carp mouths

A

Pilocarpine increases salivation

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23
Q

Round glass above nets

A

muscarinic agonists cause accommodation of lens

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24
Q

Smooth muscle crane with net zonules

A

Pilocarpine contracts ciliary muscle to increase aqueous humor outflow and decrease intraocular pressure (glaucoma)

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25
Q

Fisherman with constricted hood

A

pilocarpine activates sphincter pupillae to cause pupillary constriction - miosis (acute glaucoma)

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26
Q

Resident above QIQ Mart

A

Carbachol

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27
Q

Constricted hood blocking carbon fumes

A

Carbachol causes pupillary constriction (narrow angle glaucome)

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28
Q

Carbon fumes

A

Carbachol is muscarinic and nicotinic agonist

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29
Q

Marathon

A

Methacholine - cholinomimetic

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30
Q

Challenge

A

Metacholine challenge instigates asthma for pulmonary testing

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31
Q

Wheezing Man

A

cholinomimetrics contract bronchial smooth muscle which exacerbates asthma/COPD

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32
Q

Acetyl-Cola Mime through smog

A

Indirect cholinomimetics inhibit AChE

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33
Q

Dumpster of acetyl-cola

A

AChE degrades ACh

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34
Q

Knocked over dumpster of acetyl-cola

A

AChE inhibitors increase concentration of ACh

35
Q

Anti-Establishment graffiti

A

Anticholinesterase (AChE inhibitor)

36
Q

Stigma graffiti

A

“stigmine” drug suffix of AChE inhibitors

37
Q

Skeletal muscle brick wall

A

AChE inhibitors enhance ACh effects at NMJ by increasing nicotinic ACh receptor activty

38
Q

Grave graffiti

A

myasthenia gravis - antibodies against nicotinic ACh receptors at motor endplate of skeletal muscle NMJ; patient presents with ptosis, diplopia, difficulty swallowing, proximal limb weakness (progressive)

39
Q

Community PRIDE worker removing graffiti

A

Pyridostigmine - AChE inhibitor used as long term treatment for MG by increasing ACh concentration at NMJ

40
Q

Neon sign Stigma

A

Neostigmine - AChE inhibitor used as treatment for MG

41
Q

Phone Booth

A

Edrophonium - AChE inhibitor that transiently reverses MG symptoms (short acting)

42
Q

Quarters only

A

Pyridostigmine, neostigmine, edrophonium are quaternary amines and do not penetrate CNS

43
Q

Working Phone

A

Edrophonium reverses muscle weakness in undertreated MG patients (Positive tensilon test)

44
Q

Out of order phone with anti-esterase graffiti

A

edrophonium fails to reverse muscle weakness and exacerbates cholinergic crisis

45
Q

CURARE crayons stuck in end plate

A

nondepolarizing neuromuscular blocking agents (tubocurarine) inhibit nicotinic ACh receptors at NMJ endplate

46
Q

Neon sign store owner kicking out CURARE crayon kid

A

AChE inhibitors reverse nondepolarizing neuromuscular blockade

47
Q

SUCKS graffiti

A

Succinylcholine is depolarizing neuromuscular blocking agent (nicotinic ACh receptor agonist)

48
Q

Phase-1 cleanup crew getting shocked

A

initial phase-1 of depolarizing blockade is IRREVERSIBLE (AChE inhibitors potentiate blockade)

49
Q

Bladder hose

A

AChE inhibitors used to treat urinary retention (muscarinic activation)

50
Q

PHYS ED center

A

PHYSostigmine (AChE inhibitor with Central effects)

51
Q

Atropine in Wonderland graffiti

A

Atropine overdose - reversed by Physostigmine

52
Q

Flower

A

belladonna flower in naturally occurring form of atropine - patient presents working in garden

53
Q

Phys Ed teacher reprimanding atropine artist

A

Physostigmine reverses atropine overdose (peripheral and central effects)

54
Q

Your brain on drugs

A

Physostigmine (and organophosphates) enter CNS to cause central cholinergic effects

55
Q

DUMBBELSS

A

Diarrhea, urination, miosis, bronchospasm, bradycardia, excitement of CNS, lacrimation, salivation, sweating

56
Q

Weak nicotine kid

A

AChE inhibitor toxicity includes flaccid paralysis (NMJ nicotinic ACh receptor over-activation)

57
Q

THIOL spray

A

insecticides are organophosphates - AChE inhibitor

58
Q

Closing LID on TOXIC spray

A

praLIDoxime - reverses organophosphate toxicity (DUMBBELSS)

59
Q

New toxic waste dumpsters

A

pralidoxime regenerates AChE at PERIPHERAL muscarinic and nicotinic receptors - reduces cholinergic toxicity including flaccid paralysis

60
Q

Atropine Alice is in your head

A

atropine reverses both peripheral/central muscarinic toxicity from organophosphate poisoning but not paralysis

61
Q

Old pest control man

A

“aging” of organophosphate cholinesterase complex leads to irreversible binding

62
Q

Corroded dumpster

A

pralidoxime is ineffective once aging of complex has occurred

63
Q

Done with brain puzzle

A

Donepezil - AChE inhibitor used to treat Alzheimer’s

64
Q

Motorcycle Parking spots

A

Muscarinic ACh receptors

65
Q

Reverse parking in spot

A

Muscarinic antagonists reversibly block muscarinic receptors

66
Q

Blocked tweedleDUMBBELSS

A

antimuscarinics block muscarinic effects of diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of CNS, lacrimation, salivation, sweat

67
Q

Blocked acetyl-Cola bottle

A

antimuscarinics block action of ACh at M receptors

68
Q

Alice

A

Atropine - antimuscarinic

69
Q

Large pupil gazing into distance

A

antimuscarinics cause pupillary dilation (mydriasis) and cycloplegia (inabillity to accommodate lens for near vision - ciliary muscle)

70
Q

Heart with jewel nodes

A

antimuscarinics block parasympathetic activation of M2 receptors on SA/AV nodes - increased HR, increased AV conduction

71
Q

Elevated heart watch

A

antimuscarinics increase HR - treatment of bradycardia

72
Q

Heart shield

A

heart block

73
Q

Falling heart shields

A

antimuscarinics increase AV conduction - useful in treatment of heart block

74
Q

Cat-ipra-tropillar

A

itrapropium - M3 muscarinic antagonist

75
Q

Puffing

A

itrapropium is an inhaled antimuscarinic bronchodilator

76
Q

Blue bloater with pink puffer

A

ipratropium is useful in management of COPD - antagonize M3 receptors causing bronchodilation and decreased secretions

77
Q

Turning off bladder

A

treat incontinence - antagonize M3 receptors which relax smooth muscle in ureters and bladder wall

78
Q

Parking Center sign over M1

A

M1 muscarinic receptors are found in CNS; M1 receptor antagonists can reduce tremors and rigidity in Parkinson’s disease

79
Q

Benz parked in M1

A

Benztropine - centrally acting M1 muscarinic antagonist

80
Q

Shaking antenna

A

centrally acting antimuscarinics (benztropine) treat tremor/rigidity in Parkinson’s by blocking excess cholinergic activity

81
Q

Hot as a hare

A

antimuscarinics inhibit M3 receptors on sweat glands decreasing sweat - hyperthermia

82
Q

Dry as a cracker

A

antimuscarinics decrease salivation and dry eyes

83
Q

Blind as a bat

A

antimuscarinics cause mydriasis and cycloplegia - blurred vision

84
Q

High pressure as a kettle

A

antimuscarinics cause mydriasis which decreases outflow of aqueous humor causing acute angle closure glaucoma