Test: Autonomic Nervous System - 4 - NEET PG MCQ

Cholinergic medications enhance gastrointestinal motility. Neostigmine inhibits the enzyme AChE, which is responsible for the decomposition of ACh. Therefore, it functions similarly to a cholinergic agent.

• Glycopyrrolate and atropine are anticholinergic drugs, which consequently diminish GI motility.
• Fentanyl, an opioid, can lead to constipation.

All of these medications have anticholinergic characteristics. Glycopyrrolate is unable to penetrate the blood-brain barrier, which means it does not have central effects. In contrast, atropine sulphate can pass through the blood-brain barrier, while atropine methonitrate is a quaternary ammonium compound and lacks central action.

• No consistent or significant impact on blood pressure; however, hypotension may arise due to histamine release and direct vasodilatory effects at high doses.
• Tachycardia and stimulation of the vasomotor centre generally increase blood pressure.

• M₂ cholinergic receptors are linked to bradycardia, and their blockade can cause tachycardia.
• Initially, atropine targets presynaptic M₁ receptors, which typically reduce the release of ACh, resulting in increased ACh release that contributes to bradycardia.
• Subsequently, the inhibition of M₂ receptors leads to tachycardia.

Hyoscine acts as a CNS depressant and may be utilized as a truth serum (to induce a state of twilight sleep). At low doses, atropine stimulates the brain, while at significantly high concentrations, it has an inhibitory effect.

Glycopyrrolate is utilised to diminish secretions (to avert reflex bronchospasm) during anaesthesia. Its primary application is as a pre-anaesthetic medication.

As a tertiary amine, physostigmine is capable of counteracting the central nervous system effects caused by belladonna (the source of atropine) poisoning. Thus, it is regarded as the preferred antidote for this specific form of poisoning.

• Atropine is not recommended for use in children because of the potential risk of hyperthermia.

The discovery of penicillin marked a significant turning point in medical history. This antibiotic, derived from the mould Penicillium notatum, was first discovered by Alexander Fleming in 1928. Its introduction into medical practice in the 1940s transformed the treatment of bacterial infections.

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• Prior to penicillin, many bacterial infections were often fatal.
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• Penicillin was instrumental in reducing mortality rates during World War II.
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• The widespread use of this antibiotic paved the way for the development of other antibiotics.
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• However, the overuse and misuse of antibiotics have led to the emergence of resistant strains of bacteria, raising concerns about future treatments.
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Despite these challenges, penicillin continues to be a foundational drug in the fight against infections. Its discovery not only changed the landscape of medicine but also saved countless lives.

Atropine is classified as an anticholinergic medication. It reduces bowel sounds.

• Dry mouth (rather than increased salivation)
• Warm skin
• Dilated pupils and sensitivity to light
• Agitation
• Skin flushing
• Low blood pressure leading to cardiovascular failure
• Seizures and loss of consciousness

Hyoscine is utilised for the prevention of motion sickness, while the other medications mentioned in the question are employed for the management of vomiting.

To ensure the successful completion of a project, it is essential to adhere to the following guidelines:

• Establish clear objectives and goals that align with the overall mission.
• Maintain open communication among all team members to foster collaboration.
• Regularly review progress and make adjustments as necessary to stay on track.
• Document all key decisions and developments to maintain clarity and accountability.

By following these principles, teams can enhance their chances of achieving desired outcomes effectively.