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35 Cards in this Set
- Front
- Back
name the 2 major cholinergic receptor families.
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nicotinic and muscarinic
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what are the 2 nicotinic receptor types?
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neuronal nicotinic muscular nicotinic
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what are the 2 major groups of cholinergic agonists? how do they work?
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a. direct acting (receptor agonists) b. indirect acting (inhibit acetycholinesterase)
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acetylcholine
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direct-acting cholinergic agonist
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bethanechol
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direct-acting cholinergic agonist
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carbachol
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direct-acting cholinergic agonist
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pilocarpine
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direct-acting cholinergic agonist
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name 4 direct-acting cholinergic agonists
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Acetylcholine Bethanechol Carbachol Pilocarpine
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what receptor types does ACh stimulate?
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both muscarinic and nicotinic
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what is the clinical use of ACh?
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achieve miosis during opthalmic surgery; otherwise it's rarely used due to widespread effects and its rapid hydrolysis in the synapse by ACh-ase
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what are the side effects from excessive cholinergic stimulation?
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DUMBBELSS Diarrhea Urination Miosis Bronchospasm Bradycardia Excitation of skeletal muscle and CNS Lacrimation Sweating Salivation
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what is the antidote to ACh-ase inhibitor poisoning?
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atropine (muscarinic antagonist) plus pralidoxime (chemical antagonist used to regenerate active cholinesterase)
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on what receptors does bethanechol work? what are the clinical uses?
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works primarily on muscarinic and a little on nicotinic receptors BBB: Bethanecol stimulates Bladder and Bowel used to increase intestinal motility and to treat urinary retention
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when is carbachol used?
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rarely, but can be used for glaucoma and to stimulate miosis in opthalmic surgery
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what is Xtraordinary about pilocarpine?
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is not cleaved by ACh-ase; affects mainly muscarinic receptors
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name 5 key indirect acting cholinergic agonists.
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Echothiophate Edrophonium Physostigmine Pyridostigmine Neostigmine
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Echothiophate
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organophosphate indirect acting cholinergic agonist; binds ACh-ase irreversibly
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how do you treat organophosphate poisoning?
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atropine gastric lavage and charcoal
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how can you mitigate the effects of organophosphates?
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pralidoxime (a cholinesterase reactivator)
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neostigmine
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indirect cholinergic agonist C: postoperative and neurogenic ileus, urinary retention, MGravis, post op reversal of neuromuscular blockade
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pyridostigmine
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STRONG indirect cholinergic agonist C: myasthenia gravis
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edrophonium
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indirect cholinergic agonist C: short acting, so used to diagnose MGravis
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physostigmine
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indirect cholinergic agonist (crosses BBB!) C: glaucoma and atropine O/D
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echothiophate
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indirect cholinergic agonist C: glaucoma
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what is pralidoxime?
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a cholinesterase reactivator
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what are the effects of organophosphate poisoning?
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respiratory muscle paralysis and convulsions
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what 3 antimuscarinics are used to produce mydriasis and cycloplegia in the eye?
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HAT Homatropine Atropine Tropicamide
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what antimuscarinic is used to treat Parkinson's?
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benztropine
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what antimuscarinic is used for motion sickness?
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scopolamine
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what antimuscarinic is used to trat asthma and COPD?
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ipratropium
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hexamethonium. mxn and clinical use?
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nicotinic ACh receptor antagonist; ganglionic blocker (prevent reflex bradycardia caused by NE)
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what is atropine and what are its typical effects?
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muscarinic blocker blocks SLUD Salivation Lacrimation Urination Defecation
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atropine side effects (typical antimuscarinic side effects)?
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hot as a hare dry as a bone red as a beet blind as a bat mad as a hatter
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what is cycloplegia?
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loss of function of the ciliary muscle -> loss of accomodation
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effects of atropine on the... eye airway stomach gut bladder
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