Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
49 Cards in this Set
- Front
- Back
|
Parasympathetic stimulation |
increases activity of GI, genitourinary systems decreases activity of CV system
|
|
|
drugs that increase, decrease parasympathetic activity |
cholinergic, anticholinergic |
|
|
cholinergic drugs indicated for what? |
Alzheimers, glaucoma, MG, urinary/intestinal stasis |
|
|
Anticholinergics indicated for what? |
overactive urinary/intestinal conditions asthma/COPD motion sickness various opthalmic procedures |
|
|
neurotransmitter of PS system |
ACH |
|
|
acetylcholinesterase |
inactivates ACH when outside nerve ending and not on receptor |
|
|
pseudocholinesterase |
enzyme, located in liver and plasma, hydrolyzes ACH, other drugs |
|
|
location muscarinic (M) receptors |
internal organs, glands |
|
|
location Nn (nicotinic neural) receptors |
autonomic ganglia |
|
|
location Nm (nicotinic muscle) receptors |
skeletal muscle |
|
|
cholinergic receptors at PS postganglionic nerve endings |
muscarinic receptors |
|
|
cholinergic receptors at ganglionic sites of both S, PS nerves |
nicotinic-neural (Nn) |
|
|
drugs that act like ACH, low doses of nicotine at Nn receptors |
ganglionic stimulents |
|
|
drugs that block ACH or act like high doses nicotine at Nn receptors |
ganglionic blockers |
|
|
drugs that act like ACH or muscarine at muscarinic receptors |
cholinergic/muscarinic |
|
|
drugs that block ACH at muscarinic receptors |
anticholinergic/antimuscarinic |
|
|
cholinergic receptors at NMJ of skeletal muscle |
nicotinic-muscle (Nm) |
|
|
srugs that block effect of ACH at NMJ |
neuromuscular blockers skeletal muscle relaxants |
|
|
parasympathomimetic |
cholinergic drugs that mimic actions of ACH at cholinergic (muscarinic) receptors |
|
|
Cholinergic drug subdivisions |
direct acting indirect acting |
|
|
direct acting drugs |
bind to cholinergic (muscarinic) receptors, produce effects similar to ACH increase activity only at cholinergic (muscarinic) sites |
|
|
indirect acting drugs |
inhibit acetylcholinesterase (increase ACH concentration, actions at all muscarinic, nicotinic receptor sites). |
|
|
Direct-acting drug examples |
Acetylcholine (Miochol-E) (miotic in ophthalmology)
bethanecol (Urecholine) (urinary retention, postoperative ileus)
Carbachol (Isopto carbachol) (Glaucoma) |
|
|
indirect acting drug (anticholinesterases) examples |
Ambenonium (Mytelase)- MG Demecarium (Humorsal)- glaucoma Donepezil (Aricept)- Alzheimers Galantamine (Reminyl)- Alzheimers Rivastigmine (Exelon)- Alzheimers |
|
|
effects of direct acting drugs |
increase GI secretions/motility increase urination cause miosis
decrease heart rate bronchoconstriction (usually insignificant) |
|
|
Pilocarpine |
used as eyedrops in glaucoma treatment |
|
|
Bethanechol |
direct acting; administered orally to stimulate urinary, intestinal tracts adverse effects due to overstimulation (increased frequency, diarrhea) |
|
|
use of cholinergics for glaucoma |
eyedrops produce miosis, prpomotes better drainage of intraocular fluid from eye. Lowers pressure, helps prevent retinal damage |
|
|
anticholinesterases |
indirect acting drugs |
|
|
anticholinesterase subdivisions |
reversible inhibitors irreversible inhibitors (of acetylcholinesterase)+ |
|
|
reversible inhibitors |
diagnose/treat MG, Alzheimers, antidotes to reverse effects of drugs that block cholinergic, nicotinic receptors |
|
|
Method of diagnosing MG |
IV injection of low dose edrophonium increase in muscle strength within 1 minute positive for MG |
|
|
neostigmine pyridostigmine ambenonium |
administered orally for treatment of MG, IV to reverse effects of excessive cholinergic blockade |
|
|
physostigmine |
used parenterally to reverse CNS effects of excessive anticholinergic blockade, eyedrops in treatment of glaucoma |
|
|
Irreversible inhibitors |
derivatives of compounds used as insecticides, pesticides, chemical warfare agents |
|
|
Echothiophate (Phospholine) |
only irreversible inhibitor used clinically. Administered as eyedrops in treatment of glaucoma |
|
|
Atropine |
used for excessive cholinergic stimulation |
|
|
Pralidoxime |
antidote to organophosphate chemical warfare agents |
|
|
Organophosphates |
irreversible anticholinesterase drugs found in insecticides, pesticides, chemical warfare agents |
|
|
reversible anticholinesterase drugs |
More widely used than direct acting cholinergic drugs. Used for MG, Glaucoma, urinary retention. intestinal paralysis, Alzheimers, antidotes to curare-type skeletal muscle blockers, AC drugs |
|
|
Drugs used to treat MG |
pyridostigmine ambenonium used orally |
|
|
treatment for urinary retention (atony of bladder), intestinal stasis/paralysis (paralytic ileus) |
neostigmine |
|
|
Drugs to treat Alzheimers |
Tacrine (Cognex)- 1st drug introduced, more side effects Donepezil (Aricept)- approved all stages Galantamine (Reminyl), rivastigmine (Exelon)- newest for mild/moderate disease Memantine (Namenda)- newest, better tolerated |
|
|
Antidote for anticholinergic drug poisoning |
physostigmine- can pass blood/brain barrier |
|
|
Anticholinergic drug examples |
atropine- used for drug poisoning, eye exams scopolamine- used for intestinal disorders, motion sickness oldest, obtained from belladonna plant |
|
|
common AC side effects |
dry mouth, blurred vision (mydriasis) sedation, mental confusion |
|
|
AC contraindications |
glaucoma, prostate hypertrophy, urinary/intestinal obstruction |
|
|
treatment for AC overdose |
inducing emesis, gastric lavage,activated charcoal, saline cathartics Physostigmine |
|
|
njn |
njnn |
