Parasympathetic drugs - Introduction, Cholinomimetics

Describe acetylcholine (ACh) except:

a. Stored in the vesicle via transporter Vesicle Associated Transporter (VAT)

b. Release is via exocytosis

c. Termination is through enzymatic degradation by metabolism via Acetylcholinesterase or inhibition of reuptake

d. None

d. None

True statements except:

a. Acetylcholinesterase is a hydrolase type of enzyme.

b. Acetylcholinesterase is responsible for the hydrolysis of acetylcholine to choline and acetate.

c. Acetylcholine is made up of choline and Acetyl CoA.

d. None

e. All

d. None

Cholinergic receptors except:

a. M1

b. M2

c. M3

d. N

e. None

e. None

Actions of M1 receptor.

a. Stomach hyperacidity: increased acid and pepsin secretion

b. Stimulation of ganglion

c. CNS neurotransmission

d. a and b

e. b and c

f. All

f. All

Actions of M2 receptor.

a. SA node: bradycardia

b. Atria: reduced contractility, contraction velocity, and refractory period

c. AV node: slows conduction, AV block

d. a and b

e. b and c

f. All

f. All

Primary actions of M1 receptor.

a. Stomach

b. Heart

c. Exocrine

d. Smooth muscles

e. a and b

f. c and d

a. Stomach

Primary actions of M2 receptor.

a. Stomach

b. Heart

c. Exocrine

d. Smooth muscles

e. a and b

f. c and d

b. Heart

Primary actions of M3 receptor.

a. Stomach

b. Heart

c. Exocrine

d. Smooth muscles

e. a and b

f. c and d

f. c and d

Actions of M3 receptor except:

a. Exocrine: increase secretion of salivary, sweat, and lacrimal gland

b. Smooth muscle contraction

c. Near vision, miosis, accomodation

d. None

d. None

Actions of M3 receptors except:

a. Bronchoconstriction

b. Increased stomach motility: bowel movement

c. Bladder contract detruser, relax sphincter: urination

d. Penis erection

e. None

e. None

Action of nicotinic muscular (Nm)

a. Skeletal muscle contraction

b. Ganglion stimulation

c. CNS neurotransmission

d. a and b

e. b and c

f. All

a. Skeletal muscle contraction

Action of nicotinic neural (Nn)

a. Skeletal muscle contraction

b. Ganglion stimulation

c. CNS neurotransmission

d. a and b

e. b and c

f. All

e. b and c

Primary actions of muscarinic receptor is on

I. Nerve

II. Heart and smooth muscle

III. Glands and endothelium

IV. Neuromuscular end plate, skeletal muscle

V. Autonomic ganglionic cells

a. I, II

b. I, II, III

c. IV

d. IV, V

e. I, V

b. I, II, III

Primary actions of nicotinic receptor is on

I. Nerve

II. Heart and smooth muscle

III. Glands and endothelium

IV. Neuromuscular end plate, skeletal muscle

V. Autonomic ganglionic cells

a. I, II

b. I, II, III

c. IV

d. IV, V

e. I, V

d. IV, V

Classifications of parasympathomimetics or cholinomimetics except:

a. Direct-acting: Alkaloids

b. Direct-acting: Choline esters

c. Indirect-acting: Reversible

d. Indirect-acting: Irreversible

e. Indirect-acting: CNS acting

f. None

f. None

Alkaloid parasympathetomimetic or cholinomimetic:

I. Arecoline

II. Pilocarpine

III. Muscarine

IV. Nicotine

V. Lobeline

VI. Varenicline

a. I

b. I, II

c. II, III

d. IV, V, VI

e. IV, VI

f. I, II, III, IV, V, VI

f. I, II, III, IV, V, VI

Nonselective alkaloid parasympathetomimetic or cholinomimetic:

I. Arecoline

II. Pilocarpine

III. Muscarine

IV. Nicotine

V. Lobeline

VI. Varenicline

a. I

b. I, II

c. II, III

d. IV, V, VI

e. IV, VI

f. I, II, III, IV, V, VI

a. I

Muscarinic selective alkaloid parasympathetomimetic or cholinomimetic:

