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NU 578: PHARM > Test #1: Ch. 14 > Flashcards

Test #1: Ch. 14 Flashcards

1
Q

cholinergic drugs block actions of _________

A

acetcholine

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2
Q

muscarinic agonists represented by

A

bethanechol

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3
Q

muscarinic antagonist represented by

A

atropine

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4
Q

ganglionic stimulating agent represented by

A

nicotine

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5
Q

ganglionic blocking agents are represented by

A

mecamylamine

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6
Q

neuromuscular blocking agents represented by

A

d-tubocurarine and succinylcholine

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7
Q

cholinesterase inhibitors represented by

A

neostigmine and physostigmine.

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8
Q

bethanechol (p116)

A

embodies the properties that typify all muscarinic agonists and will serve as our prototype for the group.

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9
Q

principle structures affected by muscarinic activation are (4)

A

1) heart
2) exocrine glands
3) smooth muscles
4) eyes

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10
Q

muscarinic agonist act on the heart to cause

A

bradycardia

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11
Q

muscarinic agonist act on the exocrine glands to

A

increase sweating, salivation, bronichial secretions, and secretion of gastric acid.

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12
Q

bethanechol is approved only for _________

A

urinary retention, by relaxing the trigone and sphincter muscles and increasing voiding pressure.

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13
Q

bethanechol has been used on an investigational basis to treat _________

A

gastroesophogeal reflux

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14
Q

why is bethanechol contraindicated for patients with low bp or low CO?

A

because it can cause hypotension (secondary to vasodilation) and bradycardia.

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15
Q

adverse effects of bethanechol

A

1) hypotension and bradycardia
2) excessive salivation and increased gastric acid
3) increase pressure within the urinary tract
4) exacerbation of asthma by bronchoconstriction
5) dysrhythmias in hyperthyroid pts (increasing HR–which is an opposite effect p117)

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16
Q

Cevimeline [Evoxac]

A

derivative of acetylcholine witha ctions much like those of bethanechol. Indicated for xerostomia (dry mouth).

17
Q

Pilocarpine

A

muscarinic agonist used mainly for topical therapy of glaucoma. Also used to treat dry mouth resulting from Sjogren’s syndrome

18
Q

What is the clinical use of Acetylcholine?

A

used to produce rapid miosis (pupil constriction) following lens delivery in cataract sx.

19
Q

What is found in certain poisonous mushrooms?

A

Muscarine

20
Q

What is a selective muscarinic blocking agent?

A

atropine

21
Q

best-known muscarinic antagonist

A

atropine

22
Q

atropine _____ the heart

A

increases

23
Q

atropine ______ secretion from salivary glands, bronchial glands, sweat glands and the acid secreting cells of the stomach.

A

decrease

24
Q

atropine causes ______ of the bronchi

A

relaxation

25
Q

atropine causes blockade of muscarinic receptors on the iris spincter causing __________

A

mydriasis (dilation of the pupil)

26
Q

at therapeutic doses, atropine can cause mild central nervous system _________

A

excitation

27
Q

at toxic doses, atropine can cause __________ & ________

A

hallucinations and delirium.

28
Q

Adverse effects of atropine

A

1) xerostomia (dry mouth)
2) blurred vision & photophobia
3) elevation of intraocular pressure
4) urinary retention
5) constipation
6) anhidrosis (absence of sweat)
7) tachycardia
8) asthma

29
Q

two drugs mostly used for overactive bladder (OAB)

A

oxybutynin & tolterodine. these drugs block muscarinic receptors elsewhere and cause the typical anticholinergic SE.

30
Q

anticholinergic agent that acts primarily at M3 muscarinic receptors. approved only for OAB.

A

oxybutynin [ditropan XL, gelnique, oxytrol]

31
Q

anticholinergic agent used for OAB, and displays the greatest degree of M3 selectivitiy. Has no affect on M1 (brain) or M2 (heart).

A

darifenancin [Embalex]

32
Q

anticholinergic agent used for OAB and very similar to darifenancin but not as M3 selective.

A

solifenacin [VESIcare]

33
Q

nonselective muscarinic antagonist approved only for OAB. Available in short and long acting formulations. Can produce serious cardiac dysrhythmias.

A

tolterodine [detrol, detrol LA]

34
Q

nonselective muscarinic antagonist similar to tolterodine. both agents are used only for OAB. has not been associated with QT prolongation and does not pose a risk for dysrhythmias.

A

fesoterodine [toviaz]

35
Q

anticholinergic drug with actions much like those of atropine, with two exceptions… 1. causes CNS sedation and 2. suppresses emesis

A

Scopolamine

36
Q

anticholinergic drug used to treat asthma, COPD, and rhinitis caused by allergies and common cold.

A

Ipratropium Bromide [atrovent]

37
Q

this drug is indicated for irritable bowel syndrome by IM injection

A

Dicyclomine [Bentyl]

38
Q

centrally acting anticholinergics used to treat Parkinson’s disease and drug-induced Parkinsonism.

A

Cogentin and trihexyphenidyl.

39
Q

what is the best antidote for muscarinic antagonist poisoning?

A

physostigmine, a cholinesterase inhibitor

NU 578: PHARM (6 decks)

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