After teaching a group of students about indirect acting cholinergic agonists used to treat myasthenia gravis, the instructor determines that the teaching was effective when the students identify which agent?
a. rivastigmine
b. neostigmine
c. tacrine
d. galantamine

B. Neostigmine

Explanation:

Myasthenia gravis is an autoimmune disorder in which neurotransmitter acetylcholine receptors present at nerve and muscle junctions are destroyed. As a result muscle contractions are inhibited leading to muscle weakness.

Cholinergic agonists are medicine which resemble acetylcholine in structure and action. They can be direct acting and indirect acting. Indirect acting cholinergic agonists increase acetylcholine availability at cholinergic receptors. Examples of such agents are neostigmine, physostigmine, pyridostigmine etc. Hence if the students are able to identify Neostigimine as indirect acting cholinergic agent, the teaching was effective.

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