Group Work 2: Autonomic Pharmacology PDF

COLLEGE OF MEDICINE Group work 2 Autonomic pharmacology By: Assistant professor Dr. Gulala Ibrahim 1  COLLEGE OF MEDICINE Case Scenario 1: Urinary Retention Post-Surgery Pati...

COLLEGE OF MEDICINE Group work 2 Autonomic pharmacology By: Assistant professor Dr. Gulala Ibrahim 1  COLLEGE OF MEDICINE Case Scenario 1: Urinary Retention Post-Surgery Patient Profile Name: James Lee Age: 52 Medical History: Recent abdominal surgery, no known allergies. Presentation James is recovering from surgery but has developed urinary retention due to bladder atony. The medical team considers administering Bethanechol, a direct-acting muscarinic agonist, to stimulate bladder function. Case Analysis Bethanechol, a parasympathomimetic, can stimulate the bladder's muscarinic receptors, increasing detrusor muscle tone and promoting urination.  COLLEGE OF MEDICINE Study Questions 1. Mechanism of Action: How does Bethanechol stimulate bladder function? Discuss its action on muscarinic receptors and how this helps relieve urinary retention.  COLLEGE OF MEDICINE 2. Side Effects: List potential side effects of Bethanechol, considering its effects on other muscarinic receptors.  COLLEGE OF MEDICINE 3. Alternative Management: If Bethanechol is ineffective or not tolerated, what other treatment options could be considered for urinary retention? 5 COLLEGE OF MEDICINE Case Scenario 2: Myasthenia Gravis and Acetylcholine Esterase Inhibitors Patient Profile Name: Sarah Young Age: 34 Medical History: Diagnosed with myasthenia gravis, experiencing muscle weakness. Presentation Sarah's neurologist prescribes Pyridostigmine, a reversible acetylcholinesterase inhibitor, to help manage her myasthenia gravis symptoms. Case Analysis Pyridostigmine increases acetylcholine availability at the neuromuscular junction by inhibiting its breakdown, improving muscle strength. 6  COLLEGE OF MEDICINE Study Questions 1. Drug Action: Explain how Pyridostigmine works to improve muscle strength in myasthenia gravis. What is the role of acetylcholinesterase in normal physiology, and how does its inhibition benefit Sarah? 7  COLLEGE OF MEDICINE 2. Adverse Effects: Identify and explain common side effects associated with Pyridostigmine, including those resulting from excess acetylcholine at muscarinic receptors.  COLLEGE OF MEDICINE Dosage and Monitoring: How should Pyridostigmine dosage be adjusted based on symptom relief and side effects? Discuss the importance of careful monitoring in managing myasthenia gravis.  Case Scenario 3: Organophosphate Poisoning COLLEGE OF MEDICINE Patient Profile Name: John Patel Age: 45 Medical History: Healthy, no chronic conditions. Presentation John arrives at the ER with symptoms of excessive salivation, sweating, miosis, muscle twitching, and respiratory difficulty. He works on a farm and may have been exposed to an organophosphate pesticide. Case Analysis Organophosphate poisoning causes irreversible inhibition of acetylcholinesterase, leading to an accumulation of acetylcholine and overstimulation of muscarinic and nicotinic receptors.  COLLEGE OF MEDICINE Study Questions 1. Mechanism of Toxicity: Describe how organophosphates cause toxicity. What is the result of irreversible acetylcholinesterase inhibition on the ANS?  COLLEGE OF MEDICINE 2. Treatment Protocol: Outline the treatment approach, including the use of atropine to counter muscarinic effects and pralidoxime to regenerate acetylcholinesterase if given early.  COLLEGE OF MEDICINE 3. Long-term Effects: Discuss potential complications if treatment is delayed or incomplete.