Podcast
Questions and Answers
What is the primary reason that kinetics are not used orally?
What is the primary reason that kinetics are not used orally?
Which of the following neuromuscular blocking agents is metabolized by a combination of spontaneous degradation in plasma and ester hydrolysis by plasma esterases?
Which of the following neuromuscular blocking agents is metabolized by a combination of spontaneous degradation in plasma and ester hydrolysis by plasma esterases?
What is the medical term for bedwetting?
What is the medical term for bedwetting?
What is the difference between fever and hyperthermia?
What is the difference between fever and hyperthermia?
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What is the main purpose of electroconvulsive therapy (ECT)?
What is the main purpose of electroconvulsive therapy (ECT)?
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What is the medical term for a temporary cessation of breathing during sleep?
What is the medical term for a temporary cessation of breathing during sleep?
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Which drug is primarily used for emergency lowering of intraocular pressure (IOP) in both open-angle and closed-angle glaucoma?
Which drug is primarily used for emergency lowering of intraocular pressure (IOP) in both open-angle and closed-angle glaucoma?
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What is the primary mechanism of action of pilocarpine when used for the treatment of glaucoma?
What is the primary mechanism of action of pilocarpine when used for the treatment of glaucoma?
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Which drug has both muscarinic and nicotinic actions, and can stimulate the release of epinephrine from the adrenal medulla?
Which drug has both muscarinic and nicotinic actions, and can stimulate the release of epinephrine from the adrenal medulla?
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Which drug is primarily used for the treatment of xerostomia (dry mouth) and Sjögren's syndrome?
Which drug is primarily used for the treatment of xerostomia (dry mouth) and Sjögren's syndrome?
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Which drug is considered a tertiary amine and is stable to hydrolysis by acetylcholinesterase?
Which drug is considered a tertiary amine and is stable to hydrolysis by acetylcholinesterase?
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Which drug is primarily used for the treatment of atonic bladder (postpartum and postoperative non-obstructive retention)?
Which drug is primarily used for the treatment of atonic bladder (postpartum and postoperative non-obstructive retention)?
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What is the primary therapeutic use of inhaled ipratropium?
What is the primary therapeutic use of inhaled ipratropium?
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How does inhaled ipratropium's positive charge affect its entry into the circulation and CNS?
How does inhaled ipratropium's positive charge affect its entry into the circulation and CNS?
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Which component of cigarette smoke, although available in various forms, has no therapeutic benefit and is detrimental to health?
Which component of cigarette smoke, although available in various forms, has no therapeutic benefit and is detrimental to health?
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What is the primary effect of nicotine on autonomic ganglia at high doses?
What is the primary effect of nicotine on autonomic ganglia at high doses?
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What type of vision problem results from refractive errors?
What type of vision problem results from refractive errors?
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What is delirium characterized by?
What is delirium characterized by?
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What is the primary mechanism of action of physostigmine?
What is the primary mechanism of action of physostigmine?
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Which of the following is NOT a therapeutic use of physostigmine?
Which of the following is NOT a therapeutic use of physostigmine?
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What is the duration of action of physostigmine?
What is the duration of action of physostigmine?
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Which of the following statements about physostigmine is correct?
Which of the following statements about physostigmine is correct?
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Which of the following side effects is NOT associated with physostigmine?
Which of the following side effects is NOT associated with physostigmine?
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How does physostigmine compare to pilocarpine in its effectiveness for treating glaucoma?
How does physostigmine compare to pilocarpine in its effectiveness for treating glaucoma?
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What is the primary mechanism of action of pralidoxime in treating organophosphate poisoning?
What is the primary mechanism of action of pralidoxime in treating organophosphate poisoning?
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What is the primary limitation of using pilocarpine for chronic treatment of open-angle glaucoma?
What is the primary limitation of using pilocarpine for chronic treatment of open-angle glaucoma?
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In the context of enzyme inhibition, what is the difference between competitive and non-competitive inhibitors?
In the context of enzyme inhibition, what is the difference between competitive and non-competitive inhibitors?
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What is the primary difference between cholinergic crisis and organophosphate poisoning?
