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75 Cards in this Set
- Front
- Back
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t/f
indirect acting agonist work by acting on receptors |
f
they are indirect; they work by inhibiting ACHE |
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indirect acting cholinergic agonist stimulate --- receptors on the autonomic organs
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muscarinic
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t/f
indirect only work on muscarinic |
f
both nicotinic and muscarinic |
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indirect --- then --- ganglia and skeletal muscle
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stimulate
desensitize |
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if you overstimulate the nicotinic what happens
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it will stop working; paralyze muslce; neuromuscular blocker
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reversible indirect acting cholinergic agonists
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carbamates
quaternary ammoniums |
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duration of reversible
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min to hours
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irreversible cholingertics
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organophosphates
nerve gases |
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how long do irrervisible work
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weeks to months
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irreversible are very deadly why
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cuz you'll have to make new enzymes
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carbamoyl group slowly dissociates from the ---- site
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esteratic
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duration of carbamoyl
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up to 30 min
acetate is about 40usec |
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tx uses of indirect acting cholinergics
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paralytic ileus
stimulate urinary bladder glaucoma myasthenia gravis anticholinergic poisoning (such as w/ atropine) alzheimer's |
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of the tx which is mainly for nicotinic
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myasthenia gravis
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physostigmine is a natural ---- in calabar bean
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alkaloid
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physostigmine is ---- active
is only available as ---- |
orally
injection |
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does physostigmine cross the bbb
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yes
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uses of physostigmine
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mitotic in glaucoma
atropine toxicity |
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side effects of physostigmine
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muscarinic
can also have cns side effects |
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neostigmine doesn't enter the ---
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CNS
difference btw neostig and physostigmine |
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uses of neostig
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paralytic ileus
urinary retention myasthenia graivs reverse neuromuscular blockade |
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neostigmine works on --- blockers
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reverisble
neostig kicks them out |
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which has a slower onset, longer duration of action
pyridostigmine or neostigmine |
pyridostigmine
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route for pyridostigmine
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orall
injection |
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uses of pyridostigmine
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myasthenia gravis
prophylactic for nerve gas reverse neuromuscular blockade |
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does pyridostigmine block allthe nerve gas
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no
but's it's enough to survive and get tx |
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s/s of irreverisble nerve blocker
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muscle contraction
diaphragm stops eye sight accomadation lacrimation GI diarrhea |
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what's used to dx myasthenia gravis
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edrophonium
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edrophonium lacks the --- group
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carbamoyl
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endrophonium blocks the ---- site
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anionic
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t/f
edrophonium has a long duration of action |
f
short about 10 min |
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route for edrophonium
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injection
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tacrine is --- selective
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CNS
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tacrine is a ----- inhibitor
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reversible
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uses of tacrine
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alzheimer's disease
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t/f
tacrine has large effects on alzheimer's |
f
modest effects 15-30% |
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does tacrine stop alzheimer's
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no
it slows it |
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frequency of tacrine
prob w/ this |
4 x day
noncompliance |
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tacrine can cause ------
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hepatotoxicity
30% reversible |
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t/f
hepatotoxicity in tacrine is reversible |
t
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indication for donepezil
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alzheimer's
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when should donepezil be taken
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during the early stage
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frequency of donepezil
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q day
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t/f
prob w/ donepezil is liver disease |
f
no liver disease |
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donepezil is effective in --- % of pt's
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80%
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donepezil may --- --- progression
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slightly slow
about 55 wks doesn't alter underlying disease |
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side effects of donepezil
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muscarinic
diarrhea tearing salivation |
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galantamine is used for
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alzheimer's
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route of galantamine
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oral
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frequency of galantamine
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2 x daily
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galantamine is a natural ----- form daffodil plant
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alkaloid
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galantine is a ----- inhibitor
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reversible
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se of galantien
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liver
GI tract bronchoconstrictor drowsiness |
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new inhibitior for alzheimer's
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rivastigmine
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t/f
rivastigmine is --- lasting |
long
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duration of rivastigmine
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11 hrs
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route of rivastigmine
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oral
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frequency of rivastigmine
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2 x day
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rivastigmine may --- the progression of alzheimer's
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slow
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rivastigmine is selective for --- isoform
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G1
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where's G1 isoform mainly found
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brain
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t/f
rivastigmine slowly dissociates in the brain |
t
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side effects of rivastigmine
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muscarinic, hallucinations
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organophosphates is an ---- inhibitor
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irreversible
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organophosphates have high ---- solubility
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lipid
so, goes quickly into brain and body |
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irreverisble inhibitors have --- molecular weight
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low
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organophos are absorbed -----
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transdermally
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organophost has ---- penetration
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CNS
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uses of organophost
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insecticides
nerve gases |
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what does the organophos bind to on the Ache
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the hydroxy group
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the smaller the side group, the --- the nerve gas works
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faster
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antidote for organophos
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pralidoximine
comptetes w/ organophos for hyrdoxyl group. it will pull it off. |
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nerve gases
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tabun
sarin soman |
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insecticides
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parathion
diazinon dimpylate malathion |
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prob w/ atropine injector for nerve gases
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will only work on muscarinic but not nicotinic
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