Pharmacology Quiz on Nicotine and Pilocarpine
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Questions and Answers

What is the primary receptor that pilocarpine targets for reducing ocular pressure?

  • M1 and N (correct)
  • Beta-2
  • Alpha-1
  • A4B2

    • Which of the following effects is NOT associated with nicotine?

  • Decreased craving (correct)
  • Nausea
  • Tachycardia
  • Vomiting

    • What is a significant cardiovascular response to chronic nicotine exposure?

  • Hypotension
  • Arrhythmia
  • Bradycardia
  • Increased blood pressure (correct)

    • What is the onset of action for pilocarpine when administered intravenously?

    <p>Short acting</p> Signup and view all the answers

    What is one potential gastrointestinal effect of nicotine consumption?

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

    In what condition would pilocarpine NOT be an appropriate treatment?

    <p>Chronic hypertension</p> Signup and view all the answers

    What mechanism of action is primarily responsible for nicotine's effects?

    <p>Activation and desensitization of A4B2 receptors</p> Signup and view all the answers

    Which symptom is least likely to occur following nicotine exposure?

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

    What is the primary mechanism of action of indirect-acting cholinergics?

    <p>Target acetylcholinesterase enzyme</p> Signup and view all the answers

    Which of the following groups does neostigmine belong to?

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

    Which condition is NOT indicated for the use of carbamates?

    <p>Alzheimer's disease</p> Signup and view all the answers

    What differentiates the pharmacokinetic properties of indirect-acting cholinergics?

    <p>They have variable half-lives</p> Signup and view all the answers

    Which of the following is a characteristic of edrophonium?

    <p>It has a rapid onset of action</p> Signup and view all the answers

    What is a noted limitation of edrophonium in clinical use?

    <p>It may lead to inaccurate MG diagnosis due to false positives</p> Signup and view all the answers

    What effect does inhibition of cholinesterase have on muscle strength?

    <p>Rapidly increases muscle strength</p> Signup and view all the answers

    Which of the following is true regarding the absorption characteristics of indirect-acting cholinergics?

    <p>Carbamates have poor absorption</p> Signup and view all the answers

    What is a characteristic of carbamates in the context of drug effects?

    <p>They are reversible inhibitors with longer-lasting effects.</p> Signup and view all the answers

    Which drug is capable of crossing the blood-brain barrier?

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

    What is the primary mechanism of action for Physostigmine?

    <p>Inhibition of cholinesterase activity</p> Signup and view all the answers

    Which of the following situations is Neostigmine contraindicated for?

    <p>Anticholinergic toxicity</p> Signup and view all the answers

    What is the typical onset time for Physostigmine when used as an antidote?

    <p>30 minutes to 6 hours</p> Signup and view all the answers

    Which of the following best describes the effects of Pyridostigmine?

    <p>Long-term treatment for Myasthenia Gravis</p> Signup and view all the answers

    Neostigmine is primarily indicated for which of the following conditions?

    <p>Neuromuscular blockade reversal</p> Signup and view all the answers

    What is a significant property of Physostigmine compared to Neostigmine?

    <p>Physostigmine can cross the BBB, while Neostigmine cannot.</p> Signup and view all the answers

    Which statement is true regarding the absorption characteristics of tertiary amines in this context?

    <p>They are more toxic and better absorbed due to lipid solubility.</p> Signup and view all the answers

    What effect can strong anticholinergics have on K+ salts?

    <p>Enhance their ulcerogenic effect</p> Signup and view all the answers

    Which of the following drugs may have increased concentration due to anticholinergics?

    <p>Thiazide diuretics</p> Signup and view all the answers

    What is a common side effect associated with Botulinum Toxin Type A?

    <p>Injection site swelling/bruising</p> Signup and view all the answers

    What mechanism of action is responsible for the effect of Botulinum Toxin Type A?

    <p>Inhibition of vesicle fusion</p> Signup and view all the answers

    Which side effect is associated with the use of Abobotulinumtoxin A?