I. Arecoline

II. Pilocarpine

III. Muscarine

IV. Nicotine

V. Lobeline

VI. Varenicline

a. I

b. I, II

c. II, III

d. IV, V, VI

e. IV, VI

f. I, II, III, IV, V, VI

c. II, III

Nicotinic selective alkaloid parasympathetomimetic or cholinomimetic:

I. Arecoline

II. Pilocarpine

III. Muscarine

IV. Nicotine

V. Lobeline

VI. Varenicline

a. I

b. I, II

c. II, III

d. IV, V, VI

e. IV, VI

f. I, II, III, IV, V, VI

d. IV, V, VI

Choline ester cholinomimetic:

I. Acetylcholine

II. Metacholine

III. Carbachol

IV. Bethanecol

a. I

b. I, II

c. I, II, III

d. III, IV

e. IV

f. I, II, III, IV

f. I, II, III, IV

Nonselective choline ester cholinomimetic:

I. Acetylcholine

II. Metacholine

III. Carbachol

IV. Bethanecol

a. I

b. I, II

c. I, II, III

d. III, IV

e. IV

f. I, II, III, IV

c. I, II, III

Muscarinic selective choline ester cholinomimetic:

I. Acetylcholine

II. Metacholine

III. Carbachol

IV. Bethanecol

a. I

b. I, II

c. I, II, III

d. III, IV

e. IV

f. I, II, III, IV

e. IV

Aka Urecholine.

a. Acetylcholine

b. Metacholine

c. Carbachol

d. Bethanecol

d. Bethanecol

Indirect-acting cholinomimetics:

a. Acetylcholinesterases inhibitors

b. Block enzymes for metabolism of choline

c. Block metabolism of acetylcholine

d. a and b

e. b and c

f. All

f. All

Reversible indirect-acting cholinomimetics

a. Amino alcohol

b. Carbamates

c. Organophosphate

d. a and b

e. b and c

f. All

d. a and b

Amino alcohol:

a. Reversible indirect-acting cholinomimetics

b. Short-acting

c. Example include Edrophonium (Tensilon)

d. a and b

e. b and c

f. All

f. All

Carbamates:

a. Reversible indirect-acting cholinomimetics

b. Intermediate-acting

c. Example include Neostigmine, Pyridostigmine, Physostigmine, Ambenonium, Demecarium

d. a and b

e. b and c

f. All

f. All

Tensilon

a. Edrophonium

b. Neostigmine

c. Pyridostigmine

d. Physostigmine

e. Ambenonium

f. Demecarium

a. Edrophonium

Eserine

a. Edrophonium

b. Neostigmine

c. Pyridostigmine

d. Physostigmine

e. Ambenonium

f. Demecarium

c. Pyridostigmine

Carbamates except:

a. Edrophonium

b. Neostigmine

c. Pyridostigmine

d. Physostigmine

e. Ambenonium

f. Demecarium

a. Edrophonium - this is AMINO ALCOHOL

Irreversible indirect-acting cholinomimetics

a. Amino alcohol

b. Carbamates

c. Organophosphate

d. a and b

e. b and c

f. All

c. Organophosphate

Organophosphate except:

a. Insecticides

b. Nerve gases

c. Antiglaucoma

d. None

e. All

d. None

Insecticides organophosphate

a. Malathion

b. Parathion

c. Echothiopate

d. a and b

e. b and c

f. All

d. a and b

Nerve gases organophosphate except:

a. Soman

b. Tabbun

c. Savin

d. Echothiopate

d. Echothiopate

Organophosphate used as antiglaucoma:

a. Soman

b. Tabbun

c. Savin

d. Echothiopate

e. Edrophonium

d. Echothiopate

CNS acting indirect-acting cholinomimetics used for Alzheimer's diseases except:

a. Galantamine

b. Rivastigmine

c. Donepezil

d. Tacrine

e. Pyridostigmine

f. None

e. Pyridostigmine

Bethanecol except:

a. Used for prevention of urinary retention

b. Used to stimulate smooth muscle motor activity for post-operative abdominal distention and for gastric atony

c. Administered IV or IM

d. Low lipid solubility; poor oral absorption (GI effects predominate)

e. Longer DOA

f. None

c. Administered IV or IM - it is administered PO or SC

Used for pulmonary challenge test; used to diagnose patients with suspected bronchial asthma.

