Pharm Chapter 19

Question 1

Acetylcholine is:

Answer 1

1. One of the primary neurotransmitters in the ANS

2. The neurotransmitter at the skeletal neuromuscular junction

Question 2

How do autonomic cholinergic drugs affect synaptic activity?

Answer 2

by interacting with the acetylcholine receptor

Question 3

Types of Cholinergic receptors

Answer 3

Muscarinic - found on peripheral tissues

Nicotinic- located at skeletal neuromuscular junction

Question 4

Two categories of cholinergic drugs

Answer 4

1. Cholinergic stimulant- increase activity at Ach synapses
2. Anticholinergic drugs- diminish the response of tissue to cholinergic stimulation
   a. antinicotinic anticholinergic
   b. Antimuscarinic anticholinergic

Question 5

Cholinergic Stimulants

Answer 5

Direct acting and Indirect acting (anticholinesterase) agents

Question 6

Direct Acting Cholinergic drugs

Answer 6

MOA: bind directly to cholinergic receptor to activate it initiating a response
Drugs by condition:
Gastrointestinal and urinary bladder: Bethanechol
Glaucoma: Carbachol, Pilocarpine
Side effects: GI (nausea, vomiting, diarrhea), increase salivation, bradycardia, increased sweating, flushing

Question 7

Indirect acting cholinergic stimulants

Answer 7

MOA: inhibit acetylcholinesterase enzyme found at all cholinergic synapses
Drugs by condition:
Alzheimer’s Disease (Aricept, Remingl, Exelon, Cognex)
Reversal of Neuromuscular Blockage
Myasthenia gravis
Reversal of Anticholinergic induced CNS toxicity
Side effects: GI (Nausea, vomiting, diarrhea), increase salivation, bradycardia, increased sweating, flushing.

Question 8

Antimuscarinic anticholinergic drugs

Answer 8

MOA: block the postsynaptic cholinergic muscarinic receptor.
Drugs by condition/disease:
Multi-use (atropine)
GI ( Bentyl, hyoscyamine, homatropine) aka antispasmodics
Parkinson Disease (Benztropine, trihexyphenidyl)
Motion sickness (Scopolamine)
Urinary Tract (Detrol)
Respiratory Tract (Ipratropium, Tiotropium)
Side effects: dryness of mouth, blurred vision, urinary retention, constipation, tachycardia

Question 9

Anticholinergic Drugs

Answer 9

Antimuscarinic anticholinergic drugs