Pharmacy Tech 2.3 Notes

  1. T/F- The PANS and SANS do not work together to maintain homeostasis
    False, It does
  2. What Activities does the PANS regulate
    Rest, digestion, and excretion. It increases GI/GU and decreases Cardiovascular
  3. Define: Acetylcholine (ACH)
    The PANS Neurotransmitter
  4. Define: Cholinergic Nerves
    Nerves that release ACH
  5. Define: Cholinergic Receptors
    Receptors that respond to ACH
  6. Define: Cholinergic Drugs
    Drugs that produce effects similar to ACH
  7. Define: Cholinergic Blocking Aggents
    Drugs that prevent ACH from acting upon its receptor
  8. Where is ACH formation and storage
    Withing the Cholinergic nerve endings
  9. What Happens when Cholinergic nerve endings are stimulated
    ACH is releases, and travels to cholinergic receptors
  10. What is AchE
  11. What is Acetylcholinesterase
    An enzyme found in the synapse at the cholinergic nerve endings
  12. What does ACHE do
    Metabolizes ACH when ACH is outside the nerve endings
  13. How long do the side effects of ACH last
    A few seconds
  14. What are the types of cholinergic receptors
    • Muscarinic Receptor
    • NI (Nn) Receptor
    • NII (Nm) Receptor
  15. What is the neurotransmitter for the cholinergic receptors
  16. What is Muscarinic
    The name for the cholinergic receptor at the parasympathetic postganglionic nerve ending
  17. What is Muscarine
    A series of species of mushroom
  18. What effects does muscarine produce
    Effects Similar to ACH, but only at Muscarinic receptors
  19. What drugs act like ACH or muscarine drugs at Muscarinic nerve endings
    Muscarinic drugs or cholinergic drugs
  20. What are drugs that block the ACH or muscarine at the muscarinic receptor
    Antimuscarinic drugs or anticholinergic
  21. What is the Nicotinic-I (NI) Receptor
    Another name for the cholinergic receptor at the ganglion of both PANS/SANS nerves
  22. What is the neurotransmitter for NI receptors
  23. What works like ACH at the NI receptor
  24. What does nicotine Cause to happen
    • Low doses- stimulate NI receptor
    • High Doses- block NI receptor
  25. What are ganglionic stimulants
    Drugs which act like ACH or low doses of nicotine at the NI receptor (Ex 1 cigarette)
  26. What are Ganglionic Blockers
    Drugs which act like high doses of nicotine (Ex one pack of cigarettes)
  27. What is NII
    Nicotinic II Receptors
  28. Where is the NII Receptor found
    The cholinergic receptor at the NMJ of the skeletal muscle
  29. What is the transmitter of NII
  30. What acts like ACH at the NMJ in NII
  31. What are drugs that block the effects of ACH at the NMJ
    • Neuromuscular Blockers
    • Skeletal Muscle Relaxants
  32. What drugs mimic the action of ACH at the cholinergic receptors
    Cholinergic drugs AKA Parasympathomimetics
  33. What are the types of cholinergic drugs
    • Direct Acting
    • Indirect Acting
  34. What are direct acting cholinergic drugs
    They bind to muscarinic receptors and produce effects similar to ACH
  35. What are Indirect acting
    They Inhibit the enzyme ACHE thereby allowing accumulation of ACH at the cholinergic recepor
  36. What is the DOA of ACH
    A few seconds
  37. How long are non ACH cholinergic metabolized by ACHE
    1 Hour or longer
  38. What is Acetylcholine interocular used for
    Cataract surgery
  39. What is Bethanechol used for
    Post-op urinary retention
  40. What are the types of direct acting cholinergics
    • Muscarine
    • Acetylcholine intraocular
    • Bethanechol
    • Piolocarpine
  41. What are effects caused by Direct acting cholinergics
    • GI- Increased motility and secretions
    • GU- Increased Urinary activity
    • Lungs- Bronchoconstriction
    • Eyes- Pupillary Constriction
  42. What are the uses of direct acting choinergics
    Glaucoma- increased pressure causes excess fluid production, miotics constrict the iris

