Medical Pharmacology: Cholinergic Drugs

Classes of anticholinesterase drugs:
1. reversible, short-acting
2. intermediate, carbamylating
3. long-acting, phosphorylate agents
4. A & B
5. A, B & C
anticholinesterase agent; quaternary ammonium compound; intermediate-duration, carbamylating agent:
1. physostigmine (Antilirium)
2. neostigmine (Prostigmin)
3. edrophonium (Tensilon)
4. tacrine (Cognex)
5. atropine
Renal clearance -- acetylcholinesterase inhibitors--
1. actively secreted into renal tubule lumen
2. renal clearance: 50% for neostigmine (Prostigmin)
3. renal clearance: 75% for edrophonium (Tensilon) and pyridostigmine (Mestinon)
4. all of the above
More lipophilic:
1. neostigmine (Prostigmin)
2. most organophosphate acetylcholinesterase inhibitors
In organophosphate poisoning, this agent may be capable of re-activating inhibited acetylcholinesterase:
1. atropine
2. pilocarpine (Pilocar)
3. mecamylamine (Inversine)
4. 2-PAM
5. all of the above
Consequences of acetylcholinesterase inhibitor application to the conjunctiva
1. relaxation of the pupillary sphincter muscle
2. relaxation of the ciliary muscle
3. both
4. neither
Types of glaucoma:
1. primary
2. secondary
3. congenital
4. all the above
Which type of glaucoma response to anticholinesterase treatment?
1. primary
2. secondary
3. congenital
Anticholinesterases: used in treating glaucoma--
1. echothiophate (Phospholine)
2. demecarium (Humorsol)
3. atropine (generic)
4. A & B
5. A, B, & C
Probable cause of myasthenia gravis:
1. excessive synthesis of cholinergic receptors
2. inadequate synthesis of acetylcholine
3. failure of acetylcholine reuptake system
4. binding of anti--muscarinic receptor antibodies to the muscarinic cholinergic receptor
5. binding of anti-nicotinic receptor antibodies to the nicotinic cholinergic receptor
Rationale for prescribing anticholinesterase drugs to patients with myasthenia gravis:
1. increase acetylcholine turnover
2. increase receptor number
3. increase amount of acetylcholine available of neuromuscular junctions
4. reduce choline reuptake
5. all of the above
Associated disorders in myasthenic patients --
1. thymic abnormalities
2. hyperthyroidism
3. other autoimmune disorders
4. ventilatory dysfunction
5. all the above