Cholinergic Agonists and Antagonists: Pharmacology and Clinical Applications

Question 1

Which of the following drugs is used to reverse the effects of anticholinesterase agents?

Accepted Answer

Atropine

Answer

Neostigmine

Answer

Prustigmine

Answer

Succinylcholine

Question 2

Which of the following cholinergic agonists is used to treat glaucoma?

Accepted Answer

Pilocarpine

Answer

Bethanechol

Answer

Carbachol

Answer

Pyridostigmine

Question 3

Which of the following drugs is NOT used to treat Alzheimer's disease?

Accepted Answer

Memantine

Answer

Donepezil

Answer

Galantamine

Answer

Rivastigmine

Question 4

Which muscarinic acetylcholine receptor (mAChR) subtype is primarily responsible for mediating smooth muscle contraction?

Accepted Answer

M3

Answer

M1

Answer

M2

Answer

M4

Question 5

Which drug is a selective antagonist of muscarinic acetylcholine receptors?

Accepted Answer

Muscarinic acetylcholine receptors

Answer

Nicotinic acetylcholine receptors

Answer

Ionotropic glutamate receptors

Answer

GABAA receptors

Question 6

What is the primary mechanism of action of cholinesterase inhibitors?

Accepted Answer

Enhance cholinergic transmission

Answer

Block cholinergic transmission

Answer

Stimulate dopamine release

Answer

Inhibit GABA release

Question 7

Which of the following is a potential long-term adverse effect of cholinesterase inhibitors?

Accepted Answer

Ocular myasthenia

Answer

Hypertension

Answer

Tardive dyskinesia

Answer

Epileptic seizures

Question 8

Which of the following is NOT a mechanism of action of indirect-acting cholinergic agonists?

Accepted Answer

Direct activation of muscarinic acetylcholine receptors

Answer

Inhibition of acetylcholinesterase

Answer

Stimulation of nicotinic acetylcholine receptors

Answer

Release of acetylcholine from presynaptic terminals

Question 9

What is the primary mechanism of action of muscarinic antagonists?

Accepted Answer

Blockade of muscarinic receptors

Answer

Inhibition of acetylcholine synthesis

Answer

Activation of nicotinic receptors

Answer

Stimulation of muscarinic receptors

Question 10

Explain the key difference between direct-acting and indirect-acting parasympathomimetic drugs.

Accepted Answer

Direct-acting drugs bind directly to muscarinic receptors, while indirect-acting drugs inhibit acetylcholinesterase.

Answer

Indirect-acting drugs bind directly to muscarinic receptors, while direct-acting drugs inhibit acetylcholinesterase.

Answer

Direct-acting drugs stimulate nicotinic receptors, while indirect-acting drugs inhibit nicotinic receptors.

Answer

Indirect-acting drugs stimulate nicotinic receptors, while direct-acting drugs inhibit nicotinic receptors.

Question 11

Which of the following medications is commonly used to treat overactive bladder?

Accepted Answer

Oxybutynin

Answer

Salmeterol

Answer

Albuterol

Answer

Ipratropium

Question 12

In the emergency management of cholinergic crisis, which antidote is typically administered?

Accepted Answer

Atropine

Answer

Pralidoxime

Answer

Naloxone

Answer

Flumazenil

Question 13

Which of the following is a known side effect associated with the use of botulinum toxin?

Accepted Answer

Ptosis

Answer

Tachycardia

Answer

Bronchospasm

Answer

Hypertension

Question 14

Describe the primary mechanism of action of botulinum toxin.

Accepted Answer

Inhibition of acetylcholine release

Answer

Activation of muscarinic receptors

Answer

Blockade of nicotinic receptors

Answer

Stimulation of nicotinic receptors

Question 15

Which of the following is a directly acting cholinergic agonist that directly binds to and activates cholinergic receptors?

Accepted Answer

Acetylcholine

Answer

Pilocarpine

Answer

Pyridostigmine

Answer

Neostigmine

Question 16

What is the primary mechanism of action of cholinesterase inhibitors? How do these drugs exert their effects?

Accepted Answer

Inhibiting the breakdown of acetylcholine, thereby increasing the concentration of acetylcholine in the synaptic cleft

Answer

Blocking nicotinic receptors

Answer

Stimulating ACh synthesis

Answer

Activating muscarinic receptors

Question 17

Which of the following is a major therapeutic use of cholinergic agonists and their potential clinical applications?

Accepted Answer

Treatment of myasthenia gravis, a neuromuscular disorder characterized by muscle weakness

Answer

Treatment of hypertension

Answer

Treatment of arrhythmias

Answer

Treatment of Parkinson's disease

Question 18

Which of the following is a common adverse effect associated with the administration of cholinergic agonists? Identify a potential adverse effect.

Accepted Answer

Bradycardia, a decrease in heart rate

Answer

Tachycardia

Answer

Hypertension

Answer

Arrhythmias

Question 19

Which of the following is a non-selective muscarinic antagonist that blocks both M1 and M2 muscarinic receptors?

Accepted Answer

Atropine

Answer

Tiotropium bromide, a long-acting anticholinergic used in COPD

Answer

Ipratropium bromide, a short-acting anticholinergic used in asthma

Answer

Scopolamine, an anticholinergic with sedative effects

Question 20

What is the primary mechanism of action of muscarinic antagonists? How do these drugs achieve their effects?

Accepted Answer

Blocking muscarinic receptors, preventing the binding of acetylcholine to these receptors and inhibiting their downstream signaling pathways

Answer

Inhibiting acetylcholinesterase

Answer

Stimulating nicotinic receptors

Answer

Activating muscarinic receptors

Question 21

Which of the following is a major therapeutic use of muscarinic antagonists and their clinical applications?

Accepted Answer

Treatment of asthma, a chronic respiratory condition characterized by airway inflammation and bronchospasm

Answer

Treatment of Parkinson's disease

Answer

Treatment of hypertension

Answer

Treatment of arrhythmias

Question 22

Which of the following is a nicotinic antagonist that blocks nicotinic acetylcholine receptors?

Accepted Answer

Hexamethonium

Answer

Scopolamine

Answer

Atropine

Answer

Ipratropium bromide

Question 23

What is the primary mechanism of action of nicotinic antagonists? How do these drugs achieve their effects?

Accepted Answer

Blocking nicotinic receptors, preventing the binding of acetylcholine to these receptors and inhibiting their downstream signaling pathways

Answer

Stimulating muscarinic receptors

Answer

Activating nicotinic receptors

Answer

Inhibiting acetylcholinesterase