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Questions and Answers
What is the duration of action for Edrophonium?
Which drug is used for off-label use in acute colonic pseudoobstruction?
Which drug is indicated for the specific antidote for poisoning with belladonna or other anticholinergics?
Which drug is used for dementia of all types, from mild to moderate Alzheimer disease and in some cases of Parkinson's disease?
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What is the duration of action for Parathion?
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What is the main use of cholinergic agonists topically in the eye?
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What is the specific duration of action for Rivastigmine?
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What is the specific duration of action for Pyridostigmine?
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What is the specific duration of action for Physostigmine?
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What should healthcare workers, including pharmacists and nurses, be aware of regarding cholinergic medications?
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What is the main use of cholinergic agonists systemically?
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What is the main use of cholinesterase inhibitors like Donepezil, Galantamine, and Rivastigmine?
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Which direct-acting cholinergic agonist is resistant to cholinesterase, orally active, and has a duration of action of 30 minutes to 2 hours?
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Which direct-acting cholinergic agonist is an alkaloid, not an ester, and has a duration of action of 30 minutes to 2 hours?
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Which direct-acting cholinergic agonist is a partial agonist at N receptors, has high lipid solubility, and a duration of 12–24 hours?
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Which direct-acting cholinergic agonist is off-label used to counter the effects of cycloplegics?
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Which direct-acting cholinergic agonist is used to increase the aqueous outflow and decrease intraocular tension in open-angle glaucoma?
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Which direct-acting cholinergic agonist is resistant to cholinesterase, orally active, and used for ↑ the aqueous outflow and ↓ the intraocular tension in open-angle glaucoma?
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Which direct-acting cholinergic agonist is not an ester, has good lipid solubility, and a duration of action of 30 minutes to 2 hours?
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Which direct-acting cholinergic agonist has a duration of action of 1–6 hours and high lipid solubility?
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Which direct-acting cholinergic agonist is indicated for xerostomia?
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Which indirect-acting cholinergic agent increases the availability of acetylcholine at the cholinergic receptors?
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Study Notes
Duration of Action
- Edrophonium has a short duration of action.
- Rivastigmine has a specific duration of action of 10 hours.
- Pyridostigmine has a specific duration of action of 3–6 hours.
- Physostigmine has a specific duration of action of 2–4 hours.
- Parathion has a prolonged duration of action.
Drug Uses
- Neostigmine is used off-label for acute colonic pseudoobstruction.
- Physostigmine is indicated as the specific antidote for poisoning with belladonna or other anticholinergics.
- Cholinergic agonists are used topically in the eye primarily for inducing miosis and treating glaucoma.
- Cholinergic agonists systemically are mainly used to stimulate gastrointestinal motility and treat myasthenia gravis.
- Cholinesterase inhibitors like Donepezil, Galantamine, and Rivastigmine are primarily used to manage symptoms of Alzheimer's disease.
Cholinergic Agonists
- Carbachol is a direct-acting cholinergic agonist that is resistant to cholinesterase, orally active, and has a duration of action of 30 minutes to 2 hours.
- Pilocarpine is an alkaloid, not an ester, also with a duration of action of 30 minutes to 2 hours, used for xerostomia and glaucoma.
- Atropine is a direct-acting cholinergic agonist that is a partial agonist at N receptors, has high lipid solubility, and a duration of 12–24 hours.
- Physostigmine is off-label used to counter the effects of cycloplegics.
- Latanoprost is a direct-acting cholinergic agonist used to increase aqueous outflow and decrease intraocular tension in open-angle glaucoma.
- Carbachol or pilocarpine can also be used to enhance aqueous outflow in glaucoma treatment.
- Arecoline is not an ester, has good lipid solubility, and a duration of action of 30 minutes to 2 hours.
- Succinylcholine is indicated for xerostomia management.
Important Considerations
- Healthcare workers should be aware of the broader side effects of cholinergic medications, including possible cholinergic crises, and the need for careful monitoring in patients.
- Indirect-acting cholinergic agents enhance the availability of acetylcholine at the receptors, further aiding in therapeutic effects.
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Description
Test your knowledge of direct-acting cholinergic agonists with this quiz. Explore the pharmacokinetics, indications, and properties of choline esters such as carbachol and bethanechol. Delve into their duration of action, lipid solubility, and resistance to cholinesterase, and understand their impact on intraocular tension.
