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42 Cards in this Set
- Front
- Back
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How will a Muscarinic antagonist affect the eye?
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-Relax the sphincter circular muscle - mydriasis
-Relax the ciliary muscle - paralyse accomodation |
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How will a Muscarinic antagonist affect nonvascular smooth muscle? At what 3 sites?
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GI - decrease motility/secretion
Bladder - stop urination Bronchial - dilate airways |
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How will a Muscarinic antagonist affect exocrine gland secretion? At what 4 sites?
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-Decrease salivation
-Decrease lacrimation -Decrease sweating -Decrease mucosal secretions |
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How will a Muscarinic antagonist affect the heart?
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Increase heartrate
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How will a Muscarinic antagonist affect the CNS? (5 things)
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-Interfere with short term memory
-Delirium -Excitement -Agitation -Toxic psychosis |
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What are the 2 prototypes for Muscarinic antagonists?
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-Atropine
-Scopolamine |
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What are Atropine and Scopolamine also called historically?
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Belladonna Alkaloids
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Why belladonna?
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Because women used to put Atropine extracts on their faces to flush their cheeks and dilate their pupils to be beautiful
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What are 6 main uses of Atropine?
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1. Ophthlamic
2. Bradyarrythmias 3. GI 4. Urinary bladder spasms 5. CNS - parkinson's 6. treat organophosphate toxicity |
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What are the ophthalmic uses of Atropine?
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-Mydriasis and cycloplegia for eye exams
-Treat iritis/choroiditis |
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What 2 negative side effects can Atropine cause when given for ophthalmic use?
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-Increased IOP - acute glaucoma
-Systemic absorption and poisoning in children |
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Why isn't Atropine really used for decreasing acid secretion for peptic ulcers?
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Because it requires really high concentrations and better drugs are now available.
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What is Atropine used to treat in the CNS?
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Parkinson's disease - but there are better drugs for this too
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Which muscarinic antagonist is used to treat motion sickness?
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Scopalamine
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How is Scopalamine administered?
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In transdermal patches behind the ear
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What is Atropine used for treating in the urinary tract?
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Spastic bladder
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What is the 3rd muscarinic antagonist?
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Ipratropium
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So the 3 muscarinic antagonists are:
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ASI
-Atropine -Scopolamine -Ipratropium |
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What is Ipratropium used for treating?
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-COPD
-Asthma |
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How is Ipratropium administered?
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As an inhalant
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What type of amine does Ipratropium have and what is the consequence?
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Quanternary nitrogen - no CNS penetration
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What are the 5 side effects and symptoms of Muscarinic Antagonist Toxicity?
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-Hot as a hare (no sweat)
-Dry as a bone (no saliva) -Red as a beet (vasodilation) -Blind as a bat (mydriasis and cycloplegia) -Mad as a hatter (Psychosis) |
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What 3 conditions are contraindications to giving Muscarinic antagonists?
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1. Glaucoma
2. Prostatic hypertrophy 3. Tachycardia |
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Why is Glaucoma a contraindication?
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Muscarinic antagonists increase intraocular pressure
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Why is prostatic hypertrophy a contraindication?
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Because there is already resistance to urination; you don't want to antagonize it even more
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What is the treatment for increasing urination in prostatic hypertrophy?
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Prazosin (adrenergic antagonist)
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What is a disease where tachycardia would be a problem if you gave a Muscarinic antagonist?
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Angina pectoris
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Where does a Ganglionic Blocking Agent work?
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Between the Preganglionic neuron and the Postganglionic neuron
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What type of receptor is at the Ganglionic synapse?
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Nicotinic cholinergic
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Which autonomic systems act on the nicotinic neuronal receptors?
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Both - SNS and PNS
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What is the only current treatment use of ganglionic blockers?
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Hypertensive emergencies
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What agonist do we know works at nicotinic receptors?
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Nicotine
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Which nicotinic receptors does Nicotine work at?
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N-neuronal (ganglionic)
N-muscular (NMJ) N-CNS |
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How is Nicotine administered generally?
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In transdermal patches
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At what 3 peripheral sites is the predominant basal tone governed by the Sympathetic nervous system?
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-Arterioles
-Veins -Sweat glands |
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So what will be the effect of Neuronal ganglionic blockade at the SNS-governed sites?
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-Vasodilation
-Decreased sweating |
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What governs the heart tone at basal levels?
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Parasympathetic NS
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What is the only useful neuronal ganglionic blocker?
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Trimethaphan
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What is Trimethaphan used to treat?
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Hypertensive crises
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Why isn't Trimethaphan used to treat chronic hypertension?
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It has too many other side effects
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How is Trimethaphan administered? How long do its effects last?
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-IV
-Short acting |
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When is Trimethaphan used to control blood pressure?
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During surgeries
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