Cholinergic Pharmacology Quiz
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Questions and Answers

What is the primary mechanism by which cholinesterase inhibitors improve symptoms in myasthenia gravis?

  • They enhance NM receptor sensitivity to ACh.
  • They inhibit the breakdown of autoantibodies in the bloodstream.
  • They block autoantibodies from binding to NM receptors.
  • They increase the levels of ACh at the neuromuscular junction. (correct)

    • Which of the following is considered a first-line treatment for Alzheimer's disease?

  • Galantamine
  • Memantine
  • Rivastigmine (correct)
  • Donepezil

    • In the context of cholinergic antagonists, what is the primary clinical use of antimuscarinic drugs?

  • To treat myasthenia gravis symptoms.
  • To enhance muscle contraction.
  • To induce miosis during eye examinations.
  • To manage motion sickness. (correct)

    • Which cholinergic antagonist is known to cause mydriasis for eye examinations?

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

    What is a common symptom experienced by patients with myasthenia gravis due to impaired neuromuscular transmission?

    <p>Significant muscle weakness</p> Signup and view all the answers

    Which of the following pairs correctly identifies types of cholinergic antagonists?

    <p>Ganglionic blocker - Hexamethonium</p> Signup and view all the answers

    Which theory is proposed to explain the development of Alzheimer's disease?

    <p>Degeneration of cholinergic neurons and ACh deficiency.</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with cholinergic agonist effects?

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

    What is the primary action of Curare at the neuromuscular junction?

    <p>Competes with acetylcholine for binding sites</p> Signup and view all the answers

    Which of the following is a key difference between Succinylcholine and Acetylcholine?

    <p>Succinylcholine is not broken down by acetylcholinesterase</p> Signup and view all the answers

    What is one of the primary uses of neuromuscular blockers like Curare?

    <p>To provide muscle relaxation during surgical procedures</p> Signup and view all the answers

    Which of the following treatments utilizes Botox?

    <p>Reducing symptoms in chronic migraines</p> Signup and view all the answers

    What effect does persistent depolarization from Succinylcholine result in?

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

    Which enzyme is responsible for synthesizing acetylcholine from choline and acetyl-CoA?

    <p>Choline acetyltransferase</p> Signup and view all the answers

    What initiates the release of acetylcholine into the synaptic cleft?

    <p>Action potential causes depolarization and calcium influx</p> Signup and view all the answers

    Which receptors does acetylcholine bind to after its release into the synaptic cleft?

    <p>Muscarinic and nicotinic receptors</p> Signup and view all the answers

    How is acetylcholine metabolized in the synaptic cleft?

    <p>Conversion into choline and acetate by acetylcholinesterase</p> Signup and view all the answers

    Which component is NOT directly involved in the storage of acetylcholine within cholinergic neurons?

    <p>Choline acetyltransferase</p> Signup and view all the answers

    What differentiates the mechanisms of cholinergic neurotransmission from adrenergic neurotransmission?

    <p>Cholinergic neurotransmission does not undergo reuptake</p> Signup and view all the answers

    In which segment of the nervous system does the cholinergic system NOT play a role?

    <p>Somatic nervous system</p> Signup and view all the answers

    What is the effect of calcium influx in the process of acetylcholine release?

    <p>Initiates exocytosis of ACh vesicles</p> Signup and view all the answers

    Which of the following components is recycled after the breakdown of acetylcholine?

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

    Which drug blocks the uptake of choline into the nerve ending?

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

    What type of receptor are nicotinic receptors classified as?

    <p>Ligand-gated ion channels</p> Signup and view all the answers

    Which cholinergic agonist is completely selective for muscarinic cholinergic receptors?

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

    What is the primary action of acetylcholinesterase (AChE) inhibitors like neostigmine?

    <p>Increase the concentration of acetylcholine</p> Signup and view all the answers

    What is a notable characteristic of methacholine in comparison to acetylcholine?

    <p>3X more resistant to hydrolysis by AChE</p> Signup and view all the answers

    Which of the following drugs acts as a neuromuscular blocker?

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

    Which receptor type is primarily located at the neuromuscular junction?

    <p>Nm receptors</p> Signup and view all the answers

    What type of action do cholinergic antagonists typically have on the body?

    <p>Block cholinergic receptors</p> Signup and view all the answers

    Which drug acts as a reversible blocker of acetylcholine storage?

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

    In the context of cholinergic drugs, what do 'cholinomimetics' refer to?

    <p>Drugs that stimulate cholinergic receptors</p> Signup and view all the answers

    What is the primary action of antimuscarinic drugs like Atropine?

    <p>Inhibiting acetylcholine by occupying muscarinic receptors</p> Signup and view all the answers

    In which condition is Atropine NOT used as a treatment?

    <p>Hyperactive bladder</p> Signup and view all the answers

    What effect does atropine have on the eye?

