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12 Cards in this Set

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Glyopyrrolate:

A. Includes mandelic acid rather than tropic acid

B. Is a tertiary amine

C. Acts be phosporylation of acetylcholine

D. Results in dry mouth and bronchoconstriction

E. Is compatible with thiopentone
ANSWER A

Glycopyrrolate is a synthetic anticholinergic which contains mandelic acid contrasting with atropine and scopolamine which contain tropic acid.

It is a competitive antagonist of acetylcholine at post ganglionic muscarinic receptors.

Glycopyrrolate is a quaternary ammonium compound. It is poorly lipid soluble and has minimal central effects as it does not readily cross the blood brain barrier. (as per its charged structure)
Which statement regarding hyoscine is FALSE:

A. is naturally occuring

B. Is a quaternary ammonium compound

C. Causes mydriasis

D. Causes confusion in the elderly
ANSWER B

Hyoscine is Scopolamine

A. true

B. an alkaloid derived from scopolia carniocolia

C. Correct. Mydriasis = pupillary dilation

D. Correct. At any age, but particularly in the elderly.
Scopolamine D & L isomers:

A. D isomer is active

B. is provided as a racemic mixture

C. Does not cause central effects

D. Extensively renally excreted
ANSWER B.

Atropine and Scopolamine are both racemic mixtures. L isomer is active.

Scopolamine does cross the BBB and causes sedation/confusion.

It is extensively metabolised by the liver and tissues to scopine and scopic acid.
Atropine:

A. is an alkaloid consisting of tropic acid and tropine connected by an amide

B. Increases alvolar and anatomical dead space.

C. at low doses causes bradycardia

D. acts on both muscarinic and nicotinic receptors
ANSWER C

A. FALSE: connected by an ester

B. False, increases anatomical but not alveolar dead space via bronchodilation

C. TRUE: Bezold-Jarish reflex

D. FALSE: only muscarinic
Atropine & Glycopyrrolate:

A. Both are naturally occurring

B. Both cause confusion in the elderly

C. Atropine is 10 times as potent as glycopyrrolate

D. Both are quaternary ammonium compounds

E. Gylcopyrrolate has greater anti-sialogogue action than atropine
ANSWER E

A. FALSE: Glycopyrrolate is synthetic

B. FALSE Glyc generally thought not to cross BBB

C. FALSE: glycopyrrolate is 5 times more potent that atropine

D. FALSE

E. TRUE
Which of the following is the most toxic effect of atropine in children?

A. Hypotension

B. Tachycardia

C. Hyperthermia

D. Hypertension
C. Hyperthermia
M3 receptor subtype is located:

A. In the myocardium

B. In sympathetic postganglionic neurons

C. On effector cell membranes of glandular and smooth muscle cells

D. On the motor end plates
ANSWER C
Which of the following drugs is both a muscarinic and nicotinic blocker?

A. Atropine

B. Benztropine

C. Hexamethonium

D. Succinylcholine
ANSWER B
Indicate a muscarinic receptor-blocking drug:

A. Scopolamine

B. Pipecuronium

C. Trimethaphan

D. Pilocarpine
ANSWER A
Indicate the drug, which is rapidly and fully distributed into CNS and has a greater effect than most other antimuscarinicagents?

A. Atropine

B. Scopolamine

C. Homatropine

D. Ipratropium
ANSWER B
Atropine causes:

A. Miosis, a reduction in intraocular pressure and cyclospasm

B. Mydriasis, a rise in intraocular pressure and cycloplegia

C. Miosis, a rise in intraocular pressure and cycloplegia

D. Mydriasis, a rise in intraocular pressure and cyclospasm
ANSWER B
Compared with atropine, scopolamine has all of the following properties EXCEPT:

A. More marked central effect

B. Less potent in decreasing bronchial, salivary and sweat gland secretion

C. More potent in producing mydriasis and cycloplegia

D. Lower effects on the heart, bronchial muscle and intestines
ANSWER B