What is the primary difference between cholinergic crisis and organophosphate poisoning?
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What is the primary mechanism behind accommodative esotropia?
What is the primary mechanism behind accommodative esotropia?
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What is the primary risk factor for cataract development, according to the text?
What is the primary risk factor for cataract development, according to the text?
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Study Notes
Cholinergic Agents
- Ipratropium: a quaternary derivative of atropine, used to treat asthma and chronic obstructive pulmonary disease, with a positive charge that prevents its entry into circulation and the CNS.
Anticholinergic Agents
- D-Tropicamide and Cyclopentolate: used as eye solutions to induce mydriasis and cycloplegia, with durations of 6 and 24 hours, respectively.
Ganglionic Blockers
- A-Nicotine: a component of cigarettes, with no therapeutic benefit, and deleterious to health; available as patches, lozenges, and gums, absorbed via skin, and reduces craving for nicotine in those who want to quit smoking.
Refractive Errors
- Refractive errors: a type of vision problem that makes it hard to see clearly, occurring when the shape of the eye keeps light from focusing correctly on the retina.
Delirium and Muscle Spasms
- Delirium: a serious change in mental abilities.
- Muscle spasms: sudden, involuntary movements in one or more muscles, also known as a charley horse, muscle cramp, or twitch.
Kinetics
- Quaternary compounds: not used orally due to minimal absorption and presence of quaternary amines in their structure, making them orally ineffective; most are excreted unchanged in urine.
Urinary Incontinence and Electroconvulsive Therapy
- Urinary incontinence (enuresis): the medical term for bedwetting.
- Electroconvulsive therapy (ECT): a treatment that involves sending an electric current through the brain.
Apnea and Fever
- Apnea: when someone stops breathing while asleep or has almost no airflow.
- Fever: occurs when endogenous or exogenous pyrogens cause an elevation in the body's thermoregulatory set-point.
Atracurium and Carbachol
- Atracurium: metabolized by a combination of spontaneous degradation in plasma and ester hydrolysis, used to treat atonic bladder postpartum and postoperative non-obstructive retention.
- Carbachol: has both muscarinic and nicotinic actions, causes miosis like acetylcholine, and releases epinephrine from the adrenal medulla by its nicotinic action.
Pilocarpine and Cevimeline
- Pilocarpine: a tertiary amine, stable to hydrolyze by acetylcholinesterase, used for eye application, causing rapid miosis and not able to focus (spasm of accommodation).
- Cevimeline: another non-specific cholinergic agent like pilocarpine.
Anticholinesterase (Reversible)
- Acetylcholinesterase enzyme: cleaves acetylcholine to acetate and choline, located in pre- and post-synaptic terminals.
- Inhibition of acetylcholinesterase: prolongs the lifetime of acetylcholine and accumulates in synaptic space, introducing a response at muscarinic and nicotinic receptors.
Physostigmine and Alzheimer's
- Physostigmine: an alkaloid and a tertiary amine, a substrate for acetylcholinesterase, and forms a relatively stable enzyme-substrate intermediate that reversibly inactivates acetylcholinesterase.
- Alzheimer's: treated with acetylcholinesterase inhibitors.
Reactivation of Acetylcholinesterase
- Pralidoxime: able to reactivate the enzyme if used at a time before aging of acetylcholinesterase, not crossing into the CNS, and acts by displacing a phosphate group from organophosphate and regenerating the enzyme.
Cholinergic Antagonists
- Competitive and non-competitive inhibitors: bind to the active site and prevent substrate binding, or bind to a different site, causing changes in the enzyme.
Cataracts and Accommodative Esotropia
- Cataracts: a cloudy area in the lens of the eye, common in older adults.
- Accommodative esotropia: an inward turning of one or both eyes that occurs with activation of the accommodative reflex.
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Description
Test your knowledge on the use of Carbachol to treat atonic bladder in postpartum and postoperative non-obstructive retention, including its side effects such as sweating, salivation, flushing, decreased blood pressure, nausea, abdominal pain, diarrhea, and bronchospasm. Learn about the pharmacological properties and effects of Carbachol.