    <p>Dilates the pupil</p> Signup and view all the answers

    Which of the following is an adverse effect of antimuscarinic drugs?

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

    Which drug is classified as a competitive neuromuscular blocker?

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

    Scopolamine is primarily used for what purpose?

    <p>Motion sickness prevention</p> Signup and view all the answers

    What is NOT a contraindication for the use of antimuscarinic agents?

    <p>Angina pectoris</p> Signup and view all the answers

    What is a primary therapeutic use of Ipratropium bromide?

    <p>Anticholinergic bronchodilator for asthma and COPD</p> Signup and view all the answers

    Which of the following is true regarding muscle spasm treatment with antimuscarinic drugs?

    <p>They relax smooth muscle of the gastrointestinal tract</p> Signup and view all the answers

    D-tubocurarine is best classified under which category of neuromuscular blocker?

    <p>Competitive blockers</p> Signup and view all the answers

    Study Notes

    Cholinergic Pharmacology

    • Cholinergic pathways are present in the NMJ, ANS, CNS, and non-neuronal cholinergic system (NNCS)
    • Acetylcholine (ACh) is the neurotransmitter in cholinergic pathways
    • ACh synthesis requires choline and acetyl-CoA
    • ACh is stored in synaptic vesicles and released via exocytosis
    • ACh effects are terminated by acetylcholinesterase (AChE)
    • AChE breaks down ACh into choline and acetate
    • Choline is re-uptaked for reuse in ACh synthesis

    Cholinergic Drugs

    • Cholinergic Agonists (Parasympathomimetics) mimic ACh effects
      • Direct Acting: Stimulate cholinergic receptors (e.g., Acetylcholine, Pilocarpine)
      • Indirect Acting: Inhibit acetylcholinesterase (e.g., Neostigmine)
    • Cholinergic Antagonists (Parasympatholytics) block ACh effects
      • Antimuscarinic: Block muscarinic receptors (e.g., Atropine)
      • Neuromuscular Blockers: Block nicotinic receptors at the NMJ (e.g., Succinylcholine)

    Cholinergic Receptors

    • Two main types:
      • Muscarinic Receptors (M1-M5): G-protein coupled receptors
      • Nicotinic Receptors (Nn and Nm): Ligand-gated ion channels
    • Muscarinic receptors are located in the ANS, smooth muscle, glands, and CNS
    • Nicotinic receptors are located in autonomic ganglia, CNS, and skeletal muscle at the NMJ

    Direct Cholinergic Agonists - Muscarinic Receptor Agonists

    • Methacholine: 3X more resistant to AChE hydrolysis than ACh, primarily acts on M2 receptors
    • Bethanechol: Highly selective for muscarinic receptors, resistant to AChE
      • Uses: Pre-anesthetic medication, asthma, gastrointestinal disorders, urinary urgency, antidote for cholinesterase inhibitor poisoning, muscle spasms

    Antimuscarinic Drugs (Muscarinic Antagonists)

    • Atropine: Derived from Atropa belladonna plant, blocks ACh at muscarinic receptors
      • Uses: Preoperative medication for decreased salivation, eye dilation, gastrointestinal antispasmodic, treatment of bradycardia, antidote for muscarinic agonist poisoning
    • Adverse Effects: Dry mouth, constipation, flushing, dry skin, mydriasis, blurred vision, palpitations, tachycardia, urinary retention
    • Contraindications: Glaucoma, myasthenia gravis, myocardial ischemia
    • Ipratropium bromide: Anticholinergic bronchodilator, blocks ACh at bronchial smooth muscle
    • Scopolamine: Available orally and topically, used for motion sickness

    Neuromuscular Blockers (NMB)

    • Used as muscle relaxants
    • Two classes:
      • Competitive Blockers (Nondepolarizing Agents): Curare, Atracurium
      • Depolarizing Blockers: Succinylcholine
    • Curare: Antagonist to ACh at nicotinic receptors, used as muscle relaxant in anesthesia
    • Succinylcholine: Stimulates nicotinic receptors, causing persistent depolarization and flaccid paralysis
      • Uses: Rapid endotracheal intubation, surgical muscle relaxation, mechanical ventilation, muscle spasms, electroconvulsive therapy, prevention of shivering, diagnostic procedures, intracranial pressure control

    Other Anticholinergic Drugs

    • Botulinum Toxin (Botox): Inhibits ACh release from presynaptic terminals, resulting in flaccid paralysis
      • Uses: Muscle spasms, chronic migraines, cosmetic treatment for facial lines

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    Cholinergic Pharmacology Lecture Notes PDF

    Description

    Test your knowledge on cholinergic pharmacology, including the pathways, drugs, and receptors involved in acetylcholine transmission. This quiz covers key aspects such as cholinergic agonists and antagonists, as well as the mechanisms of action in the nervous system.

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