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Pharmacology - Cholinergics

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ewright2's version from 2016-08-30 14:30

Section 1

Question Answer
A short acting AChE inhibitor used to diagnose myastenia gravis Edrophonium
Intermediate acting ACeH inhibitor used for treatment of myastenia gravis Neostigmine, Pyridostigmine
Irriversible AChE inhibitors Organophosphates - nerve gasses/insecticides, echpthiopate (for glaucoma)
ACeE Inhibitor Effects - Autonomic system: "SLUD"Salivation, Lacrimation, Urination, Defication
When would you use Anticholinesterases?Reversal of nicotinic receptor neuromuscular blocking agents, manage myastenia gravis, and treatment for slow angle glaucoma
How does the mAChR work to treat glaucoma?It causes ciliary muscle contraction to open the pathway to the Canal of Schlemm to allow for drainage of excess aqueous humor
What does Pralidoxime (2-PAM) treat?Prevents the neuromusclar effects of organophasphate poisoning. Will still see muscarinic effects. (Use atropine for that)
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Section 2

Question Answer
What are the effects of Muscarinic Antagonists?Inhibition of secretion, blockade of vagaly mediated bradycardia, mydriasis, inhibition of GI motility, relaxation of smooth muscle, CNS effects: depressant, antiemesis
A preanesthetic agentAtropine
Preanesthetic agent & for bradycardia (and less side effects) Glycopyrrolate
Antiemetic (motion sickness prevention)Scopolamine
Mydriasis for opthamology exams Tropicamide
Ulcers (M1 selective, inhiits gastric secretions)Pirenzepine
What are the SIDE-effects of Muscarinic Antagonists?Tachycardia, Increased intraocular pressure, difficulty in micturition, constipation from GI atony, CNS excitability, hyperthermia
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Section 3

Question Answer
Non-depolarizing agents - neuromusclar nicotinic receptor competitive antagonists D-tubocurarine and Pancuronium
Effects of Non-depolarizing blockersSkeletal muscle relaxation (super awesome for surgeries)
Progession of paralysisRespiratory if first to develop and last to recover
How to reverse the Non-depolarizing blockers?Use an AChE inhibitor to increase endogenous ACh levels (neostigmine)
Depolarizing blockers Succinylcholine - euthanasia solution in horses ; intensified by AChE inhibitors
Other inhibitors of Cholinergic transmissionBotulinum toxin, Mg++, Aminoglycosides
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