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30 Cards in this Set

  • Front
  • Back
What are cholinolytic agents?
Block cholinergic transmission
Muscarinic antagonists agents
Atropine
Scopolamine
Tropicamide
Cyclopentolate
Ipratropium bromide
Tiotropium bromide
Tolterodine
Oxybutynin
Darifenacin
Solifenacin
Dicyclomine
Hyoscyamine
Muscarinic antagonists MOA
competitive, reversible muscarinic blocker
What is the order of blockade of MOA?
Salivary, bronchial, sweat glands
Iris, ciliary muscle, heart
Bladder, gut
gastric acid secretion
What is the problem in using M antagonists to treat ulcers?
Need high concentrations and too many side effects
What are the therapeutic uses of muscarinic antagonists?
Mydriasis
Cycloplegia
Acute rhinitis
Asthma/COPD
Preanesthetic medication
Sedative/amnesia effects
Hyperactive carotid sinus
Vagal induced heart block
Ulcers
Irritable bowel syndrome
GI spasm
parathion/mushroom poisoning
motion sickness
urinary incontinence
What other drugs can cause mydriasis?
Alpha 1 agonists
Phenylephrine
What agents are used for mydriasis and cycloplegia?
Tropicamide--short
Atropine--long
Scopolamine--long
How does a muscarinic antagonist work on acute rhinitis?
Atropine blocks M receptor on nasopharyngeal glands --> decreased secretion in the respiratory tract
What is the advantage of using ipratropium bromide as opposed to atropine?
Less systemic absorption and less side effects
What muscarinic antagonist agents are used for asthma/COPD?
Ipratropium bromide--short DOA
Tiotropium bromide--long DOA
How does a muscarinic antagonist work on the lungs for asthma/COPD?
Ipratropium blocks M on lung --> bronchodilation
Why is advantageous for ipratropium bromide use in COPD?
An increase in cholinergic tone is a major reversible component in COPD and usually less side effects than beta agonists.
Why use a muscarinic antagonists prior to general anesthesia?
Atropine --> less secretions in respiratory tract
What can a therapeutic dose of scopolamine do?
CNS depression, depression, amnesia, fatigue, and dreamless sleep
Atroprine has no effect on ventricuar arrhythmias. Why?
Few M receptors in the ventricles.
What muscarnic agents are used for IBS?
Dicyclomine
Hyoscyamine
Why would you add a subtherapeutic dose of atropine to an opiod antiadiarrhea medication?
Prevent drug abuse
Will Atropine treat most of the symptoms of poisoning by inocybe mushrooms?
Yes
Will Atropine treat most of the symptoms of poisoning by parathion?
No...will need 2-PAM to block the nicotinic receptors
How does scopolamine used in motion sickness?
Vestibular apparatus (in inner ear) --> scopolamine --> M receptor --> blocks vomit center in medulla --> prevent motion sickness
What muscarinic antagonists are used for urinary incontinence?
Tolterodine
Oxybutynin chloride
Darifenancin
Solifenacin
Trospium chloride
How does muscarinic antagonists work for urinary incontinence?
Rem: ACh on M (detrusor muscle-contracts) and ACh on M (trigone muscle-relax) --> micturation --> block M receptors --> decrease urinary frequency
What are the CNS adverse effects of muscarinic antagonists?
Sedation or excitement
Disorientation, memory disturbances, dizziness, restlessness, hallucinations, delirium, and confusion
CNS effects in muscarinics...
Scopolamine > Atroprine >>>> Ipratroprium
Muscarinic antagonist contraindications
NAG
Effects of nicotine?
--Stimulation is followed by depression
--Increase in HR/BP
--NVD
--Stimulation and tremors
Ganglionic blocker agents
Trimethaphan
Mecamylamine
What is the MOA of ganglionic blockers?
nicotinic receptor antagonists
What is the clinical use of ganglionic blockers?
Obsolete--Mecamylamine was d/c then reintroduced --> nicotine withdrawl and Tourette's