    • Cataract surgery- Miotics constrict iris, drawing it away from the lens
    • Post-op Urinary Retention- Stimulate GI and GU peristalsis
  43. What is a cararact
    Opacities in the lens of the eye which results in blurred vision
  44. What is another name for indirect acting cholinergics
  45. What is the MOA of indirect acting cholinergics
    inhibit the enzyme ACHE allow the accumulation of ACH
  46. What are indirect acting cholinergic s used for
    Myasthenia gravis, antidote for curare poisoning, glaucoma, alzheimer's disease
  47. What do myasthenia gravis patients lack
    Enough ACH to adequately stimulate NII receptors this causes skeletal muscle tone to be weak, difficulty standing, breathing, raising head, eyelids characteristically droop
  48. What is indirect acting cholinergic used as a antidote for
    Curare poisoning
  49. What is curare
    A NMB used in darts to immobilize prey
  50. What does curare do
    Blocks ACH at the NII receptor of skeletal muscle, producing paralysis
  51. What does anticholinesterases do when curare is used
    Inhibit ACHE, allowing ACH to accumulate at the NII receptor, thereby reversing the effects of NMB
  52. What is alzheimer's disease
    A progressive form of dementia that occurs later in life, with short term memory loss, believed to be caused by damage to the cholinergic pathways, not ACH
  53. What are the types of indirect acting cholinergic's
    • Reversible inhibitors of ACHE
    • Irreversible inhibitors of ACHE
  54. What is the DOA for reversible inhibitors of ACHE
    10 min-36 hrs
  55. What do reversible inhibitors of ACHE bind to
  56. How is the reversible inhibitors of ACHE strength
    Bond is weak, after it wears off, ACHE is again able to metabolize ACH
  57. What are reversible inhibitors of ACHE agents
    • Edrophonium
    • Neostigmine
    • Pyridostigmine
    • Physostigmine
  58. What is the generic name for physostigmine
  59. What is physostigmine
    Cholinergic, indirect acting, reversible drug. Used as an antidote for anti-cholinergic poisoning
  60. What are irreversible inhibitors of ACHE
    Form an irreversible bond with ACHE
  61. How is the bond with irreversible inhibitors of ACHE
    Strong covalent bond can only be diminished by aging.
  62. What is the DOA for irreversible inhibitors of ACHE
    Very long 1-4 weeks
  63. What are some irreversible inhibitors of ACHE agents
    • Isoflourophate
    • Echothiophate Iodide
  64. What is the generic name for echothiophate iodide
    phospholine iodied
  65. What does echothiophate do
    A Cholinergic, indirect acting, irreversible. For Glaucoma
  66. What does adverse effects of cholinergic cause
    • Excess PANS stimulation
    • N/V/D
    • Miosis
    • Excessive sweating
    • Muscular tremors
    • Bronchoconstriction
    • Bradycardia and hypotension
  67. What are the toxic effects of cholinergics
    • Muscular paralysis
    • Respiratory depression
    • Death
    • Muscarinic poisoning (Caused by the mushroom Amanita Muscaria)
  68. What will the mushroom Amanita Muscaria cause
    • Symptoms are the same as for cholinergic poisoing
    • Death can occur within hours
    • The antidote for cholinergic poisoning is the anticholinergic drug
  69. What are Anticholinergic drugs
    Drugs which bind to muscarinic receptors also called parasympatholytics
  70. What is the MOA of anticholinergic drugs
    Competitive antagonism of ACH
  71. Where are the oldest anticholinergic drugs from
    The Belladonna Plant (Deadly nightshade)
  72. What are types of Belladonna Alkaloids
    • Atropine
    • Hyroscyamine
    • Scopolamine
  73. What are types of synthetic anticholinergics
    • Dicyclomine
    • Glycopyrrolate
    • Propantheline Bromide
    • Oxybutynin
    • Flavoxate
    • Tolterodine
  74. What are the cardiovascular effects of anticholinergic drugs
    ACH stimulates the vagus nerve, thus slowing the heart beat

    • Anticholinergic prevent the binding of ACH to cholinergic receptors in the heart
    • As the PANS decreases, the SANS increases producing Tachycardia
  75. What are the cardiovascular use of anticholinergic drugs
    Atropine may be given by injection or by ET tube for bradycardia
  76. What are the respiratory effects of anticholinergic drugs
    • ACH increases respiratory secretions and caused bronchoconstriction
    • Anticholinergic's prevent the binding of ACH to cholinergic receptors on the respiratory tract
  77. What are the respiratory uses of anticholinergic drugs
    • Atropine may be given pre-op to inhibit respiratory secretions which interfere with general anesthesia or intubations
    • Atropine may be given by nebulizer for asthma
  78. What are the GI effects of anticholinergic's
    • ACH increases GI motility and secretions
    • Anticholinergics prevet the binding of ACH to cholinergic receptors in the bowel and stomach
    • This relaxes intestinal smooth muscle and inhibits GI secretions
  79. What are the GI uses of anticholinergics
    • IBS
    • Adjunctin the treatment of peptic ulcer
  80. What are the CNS effects of anticholinergics
    • ACH receptors are located in the brain
    • When blocked by anticholinergics, drowsiness and sedation occur
    • Respiratory depression and death occur as the dose becomes toxic
  81. What are CNS uses of anticholinergics
    • Cold symptoms
    • Motion sickness
    • Parkinson's disease
  82. What is Parkinson's disease
    There is too much ACH and not enough DA in areas of brain responsible for movement
  83. What are the GU effects of anticholinergics
    • ACH contract the bladder, voiding urine
    • Anticholinergics inhibit urinary peristalsis and the voiding of urine
    • Used for bladder spasms and enuresis
  84. What are ocular effects of anticholinergics
    • ACH constricts the pupils, producing miosis
    • Anticholinergics block ACH, producing mydrias and cycloplegia
    • Used for retinal exams, iritis
  85. What are adverse effects of anticholinergics
    • Drowsiness/dizziness
    • Dry mouth, constipation, dry skin
    • Blurred vision, mydriasis, photophobia
  86. What are cholinesterase reactivators
    • Protopam
    • Reactivates ACHE after it has been inactivated by an irreversible inhibitor
    • Most effective immediately after exposure
Card Set
Pharmacy Tech 2.3 Notes
Pharmacy Tech 2.3 Notes