hasidaho.blogg.se - Sketchy micro and pharm

High -P as a Kettle Î Mydriasis Æ Decreased Outflow of Aqueous Humor (due to narrowing of anterior chamber).Blind as a Bat Î Mydriasis and Cycloplegia Æ blurred vision.Block the Cholinomimetic effects Muscarinic Rs: Reversibly block the action of Ach at M Rs. Pralidoxime is ineffective once aging of organophosphatecholinesterase complex has occurredġ.3 – muscarinic antagonists “Atropine in Wonderland” ■ “aging: of the organophosphate-cholinesterase complex leads to irreversible binding. Poisoning (pralidoxime is peripheral only) ■ Atropine reverses both peripheral and CENTRAL muscarinic toxicity from organophosphate ■ praLIDoxime reverses organophosphate toxicity (DUMBBELS) by regenerating Achesterase and NICOTINIC R (reverses cholinergic toxicity INCLUDING FLACCID PARALYSIS) ■ Physostigmine (and organophosphates) enters CNS to cause central cholinergic effects & Jimson weed is a naturally occurring form of atropine

■ reverses atropine overdose (mad as a hatter, hot as a hare, blind as a bat) Æ Belladonna flower

PHYSostigmine (acetylcholinesterase inhibitor with CENTRAL effects) + organophosphates enter CNS to.

■ Tertiary amines – peripheral and CENTRAL effects ■ Galantamine & Rivastigmine & Donepezil (acetylcholinesterase inhibitor used to treat Alzheimer’s disease) Of depolarizing blockade is IRREVERSIBLE (acetylcholinesterase inhibitors potentiate blockade) ■ Succinylcholine is a depolarizing neuromuscular blocking agent (nicotinic Ach receptor AGONIST). tubocurarine, pancuronium, cisatracurium) inhibit nicotinic Ach ■ Nondepolarizing NM blocking agents (e.g. IFFFF edrophonium FAILS to reverse muscle weakness during cholinergic crisis (NEGATIVE tensilon test)

Tensilon test Æ edrophonium reverses (positive) or fails to reverse (negative) muscle weakness. Edrophonium REVERSES muscle weakness in undertreated MG patients (POSITIVE tensilon test). Edrophonium (Achesterase (-) that transiently reverses S/S of MG for 5-15 mins) Æ used as a diagnostic tool.Over stimulating and leading to refractory Your office with worsening muscle weakness Rx urinary retention (muscarinic activation) Neostigmine (AChesterase inhibitor used as Rx for MG). PYRIDOstigmine (AChesterase inhibitor used as long-term Rx for MG) Æ increase Ach at NMJ endplate to outcompete MG antibodies ■ Quarternary amines, do not penetrate the CNS: Pogressive proximal weakness, ptosis, diplopia (inactivated nicotinic Ach R at ■ Myasthenia Gravis Æ Ab against nicotinic Ach R motorĮndplate (skeletal muscle NMJ). Organophosphates are a major cause of acute ■ THIOL spray: insecticides (parathion, malathion,Įchothiophate) are organophosphates, a type ofĪcetylcholinesterase inhibitor (also includes nerve agents and Paralysis (NMJ nicotinic Ach receptor over-activation) ■ Acetylcholinesterase inhibitor toxicity includes flaccid Urination, Miosis, Bronchospasm, Bradycardia, Lacrimation, ■ DUMBBELS: acetylcholinesterase inhibitor toxicity (Diarrhea, NMJ (increase activity of NICOTINIC ACh receptors) ■ Acetylcholinesterase inhibitors enhance effects of ACh at the ■ Indirect cholinomimetics (inhibit acetylcholinesterase).Īcetylcholinesterase inhibitors ↑ synaptic “-stigmine” ■ Varenicline (a nicotinic receptor partial agonist) is used for smoking cessationġ.2 – Acetylcholinesterase inhibitors “Stigmata Gravis” Contracts bronchial smooth muscle which may ■ Methacholine Æ instigates asthma for pulmonary testing. ■ Carbachol causes pupillary constriction (useful in acute angle-closure glaucoma). Annya’s Sketchy Pharm Credits: Arber Frakulli, Henika Kaura