Term
What are cholinesterase inhibitors? |
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Definition
Drugs that prevent the degradatin of ACh by acetylcholinesterase (also known as cholinesterase ChE). |
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Term
How do choinesterase inhibitors (cholinergic agonists) work? |
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Definition
prevent inactivation of ACh and enhance actrions of ACh released from cholinergic neurons.
can be viewed as Indirect-acting cholinergic agonists |
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Term
What is the protogype for reversible cholinesterase inhibitors?
What is it's mechanism of action? |
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Definition
Prostigmin
Action: Binds to cholinesterase preventing destracting of ACh resulting in more ACh available in neuromuscular junction |
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Term
What are the uses for reversible cholinesterase inhibitors?
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Definition
1. PRIMARY - **Myasthenia Gravis - benefits derive from accumulation of ACh at the NMJ's.
SECONDARY
2. Alzheimers Disease - aricept, exelon
3. Reverse neuromuscular blocking agents
4. Atropine poisoning
5. Military Use: pretreat for nerve gas exposure |
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Term
What are the ADRs - Contraindications? |
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Definition
1. Limited CNS effects
2. Muscarinic stimulation
3. Cholinergic crisis - treatment is atropine! |
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Term
What are irreversible cholinesterase inhibitors used for? |
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Definition
1. Insecticides!
2. ONLY glaucoma |
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Term
Because irreversible cholinesterase inhibitors are highly lipid soluble, what can happen when handling them? |
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Definition
Easily absorb through the skin and distribute to all tissues and organs |
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Term
What is the result of overdose with cholinesterase inhibitors? |
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Definition
Cholinergic crisis - death results from respiratory depression |
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Term
What is the treatment for poisoning with reversible cholinesterase inhibitos? |
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Definition
Atropine and mechanical ventilation |
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Term
What is the treatment for poisoning with irreversible cholinesterase inhibitors?
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Definition
Atropine
mechanical ventilation
pralidoxime
Valium to prevent seizures |
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