Spring 2020 - Pharm exam 2 Flashcards
Two major classes of cholinergic drugs are: (2)
- Cholinergic agonists
- Anticholinesterase drugs
Which of the following medications would the SRNA hold during an induction of a patient with a major burn 4 days prior:
Succinylcholine
After acetylcholine stimulates the ____ receptor, it is destroyed by ______.
Cholinergic
Acetylcholinesterase
which of the following symptoms would the SRNA not expect from a cholinergic agonist drug:
Mydraisis
Direct effects: miosis, decreased HR, bronchoconstriction, increased secretions, etc
Cholinergic agonists are used in the following conditions: (2)
- urinary retention due to weak or atonic bladder
- lack of bowel movement
An example of an irreversible long-lasting anticholinesterase would be:
Insecticide or Nerve gas
Pharmacokinetics of cholinergic drugs include:
Crossing BBB
Crossing the BBB is an element of pharmacokinetics in :
cholinergic drugs
cholinergic blocking agents have all the following adverse reactions except which two: (choose 2)
- bradycardia
- increased sweating
Adverse reactions to cholinergic blocking agents include:
“blind as a bat, red as a beet, mad as a hatter, hot as a hare, dry as a bone”
Dry mouth decreased sweating reduced secretions blurred vision d/t mydriasis confusion tachycardia increased temp
Considering the dose-dependent effects of atropine, which is true:
a. slight cardiac slowing at 5mg
b. hallucinations at 8mg
c. Coma > 10mg
d. pupil constriction at 5 mg
C. Coma > 10mg of atropine
atropine speeds up the heart rate by:
blocking acetylcholine
what would be used to treat organophosphate poisoning, and treat disorders of the GI and lower urinary tract?
Atropine
anticholinergic drugs competitively antagonize
acetylcholine at the cholinergic post ganglionic sites
muscarinic receptors are located in:
GU tract
GI smooth muscle
Heart
Muscarinic receptors are not located in
spinal tract
What drug is more potent than its parent compound, has no CNS effects secondary to poor brain penetration?
glycopyrrolate
Does Atropine cross the placenta?
yes
Does atropine affect the fetal heart rate?
Little fetal heart change
This drug crosses the placenta with little fetal heart change:
atropine
which drug would be the best choice when sedation and an antisialagogue is needed?
scopolamine
What drug, when given in the same dose as atropine produces a similar increase in HR, but with a slower onset?
Glycopyrrolate
Is an increase in extrapyramidal side effects a disadvantage of using anticholinergics in patients with Parkinson’s Disease?
No.
Name a few disadvantages of using anticholinergics in pts with Parkinson’s Disease:
- aggravation of glaucoma
- Hallucinations
- Visual blurring
Treatment of Central Anticholinergic Syndrome :
Physostigmine
Glycopyrrolate is not likely to cause Central Anticholinergic Syndrome because:
It does not cross the BBB
What are synthesized in the liver and catalyzes the hydrolysis of succinylcholine:
- butyrylcholinesterase
- plasma cholinesterase
- pseudocholinesterase
Which of the following drugs would be considered a benzyl lisoquinolinium?
- pancuronium
- cisatricurium
- rocuronium
- vecuronium
-Cisatricurium
List (Greatest to least) the inhalation anesthetics that potentiate the NMB effect of NMB drugs:
Des>Sevo>Halothane> Nitrous
“DSHN”
Will Hyperthermia potentiate the blockade of a NMB drug?
no
What will potentiate the blockage of NMB drugs?
- LAs in large doses
- Magnesium
- some antidysrhythmics
What is most likely to DECREASE the potency of NMB agents?
- hypercalecemia
- hyperparathyroidism
Regarding NMB Drugs:
High potency =
slow onset
Regarding NMB Drugs:
Low potency =
rapid onset
buffered diffusion can be seen in
High potency drugs
What NMB drugs are typically not associated with histamine release:
Cisatricurium
Rocuronium
Common dose of Succinylcholine:
1-1.5mg/kg
Max dose of Neostigmine:
5mg
Dose for glycopyrrolate:
7-15mcg/kg
Sugammadex reversal from greatest to least:
Roc > Vec»_space; Pancuronium
Sugammadex is based on:
actual body weight
Substantia Gelatinosa is located in Lamina:
II and III
What opioid receptor is associated with respiratory depression due to decrease sensitivity of respiratory center to CO2?
Mu-2
What is a depolarizing skeletal muscle relaxant?
succinylcholine
Induction dose of ketamine would be:
1-2 mg/kg
Indirect stimulation of alpha and beta adrenergic receptors and direct stimulation of adrenergic receptors and stimulation of release of endogenous norepinephrine by indirect action best describes:
Ephedrine
Naloxone dose:
1-4mcg/kg
Intubating dose of vecuronium:
0.1 mg/kg
