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The main questions of the theme

What are the functions of autonomic nervous system?

How is acetylcholine synthesized and terminated at the nerve terminals? At what sites acetylcholine is released?

Describe the synthesis, storage, release and termination of norepinephrine at the postganglionic sympathetic nerve terminals.

What do you understand by uptake (reuptake) of norepinephrine? What is its significance?

What are the different types of cholinoceptors and their location?

What are muscarinic and nicotinic actions of acetylcholine?

Classify cholinomimetic drugs.

Compare choline esters regarding receptor specificity and hydrolysis by acetylcholinesterases.

Which alkaloids have cholinergic effects? What are the uses and adverse effects of carbachol and pilocarpine?

Describe the effects of cholinergic drugs on different organ systems.

List the drugs which inhibit cholinesterases. What are their uses and adverse effects? How are these adverse effects treated?

Write prescriptions for next drugs and note their indications and contraindications (precautions):

1. Direct-acting cholinomimetic that is lipid-soluble and is favored in the treatment of glaucoma

2. Indirect-acting cholinomimetic with a duration of many days; used in the treatment of glaucoma

3. Indirect-acting carbamate cholinomimetic; poor lipid solubility; duration of action about 2-4 hours

4. An ester of carbaminic acid, resistant to cholinesterase, orally active, poor lipid solubility, acting mainly on muscarinic cholinoceptors.

5. Agent that is normally released from sympathetic nerve endings innervating thermoregulatory sweat glands

6. Indirect-acting cholinomimetic, tertiary amine, lipid soluble; duration of action 30 minutes to 2 hours.

7. Indirect-acting carbamate cholinomimetic, quarternary amine, poor lipid solubility, orally active, duration of action 4 to 8 hours.

8. Indirect-acting cholinomimetic, alcohol, quarternary amine, poor lipid solubility, not orally active; 5-15 minutes duration of action

9. An ester of carbaminic acid, resistant to cholinesterase, orally active, poor lipid solubility, acting on both types of cholinoceptors.

10. Indirectly acting drug that releases norepinephrine and dopamine from their nerve endings


Amphetamine T.5,10-PO
Acethylcholine 10/ml-Eye drops
Betanechol T.5,10,25,50-PO; A.5/ml-SC
Carbachol 0.75, 1.5, 2.25, 3% Eye drops - Top
Pilocarpine 0.25,0.5,1,2,3,4,6,8, 10%-Eye drops, 4%-Eye gelum
Echothiophate 0.03%, 0.06, 0.125, 0.25%-Eye drops
Edrophonium 10/ml-IV, IM injections
Neostigmine T.15-PO, 0.1%-10 ml,0.05%,0.025%-1 ml solutions for injections
Pyridostigmine T.60,180, 5/ml-IV, IM-for injections
Physostigmine 0.25, 0.5%-Eye drps; 0.25%-Eye ointment, 1/ml-IV,IM


5. Teaching methods working in pairs, the prescription writing of drugs for concrete situations; training, defining terms, solving problems, answer questions, working out examples (of the slides, of the handbooks and handouts), MCQs.



1.Katzung B. G., ed. 2001. Basic and Clinical Pharmacology, 8th ed., Lange Medical Books/McGraw-Hill, Appleton and Lange. PP. 107-119, 446-462.

2.Katzung B.G., Trevor A.J., ed. 1998, Examination & Board Rewiew. 5th ed., Stamford, Connecticut, Appleton & Lange. PP. 61-68, 205-212.

2.Tripathi K.D., ed.1999, Essentials of Medical Pharmacology. 4th ed., New Delhi, India, Jaypee Brothers. PP. 103-114, 148-159.

3.Sharma V.N., ed.1996 Essentials of Pharmacology. 1th ed., New Delhi, India, CBS Publishers & Distributors. PP. 54-58, 69-70, 119-125.

7. Assessment Prescriptions Writing, MCQs, ECQs.

Date: 2014-12-28; view: 772

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