D-204 Cholinergic agonists and antagonists part 2. (part 1 is in doc)
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Questions and Answers

What is the clinical indication for using anti-ChEs in patients with myasthenia gravis?

  • Treatment of Alzheimer's Disease
  • Atony of smooth muscle of GI and urinary bladder
  • Decrease metabolism of ester anesthetics
  • Reversal of paralysis induced by competitive neuromuscular blocking drugs (correct)

    • Which anti-AchE is used as a diagnostic tool for myasthenia gravis?

  • Physostigmine
  • Edrophonium (correct)
  • Carbaryl
  • Neostigmine

    • Which anti-AchE is composed of a carbamic acid and a phenol bearing a quaternary ammonium group?

  • Edrophonium
  • Carbaryl
  • Neostigmine (correct)
  • Physostigmine

    • Which anti-AchE is the only irreversible inhibitor used therapeutically for glaucoma?

    <p>Echothiophate</p> Signup and view all the answers

    Which anti-AchE is a plant alkaloid and a reversible anit-AchE?

    <p>Physostigmine</p> Signup and view all the answers

    Which anti-AchE has a short duration of action and is limited to the peripheral nervous system?

    <p>Edrophonium</p> Signup and view all the answers

    What is the common use of carbaryl?

    <p>Insecticide</p> Signup and view all the answers

    Which irreversible AchE inhibitors are used as insecticides?

    <p>Parathion and malathion</p> Signup and view all the answers

    Which anti-ChEs can be used in the treatment of Alzheimer's Disease?

    <p>Donepezil, Rivastigmine</p> Signup and view all the answers

    What is the purpose of administering pralidoxime before exposure to an organophosphate?

    <p>To prevent the aging response due to the organophosphate</p> Signup and view all the answers

    What is the recommended treatment for cholinergic crisis?

    <p>Discontinuing the AchE inhibitor</p> Signup and view all the answers

    Which type of drug is used in the treatment of Alzheimer's Disease?

    <p>Galantamine</p> Signup and view all the answers

    What is the purpose of atropine when given with pralidoxime?

    <p>To counteract the potential muscarinic effects of pralidoxime</p> Signup and view all the answers

    What is the purpose of edrophonium in the diagnosis of myasthenia gravis?

    <p>To see if someone has myasthenia gravis</p> Signup and view all the answers

    What is the main difference between direct-acting and indirect-acting cholinergic drugs?

    <p>Indirect-acting drugs activate muscarinic and/or nicotinic receptors</p> Signup and view all the answers

    What is the purpose of pyridostigmine in the treatment of myasthenia gravis?

    <p>To treat myasthenia gravis</p> Signup and view all the answers

    What is the result of myasthenia crisis?

    <p>Severe muscle weakness and possibly respiratory muscle paralysis</p> Signup and view all the answers

    What is the purpose of plasmapheresis in the treatment of myasthenia gravis?

    <p>To remove auto-antibodies</p> Signup and view all the answers

    What is the effect of pralidoxime on the blood-brain barrier?

    <p>It can't cross the blood-brain barrier</p> Signup and view all the answers

    Which medication is preferred for paralytic ileus and urinary bladder atony?

    <p>Neostigmine</p> Signup and view all the answers

    Which medication is the last line of defense for open-angle glaucoma?

    <p>Echothiophate</p> Signup and view all the answers

    What type of medications are used in the treatment of myasthenia gravis?

    <p>Glucocorticoids and immunosuppressive agents</p> Signup and view all the answers

    Which medications can be used to improve cognitive function in Alzheimer's Disease?

    <p>Donepezil, galantamine, and rivastigmine</p> Signup and view all the answers

    What condition should neostigmine not be used for?

    <p>All of the above</p> Signup and view all the answers

    Which type of cholinergic antagonist is used for eye exams and Parkinson's disease?

    <p>Muscarinic antagonists</p> Signup and view all the answers

    What is the clinical indication for using atropine?

    <p>Treatment of poisoning by organophosphate nerve agents</p> Signup and view all the answers

    What is the onset of action for atropine?

    <p>30 minutes to 1 hour</p> Signup and view all the answers

    Which type of cholinergic antagonist lacks receptor subtype selectivity?

    <p>Muscarinic antagonists</p> Signup and view all the answers

    What is the clinical indication for using muscarinic antagonists in the treatment of hypermotility of gastrointestinal tract?

    <p>Irritable bowel syndrome</p> Signup and view all the answers

    What is the purpose of atropine in the treatment of organophosphate poisoning?

    <p>To counteract the effects of anti-cholinesterase activity</p> Signup and view all the answers

    What is the primary use of scopolamine?

    <p>Treatment of motion sickness</p> Signup and view all the answers

    Why is scopolamine not used as eye drops?

    <p>It induces mydriasis with an extremely long recovery</p> Signup and view all the answers

    What is a potential use of scopolamine in chemotherapy?

    <p>Treatment of nausea and vomiting</p> Signup and view all the answers

    What are the adverse effects of scopolamine?

    <p>Drowsiness and sedation</p> Signup and view all the answers

    What is the primary effect of scopolamine on the body?

    <p>Induces mydriasis</p> Signup and view all the answers

    What is the pharmacokinetic property of scopolamine?

    <p>It crosses the BBB</p> Signup and view all the answers

    What is the clinical indication for using tropicamide?

    <p>To determine refractive index</p> Signup and view all the answers

    What are the side effects of tropicamide?

    <p>Mydriasis and cycloplegia</p> Signup and view all the answers

    What is the clinical indication for using benztropine?

