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WorksheetsDental Cholinergic, anticholinesterase and antimuscarinic agents
Total questions: 20
Worksheet time: 11mins
Which of the following best describes the action of pilocarpine ?
Blocks muscarinic M3 receptors in salivary glands
Stimulates muscarinic M3 receptors to increase salivary secretion
Stimulates muscarinic M1 receptor promoting salivation
Blocks nicotinic NM receptors at neuromuscular junctions
Bethanechol is useful for patients with urinary retention after anaesthesia using atropine-containing premedication.
True
False
Which of the following cholinergic agonists is most likely to cause bronchospasm?
Cevimeline
Bethanechol
Pilocarpine
Neostigmine
Indirect-acting cholinergic agonists can increase salivation by preventing ACh breakdown.
True
False
Which drug reverses atropine overdose?
Physostigmine
Neostigmine
Carbachol
Pilocarpine
Possible adverse effects of cholinergic agonists
Excessive sweating
Bradycardia
Dry mouth
urinary retention
Which receptor subtype mediates M3-induced salivary secretion?
G protein Gs → ↑ cAMP
G protein Gq → ↑ Ca²⁺, IP₃/DAG
Gi → ↓ cAMP
Ligand-gated Na⁺
Which muscarinic receptor antagonist is most likely to cause xerostomia in dental patients?
Atropine
Ipratropium
Benztropine
Oxybutynin
Scopolamine is commonly used to prevent headache during long transport.
True
False
A dental patient taking oxybutynin for urinary incontinence complains of difficulty wearing dentures due to dry mouth. What explains this?
Sympathomimetic effect
Muscarinic stimulation
Muscarinic blockade
Nicotinic activation
Select the likely adverse effects of systemic antimuscarinic use relevant to oral health:
Xerostomia
Dysphagia
Miosis
Tachycardia
During a restorative dental procedure, atropine was given to reduce salivation. Which ocular side effect may the patient report?
Blurred near vision and photophobia
Pupil constriction
Improved oral hygiene
Lacrimation
Ipratropium bromide produces CNS excitation similar to atropine.
True
FAlse
Which antimuscarinic is preferred to reduce salivation before oral surgery without CNS effects?
Scopolamine
Atropine
Glycopyrrolate
Benztropine
Which of the following are contraindications for antimuscarinic use?
Glaucoma
Asthma
Prostatic hypertrophy
Hypertension
Benztropine improves Parkinson’s rigidity by blocking central M1 receptors.
True
FAlse
A dental patient on donepezil for Alzheimer’s disease experiences excessive salivation during scaling.
What is the pharmacological explanation?
Increased acetylcholinesterase activity
Inhibition of acetylcholinesterase
Inhibition of dopamine reuptake
Blockade of nicotinic receptors
Which of the following best explains why neostigmine cannot reverse atropine toxicity in the CNS?
It is metabolized too quickly
It cannot cross the blood–brain barrier
It lacks affinity for muscarinic receptors
It binds irreversibly to acetylcholinesterase
Dental implications of antimuscarinic drug use include:
Difficulty wearing dentures
Altered taste
Delayed wound healing
Increased dental plaque
An elderly female presents with rampant caries and a medication list that includes benztropine and oxybutynin.What is the primary oral diagnosis linked to her medications?
Mucositis
Xerostomia
Candidiasis
.Tooth erosion
