Test #1: Ch. 15 Flashcards
What are the drugs that prevent the degradation of acetylcholine by acetylcholinesterase?
Cholinesterase inhibitors
Two basic categories of cholinesterase inhibitors:
1) reversible inhibitors
2) irreversible inhibitors
principle indication for Neostigmine [Bloxiverz, Prostigmin]
myasthenia gravis. it reverses the actions of nondepolarizing neuromuscular blockade following surgery.
What is myasthenia gravis?
it is a major indication for neostigmine and several other reversible cholinesterase inhibitors.
Physostigime
identical to that of neostigmine–except that this physostigime readily crosses membranes, whereas neostigmine does not. It also does not carry a charge.
What is the drug of choice for poisoning by atropine and other drugs that cause muscarinic blockade?
Physostigmine
What is Edrophonium [Enlon] & pyridostigmine [Mestinon] used for?
Myasthenia gravis
Drugs for alzheimer’s disease? (3)
1) Donepezil [Aricept]
2) Galantamin [Razadyne]
3) Rivastigmine [Exelon]
The irreversible cholinesterase inhibitors have only one indication:
glaucoma
only this drug is available for the treatment of glaucoma.
echothiophate
toxic doses of irreversible cholinesterase inhibitors produce
cholinergic crisis, a condition characterized by excessive muscarinic stimulation and depolarizing neuromuscular blockade.
What is Pralidoxime?
specific antidote to poisoning by the irreversible cholinesterase inhibitors; the drug is NOT effective against poisoning by reversible cholinesterase inhibitors.
What is myasthenic crisis
a state characterized by extreme muscle weakness caused by insufficient acetylcholine at the NMJ. Left untreated, MC can result in death from paralysis of the mm of respiration.
What is cholinergic crisis
overdose with a cholinesterase inhibitor can produce this. characterized by extreme mm weakness or frank paralysis. abls w signs of excessive muscarinic stimulation.
How can you tell the difference in Myasthenic crisis and Cholinergic crisis?
providers may elect o administer a challenging dose of edrophonium, an ultrashort-acting cholinesterase inhibitor. If this alleviates symptoms it is a myasthenic crisis.