    <p>To treat tardive dyskinesia</p> Signup and view all the answers

    What is the clinical indication for using oxybutynin and trospium?

    <p>To treat overactive bladder</p> Signup and view all the answers

    What is the primary use of scopolamine?

    <p>To prevent motion sickness</p> Signup and view all the answers

    What is the purpose of plasmapheresis in the treatment of myasthenia gravis?

    <p>To remove autoantibodies</p> Signup and view all the answers

    What is the pharmacodynamic effect of oxybutynin and trospium?

    <p>Antagonizes M1/M3 receptors (↓IP3 and DAG)</p> Signup and view all the answers

    What is the main adverse effect of darifenacin and solifenacin?

    <p>Dry mouth</p> Signup and view all the answers

    Which medication is used as an adjunct therapy to BPH if there is an increase in urinary frequency?

    <p>Darifenacin</p> Signup and view all the answers

    What is the pharmacokinetic advantage of trospium over other medications in its class?

    <p>Less CNS effect due to quaternary amine group</p> Signup and view all the answers

    What are the adverse effects of trospium?

    <p>Constipation, xerostomia, decreased perspiration</p> Signup and view all the answers

    What are the severe side effects of darifenacin and solifenacin?

    <p>Urinary retention, QT prolongation, hallucinations, and glaucoma</p> Signup and view all the answers

    What is the clinical indication for using darifenacin and solifenacin?

    <p>Overactive bladder with symptoms of urge urinary incontinence, urgency and frequency</p> Signup and view all the answers

    What are the adverse effects of glycopyrrolate?

    <p>Dry mouth, urinary retention, headaches, blurry vision</p> Signup and view all the answers

    What is the primary pharmacotherapeutic effect of ipratropium and tiotropium?

    <p>Reduce bronchospasm and bronchial secretions</p> Signup and view all the answers

    How is glycopyrrolate administered?

    <p>Inhalation, nebulizer, or intranasal</p> Signup and view all the answers

    What are the adverse effects of ipratropium and tiotropium?

    <p>Dry nose/mouth, cough, headache</p> Signup and view all the answers

    What is the potential risk associated with glycopyrrolate use?

    <p>Hyperthermia or heat stroke due to reduction in sweating</p> Signup and view all the answers

    What is the purpose of formulating glycopyrrolate with budesonide and formoterol?

    <p>Treatment of COPD</p> Signup and view all the answers

    What is the primary pharmacotherapeutic effect of ipratropium and tiotropium on postnasal drip?

    <p>Reduces postnasal drip</p> Signup and view all the answers

    Which drugs are selective for M2/M3 antagonists and used to treat overactive bladder?

    <p>Tolterodine and Fesoterodine</p> Signup and view all the answers

    What is the clinical indication for using glycopyrrolate topically?

    <p>To reduce excessive sweating</p> Signup and view all the answers

    What is the clinical indication for using dicyclomine?

    <p>To treat irritable bowel syndrome</p> Signup and view all the answers

    Which drug can be given topically, inhalational, or systemic (IV, IM) to reduce airway secretions, gastric secretions, and block inhibitory reflexes during the induction of anesthesia and intubation?

    <p>Glycopyrrolate</p> Signup and view all the answers

    What is the primary clinical indication for using an oral solution of glycopyrrolate in children and adolescents?

    <p>To help with excessive drooling</p> Signup and view all the answers

    Which drug is a pro-drug and broken down into the active metabolite tolterodine by plasma esterases, and also requires hydroxylation by CYP2D6?

    <p>Fesoterodine</p> Signup and view all the answers

    Which drug has partial antagonism of bradykinin and histamine, and can be utilized in reducing secretions such as salivary, sweating, bronchial, and gastric secretions?

    <p>Dicyclomine</p> Signup and view all the answers

    What is the clinical indication for using mecamylamine?

    <p>Treatment of essential hypertension</p> Signup and view all the answers

    What is the primary use of non-depolarizing neuromuscular blockers?

    <p>Muscle paralysis for surgical procedures</p> Signup and view all the answers

    What is the effect of nicotinic receptor antagonists on cardiovascular system?

    <p>Decrease in arteriolar and venous tone, decrease in blood pressure, tachycardia</p> Signup and view all the answers

    What is the effect of nicotinic receptor antagonists on the gastrointestinal tract?

    <p>Inhibits motility, constipation</p> Signup and view all the answers

    What is the primary use of depolarizing neuromuscular blockers?

    <p>Muscle paralysis for surgical procedures</p> Signup and view all the answers

    What is the effect of nicotinic receptor antagonists on the urinary tract?

    <p>Urinary retention</p> Signup and view all the answers

    What are the CNS effects of nicotinic receptor antagonists?

    <p>Sedation, tremor, choreiform movements, mental aberration</p> Signup and view all the answers

    Which of the following neuromuscular blockers is a depolarizing agent?

    <p>Succinylcholine</p> Signup and view all the answers

    What is the therapeutic use of spasmolytics?

    <p>Surgical relaxation</p> Signup and view all the answers

    Which receptor is targeted by dantrolene, a spasmolytic drug?

    <p>Ryanodine</p> Signup and view all the answers

    What is the potential adverse effect of neuromuscular blockers?

    <p>Respiratory paralysis</p> Signup and view all the answers

    What is the pharmacodynamic effect of botulinum toxin?

    <p>Inhibitor of Ach release</p> Signup and view all the answers

    What are the therapeutic uses of botulinum toxin?

    <p>All of the above</p> Signup and view all the answers

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