Pharmacology Chapter 14

Front 1

What are the six categories of cholinergic drugs

Back 1

muscarinic agonists, muscarinic antagonists, ganglionic stimulating agents, ganglionic blocking agents, neuromuscular glocking agents, cholinesterase inhibitors

Front 2

Muscarinic agonists are also known as

Back 2

parasympathetic agents, produce same effects of parasympathetic nerves

Front 3

muscarinic receptors are associated with what part of nervous system

Back 3

parasympathetic

Front 4

What do muscarinic agonists do

Back 4

Heart-bradycardia, exocrine glands to increase sweating, salivation, bhronchial secretions, secretion of gastric acid, in lung and GI tract promote contraction resulting in constriction of bronchi and increased tone and motility of GI smooth muscle. In bladder contraction of detrusor muscle and relaxation of trigone and sphincter causing in bladder emptying. relax of smooth muscle causing vasodilation and hypotension. In the eye causes mitosis, contraction of pupil, and contraction of ciliary muscle to accommodate for near vision

Front 5

Why is muscarine not used

Back 5

It is found in poisonous (Inocybe and Clitocybe species) mushrooms and causes a toxic effect.

Front 6

When is acetylcholine used as a drug

Back 6

during lens cataract surgery in order to constrict the pupil

Front 7

How can muscarinic poisoning occur?

Back 7

1. direct acting muscarinic agents
2. cholinesterase inhibitors

Front 8

what are the symptoms of muscarinic poisoning

Back 8

results from excessive activation of receptors

profuse salivation lacrimination, visual distrubances, bronchospasm, diarrhea, bradycardia, hypotension,

severe can result in cardiovascular collapse.

Front 9

what is treatment of muscarinic poisoning

Back 9

atropine, a muscarinic blocking agent

Front 10

what are muscarinic antatgonists

Back 10

block actions of acetylcholine, also known as parsympatholytic drugs, anticholinergic drugs, muscarinic blockers

Front 11

List 4 symptoms of overactive bladder

Back 11

urinary urgency, urinary frequency (>8 in 24 hrs), nocturia, urge incontinence

Front 12

define urge incontinence

Back 12

involuntary leaking associated with strong urge to void resulting from involunary contractions of the bladder detrusor

Front 13

what drugs are given for overactve bladder and what do they do

Back 13

oxybutynin and tolterodine, anticholinergic. They block muscarinic receptors on bladder detrusor and inhibit bladder contrctions

Front 14

How can effects of anticholinergics be reduced

Back 14

use long-acting formulas, use durgs that don't cross blood brain barrier, and use drugs that are selective for muscarinic receptors in teh bladder

Front 15

list the muscarinic subtypes and their locations

Back 15

M1 found only in salivary glands and the CNs
M2 found only in heart
M3 most widely distributed and found in salivary glands and bladder detrusor, GI smooth muscle and the eye.

Front 16

Who is most prone to overactive bladder

Back 16

ages 40-44, age over 75 most common. most disturbing system is urine leakage

Front 17

list two primary modes of treatment for OAB

Back 17

behavioral and drug therapy

Front 18

what is included in behavioral therapy for OAB

Back 18

schedule voiding, timing fluid intake appropriately, doing Kagel exercises to strengthen pelvic floor exercise, avoiding caffeine

Front 19

what is PTNS in relation to OAB

Back 19

percutaneous tibial nerve stimulation-reduces urinary urgency by stimulating posterior tibial nerve, which projects to sacra plexus, which controls bladder.

stimulation is done by sending current through fine needled inserted in skin into tibial nerve near ankle. treatments are done for 30min, once a week for 12 weeks and last a year

Front 20

what is drug therapy for OAB

Back 20

anticholinergic-oxybutynin and tolterodine, block muscarinic receptors on bladder detrusor, inhibiting bladder contractions and urge to void

Front 21

What are anticholinergic side effects

Back 21

dry mouth, constipation, urinary retention, blurred vision, photophobia, tachycardia,

elderly-ognitive impariment

Front 22

anticholinergics are intensified by

Back 22

antihistamines, tricyclic antidepressants, phenothiazine antipsychotic agents

Front 23

How can you reduce anticholinergic side effects

Back 23

using long acting formulation, sue drugs that don't cross blood brain barrier, using drugs that are selective for muscarinic receptors in the bladder

Front 24

what are the three most identified muscarinic subtype receptors and where are they found

Back 24

M1-salivary glands and CNS
M2- only in heart
M3salivary glands, bladder detrusor, Gi smooth muscle, eye

Front 25

What are symptoms of antimuscarinic poisoning?

Back 25

dry mouth, blurred vision, photophobia, hyperthermia, hallucinations, delirium, skin that is hot and dry and flushed. Death results from respiratory depression secondary to blockade of cholinergic receptors in the brain

Front 26

What is treatment for antimuscarinic poisoning

Back 26

minimize intestinal absoprtion by giving activated charcoal.

Most effective antidote is physostigmine, and inhibitor of acetycholinesterase. It causes acetylcholine to accumulate in all cholinergic junctions competing with antimuscarinic agent for receptro binding and reversing excessive muscarinic blockade