    <p>Flu-like symptoms</p> Signup and view all the answers

    Which indication is NOT associated with Botulinum Toxin Type A?

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

    What type of neuromuscular interaction does Botulinum Toxin Type A primarily affect?

    <p>Inhibits neurotransmitter release</p> Signup and view all the answers

    Hexamethonium, a ganglionic blocker, is primarily indicated for which of the following conditions?

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

    Which side effect is NOT commonly associated with the use of Botulinum Toxin?

    <p>Increased sweating</p> Signup and view all the answers

    What overarching effect does Botulinum Toxin Type A have on muscle activity?

    <p>Leads to flaccid paralysis</p> Signup and view all the answers

    What is the primary mechanism of action for direct-acting cholinergic drugs?

    <p>Direct binding to M and N receptors</p> Signup and view all the answers

    Which of the following is an indication for using bethanechol?

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

    Which direct-acting cholinergic is known to cause bronchoconstriction most effectively?

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

    What is a significant contraindication when using methacholine?

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

    Which cholinergic drug is specifically indicated for the treatment of glaucoma by decreasing ocular pressure?

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

    Which characteristic accurately describes the choline esters among the cholinergic drugs?

    <p>Quaternary amines and poorly absorbed</p> Signup and view all the answers

    Which effect is commonly associated with acetylcholine administration?

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

    What defines a primary action of carbachol?

    <p>It has a long duration of action.</p> Signup and view all the answers

    Which of the following drugs is least likely to cause a significant direct effect on the lungs?

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

    Which characteristic is true of direct-acting cholinergic agents relative to acetylcholine?

    <p>They mimic acetylcholine's effects with variations in potency.</p> Signup and view all the answers

    Which statement about the pharmacokinetics of choline esters is accurate?

    <p>They are rapidly hydrolyzed by acetylcholinesterase.</p> Signup and view all the answers

    Which of the following drugs would most likely be used in bronchoprovocation testing?

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

    What effect does carbachol have on the pupils during surgery?

    <p>Miosis (pupil constriction)</p> Signup and view all the answers

    What is a common adverse effect of administering acetylcholine in larger doses?

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

    Which aspect distinguishes the mechanism of action of methacholine from that of acetylcholine?

    <p>Methacholine is not hydrolyzed rapidly by ACE.</p> Signup and view all the answers

    What is the primary mechanism of action of Donepezil?

    <p>Inhibition of cholinesterase</p> Signup and view all the answers

    Which of the following is a contraindication for Rivastigmine?

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

    What is one of the main differences in the duration of action among the central acetylcholinesterase inhibitors?

    <p>Donepezil is long-acting, Rivastigmine is intermediate-acting</p> Signup and view all the answers

    Which central acetylcholinesterase inhibitor is known for having a reversible, yet high bioavailability?

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

    What common interaction should be avoided with all the central acetylcholinesterase inhibitors listed?

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

    Which condition is indicated for the use of Galantamine?

    <p>Alzheimer's disease</p> Signup and view all the answers

    What type of amine is associated with Donepezil's ability to cross the blood-brain barrier?

    <p>Tertiary amine</p> Signup and view all the answers

    What is the potential side effect associated with Rivastigmine if it is stopped for more than three days?

    <p>Vomiting with esophageal rupture</p> Signup and view all the answers

    Which of the following is true regarding the onset of action for Donepezil?

    <p>It is long-acting</p> Signup and view all the answers

    Which central acetylcholinesterase inhibitor is classified as pseudoirreversible?

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

    What is a potential outcome of increasing acetylcholine levels in the brain through acetylcholinesterase inhibitors?

    <p>Improved cognitive function</p> Signup and view all the answers

    Which acetylcholinesterase inhibitor can cause vomiting when stopped abruptly after extended use?

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

    What characteristic administration route is associated with Galantamine?

    <p>Oral administration</p> Signup and view all the answers

    What is a key limitation of acetylcholinesterase inhibitors in treating Alzheimer's disease?