a. Histamine

b. Methacholine

c. Bethenechol

d. Pilocarpine

b. Methacholine

Formerly used for pulmonary challenge test; it is now obsolete.

a. Histamine

b. Methacholine

c. Bethenechol

d. Pilocarpine

a. Histamine

Pilocarpine except:

a. For open-angle glaucoma

b. Effective anti-glaucoma agents

c. For acute narrow-angle glaucoma (combined with physostigmine)

d. Treatment of Sjogren Syndrome

e. None

e. None

Used for treatment of Sjogren Syndrome.

a. Histamine

b. Methacholine

c. Bethenechol

d. Pilocarpine

d. Pilocarpine

Pilocarpine when used for acute narrow-angle glaucoma is combined with

a. Galantamine

b. Rivastigmine

c. Neostigmine

d. Physostigmine

e. Pyridostigmine

d. Physostigmine

Used for chronic open-angle glaucoma

a. Physostigmine

b. Demecarium

c. Echothiophate

d. a and b

e. b and c

f. All

f. All

Combined with Pilocarpine for acute narrow close-angle glaucoma

a. Physostigmine

b. Demecarium

c. Echothiophate

d. Pyridostigmine

e. a and b

f. a, b, and c

a. Physostigmine

For GI and urinary tract atony

a. Galantamine

b. Rivastigmine

c. Neostigmine

d. Physostigmine

e. Pyridostigmine

f. Edrophonium

c. Neostigmine

For diagnosis of Myasthenia Gravis

a. Neostigmine

b. Pyridostigmine

c. Ambemonium

d. Edrophonium

e. a and b

f. a, b, and c

d. Edrophonium - TENSILON Test

Increase muscular strength for treatment of Myasthenia Gravis.

a. Neostigmine

b. Pyridostigmine

c. Ambemonium

d. Edrophonium

e. a, b, and c

f. a and d

e. a, b, and c

For eversal of Neuromuscular Blockade Toxicity characterized as excessive respiratory paralysis

a. Neostigmine

b. Pyridostigmine

c. Ambemonium

d. Edrophonium

e. a, b, and c

f. a and d

f. a and d

For Atropine and Scopolamine poisoning

a. Neostigmine

b. Pyridostigmine

c. Ambemonium

d. Edrophonium

e. Physostigmine

e. Physostigmine

Adverse effects of cholinomimetics except:

Diarrhea

Urination

Miosis

Bradycardia

Bronchocodilation

Emesis

Lacrimation

Salivation

Sweating

a. Urination

b. Bradycardia

c. Emesis

d. Salivation

e. Sweating

f. Bronchocodilation

f. Bronchocodilation - it should ne BRONCHOCONSTRICTION

Primary principal agent uses during cholinomimetic toxic syndrome.

a. Atropine

b. Pralidoxime

c. Diacetyl monoxime

d. a and b

e. b and c

f. All

a. Atropine

Adjunct in the treatment of DUMBBELSS.

a. Atropine

b. Pralidoxime

c. Diacetyl monoxime

d. a and b

e. b and c

f. All

b. Pralidoxime

Competitive, reversible muscarinic antagonist.

a. Atropine

b. Pralidoxime

c. Diacetyl monoxime

d. a and b

e. b and c

f. All

a. Atropine

Cholinesterase reactivator.

a. Atropine

b. Pralidoxime

c. Diacetyl monoxime

d. a and b

e. b and c

f. All

e. b and c