Dr. Asmaa Fady's Academic Background Quiz

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Questions and Answers

What is the highest degree obtained by Dr. Asmaa Fady?

JMHPE

MBBCh

MSc.

PhD. (correct)

Which of the following degrees does Dr. Asmaa Fady NOT hold?

JMHPE

MSc.

MBA (correct)

MBBCh

In which field is Dr. Asmaa Fady's PhD likely to be awarded?

Social Work

Medical Education (correct)

Public Health

Business Administration

What is the role of Dr. Asmaa Fady based on the information provided?

Medical Educator Signup and view all the answers

Which college is associated with Dr. Asmaa Fady?

College of Medicine Signup and view all the answers

Which drug is primarily used for treating glaucoma?

Physostigmine Signup and view all the answers

What is the primary adverse effect associated with carbamate esters?

GI distress Signup and view all the answers

Which drug is indicated for treating myasthenia gravis and has a half-life of 3-6 hours?

Pyridostigmine Signup and view all the answers

Which drug is effective for curare toxicity?

Neostigmine Signup and view all the answers

Which statement is true regarding the action of these carbamate esters?

Their action is primarily central nervous system based. Signup and view all the answers

Which drug has a longer half-life of 4-8 hours among the options?

Ambenonium Signup and view all the answers

What class of action does physostigmine exhibit?

Cholinergic agonist Signup and view all the answers

What is the effect of cholinergic neuron deficiency in Alzheimer’s disease?

Cognitive decline Signup and view all the answers

What types of actions do all anticholinesterases exhibit?

Muscarinic and nicotinic actions Signup and view all the answers

Which characteristic is true for some anticholinesterases?

Have CNS effects if lipid soluble Signup and view all the answers

Which type of drug effects are attributed to lipid-soluble anticholinesterases?

CNS effects Signup and view all the answers

What is one of the main properties of anticholinesterases?

Possess both muscarinic and nicotinic actions Signup and view all the answers

Which of the following statements about anticholinesterases is incorrect?

They exclusively act on the central nervous system. Signup and view all the answers

Which of the following best describes the actions of anticholinesterases?

They participate in both muscarinic and nicotinic signaling. Signup and view all the answers

Which of the following is NOT a CNS manifestation?

Fatigue Signup and view all the answers

Which CNS manifestation is characterized by an involuntary shaking movement?

Tremor Signup and view all the answers

Which of these symptoms involves a loss of awareness and responsiveness?

Convulsion Signup and view all the answers

Which symptom indicates a state of extreme mental confusion and disorientation?

Confusion Signup and view all the answers

Which of the following symptoms is characterized by an extreme state of worry or fear?

Anxiety Signup and view all the answers

Which CNS manifestation can result from various neurological conditions, presenting as a severe headache?

Headache Signup and view all the answers

Which of the following symptoms can lead to a deep state of unresponsiveness?

Coma Signup and view all the answers

Study Notes

Indirect Cholinergic Drugs

Cholinergic drugs mimic or enhance the effects of acetylcholine (ACh), a neurotransmitter.
Indirect cholinergic drugs, also called anticholinesterases, work by inhibiting the enzyme acetylcholinesterase, preventing the breakdown of ACh. This results in increased ACh concentrations and subsequent stimulation of cholinergic receptors.
Anticholinesterases have various actions, including muscarinic and nicotinic actions, as well as potential effects in the central nervous system (CNS).

Learning Objectives

Students should be able to classify indirect-acting cholinomimetics.
Describe the mechanism of action, kinetics, dynamics, and applications of anticholinesterases.
Identify the main side effects and contraindications of anticholinesterases.
Describe organophosphate toxicity's symptoms and treatment.
Identify the key side effects of direct cholinomimetics.

Classification

Cholinergic agonists are categorized into direct-acting and indirect-acting.
Direct-acting agonists directly stimulate cholinergic receptors.
Indirect-acting agonists work by inhibiting acetylcholinesterase.
Anticholinesterases are further classified as reversible or irreversible.

Indirect Cholinergic Drugs (Anticholinesterases)

Anticholinesterases structurally resemble ACh.
They bind to cholinesterase instead of ACh.
Mechanism of Action: Anticholinesterases stop ACh hydrolysis by the cholinesterase inhibiting the enzyme, thus resulting in increased ACh concentrations and actions on cholinergic receptors.
Anticholinesterase effects occur at muscarinic and nicotinic receptors, and in the neuro muscular junction and CNS.

Anticholinesterases: Reversible Agents

Short-Acting: Alcohol, Edrophonium
Intermediate-Acting: Carbamate esters (Physostigmine, Neostigmine, Pyridostigmine, Ambenonium)

Anticholinesterases: Irreversible Agents

Very Long-Acting: Phosphate esters (Isoflurophate, Ecothiophate)

Pharmacological Actions of Indirect Cholinergic Drugs

All anticholinesterases have muscarinic and nicotinic effects.
Some anticholinesterases can affect the CNS, but only those that are lipid-soluble.

Muscarinic Actions

Eye: Miosis, contraction of ciliary muscles
Heart: Bradycardia, NO release, vasodilation
Lung: Bronchial constriction, increased secretions
Gastrointestinal (GI) Tract: Increased motility, sphincter relaxation, increased secretions
Urinary Bladder: Contraction of muscles, sphincter relaxation
Exocrine Glands: Increased secretions (sweat, saliva, tears, etc.)

Nicotinic Actions

Neuromuscular junction: Therapeutic dose causes muscle contraction; toxic dose causes paralysis. This action is at the neuro muscular junction
Ganglia: Stimulates both sympathetic and parasympathetic ganglia.
Adrenal medulla: Causes catecholamine release (epinephrine and norepinephrine).

Reversible Anticholinesterase Agents: Details

Edrophonium: Short-acting, primarily peripheral action, used for diagnosing myasthenia gravis.
Physostigmine: Intermediate-acting, penetrates CNS, used for glaucoma and reversing anticholinergic toxicity.
Neostigmine: Intermediate-acting, doesn't penetrate CNS, used for myasthenia gravis.

Adverse Effects of Anticholinesterases

Parasympathetic excess: Sweating, salivation, flushing, diaphoresis, nausea, abdominal pain, diarrhea, urinary urgency, decreased BP, bradycardia, bronchospasm.

Organophosphate Toxicity

Highly toxic compounds, including nerve gases and insecticides.
Irreversible inhibition of acetylcholinesterase.
Muscarinic and nicotinic effects similar to those of anticholinesterases, leading to the increased concentration of ACh
CNS effects include headache, dizziness, tremor, restlessness, anxiety, confusion, convulsions, coma.

Treatment of Organophosphate Toxicity

Supportive measures (maintaining respiration).
Atropine: Blocks muscarinic receptors.
Pralidoxime (2-PAM): Reverses the effects of organophosphates (if given before aging of enzyme)

Summary Table of Anticholinesterase Agents

(Refer to provided table for specific details on these agents).

Summary of Other Information

Donepezil: Used in Alzheimer's disease; primarily CNS action. GI distress is a side effect.
Key drugs for various conditions (e.g., glaucoma, myasthenia gravis, Alzheimer's disease) are detailed in the provided summary tables.

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Description

Test your knowledge about Dr. Asmaa Fady's academic qualifications and professional role. This quiz covers her highest degrees, associated college, and specific fields of expertise. Perfect for anyone interested in higher education and notable academics.