    <p>They primarily ease symptoms</p> Signup and view all the answers

    Study Notes

    Cholinergic Transmission

    • Synthesis: Acetyl CoA from mitochondria + choline → Acetylcholine (ACh) using choline acetyltransferase
    • Blocked by: Hemicholinium
    • Storage: Cytoplasm to vesicle using vesicle-associated transporter (VAT)
    • Blocked by: Vesamicol
    • Release: Vesicle fusion with membrane triggered by calcium ion (Ca2+) influx
      • Blocked by: Botulinum toxin
    • Termination: ACh is broken down into acetate and choline by acetylcholinesterase

    Muscarinic Receptors

    • M1: Gq receptor subtype, found in glands (gastric, salivary), stimulates secretions
    • M2: Gi receptor subtype, found in heart (SA & AV nodes), decreases heart rate and conduction
    • M3: Gq receptor subtype, found in exocrine glands, stimulates secretion (saliva, sweat, nasal, bronchial), pancreatic (insulin), bladder, and GI tract smooth muscle
    • M4: Gi receptor subtype, found in CNS, involved in learning, memory, and other functions.
    • M5: Gi receptor subtype, found in iris, ciliary muscles, and CNS, affecting things like accommodation, body temperature, and learning.

    Organ System Effects - Muscarinic

    • Eyes: Miosis (constriction of iris sphincter), Accommodation (ciliary muscle contraction for near vision)
    • Cardiovascular: Bradycardia (slow heart rate), decreased contractility & conduction, vasodilation (requires intact endothelium), hypotension
    • Respiratory: Bronchoconstriction, stimulation of glands (salivary & gastric)
    • CNS: M1 receptors are abundant in brain areas involved in cognition, ACh and Nicotine regulates 5-HT, GABA, DA, NE.
    • M1, M3, M5 use IP3/DAG (Gq pathway), and M2, M4 use cAMP/cGMP (Gi pathway).

    Cholinergic Drugs

    • Direct-Acting Cholinergics (Choline Esters):

      • Quaternary amines (lipid-insoluble, do not cross BBB)
      • Poorly absorbed; distributed poorly in CNS.
      • ACh-like effects (similiar potency and duration of action).
      • Acetylcholine: nonspecific ACh-like effects.
        • lower doses used for vasodilation, higher doses cause bradycardia.
      • Bethanecol: mainly used to increase Gl motility and bladder emptying.
      • Methacholine: mainly used to assess bronchial responsiveness and bronchoconstriction, similar effects on Gl and urinary tract
      • Carbachol: resistant to hydrolysis, mainly used for glaucoma treatment.

    • Indirect-Acting Cholinergics:

      • Inhibiting acetylcholinesterase.
      • Edrophonium: diagnostic for Myasthenia Gravis
      • Pyridostigmine: long-term management of myasthenia Gravis
      • Physostigmine: Can cross the blood–brain barrier, used in treating anticholinergic poisoning.
      • Neostigmine: reverses paralysis.

    • Organophosphates:

      • Irreversible inhibitors of acetylcholinesterase.
      • Echothiophate: used for glaucoma.
      • Parathion, Malathion: Insecticides.

    • Alkaloids:

      • Well absorbed and lipid-soluble.
      • Nicotine: increases craving, chronic exposure leads to activation (depolarization).
      • Pilocarpine: decreases ocular pressure.

    • Ganglionic Blockers:

      • Hexamethonium, Trimethaphan, Nicotine,
      • Block nicotinic receptors in the autonomic ganglia.
      • Rarely used.
      • Used in hypertensive emergencies (obsolete).

    • Anticholinergic (Anti-muscarinic):

      • Atropine: blocks muscarinic receptors (non-specific).
      • Biperiden: used for Parkinson's.
      • Hyoscine/Scopolamine: motion sickness.
      • Dicycloverine: GI and GU symptoms.

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    Description

    Test your knowledge on the pharmacological effects of nicotine and pilocarpine. This quiz covers their mechanisms of action, cardiovascular responses, and ocular pressure management. Dive into specific questions that challenge your understanding of these compounds.

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