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27 Cards in this Set
- Front
- Back
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1. What kind of linkage is needed for binding anticholinergics to the acetylcholine receptors?
a. Ester Linkage b. Acetyl Linkage c. Carbonic Linkage d. Amide Linkage |
a
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2. According to M/M, why does bradycardia occur when low doses of anticholinergics are given?
a. Because anticholinergics block sympathetic receptors b. Because anticholinergics agonize sympathetic receptors c. Because anticholinergics block cholinergic receptors d. Because anticholinergics agonize cholinergic receptors |
d
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3. Which of the following is NOT correct with regards to cardiovascular activity seen with anticholinergics?
a. Anticholinergics block muscarinic receptors in the SA node b. Anticholinergics alter ventricular function and can cause ventricular dysrhythmias c. Low doses of anticholinergics can cause bradycardia d. Large doses of anticholinergics can result in dilatation of cutaneous blood vessles |
b
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4. Which of the following is not an effect of anticholinergic
a. Decrease airway resistance b. Can cause cerebral excitation, restlessness, or hallucinations c. Increases intestinal motility and peristalsis d. Causes Mydriasis and cycloplegia |
c
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5. You have given a large dose of scopolamine to your patient and are now questioning your patient having central anticholinergic syndrome. Which of the following will not be seen if CAS is present?
a. Mydriasis b. Cerebral depression c. Increase in body temperature d. Perfuse sweating |
d
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6. In which of the following patients should atropine not be used with caution?
a. A septic patient b. A patient with narrow-angle glaucoma c. A patient with prostatic hypertrophy d. A patient with bladder-neck obstruction |
a
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7. Which of the following is correct with regards to the potency of antisialagogue effects of anticholinergics?
a. Scopalamine > atropine> Robinol b. Robinol > Scopalamine > atropine c. Scopalamine > Robinol > Atropine d. Atropine > Robinol > Scopalamine |
c
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8. What is the primary reason for using robinol as a premed?
a. Antisialagogue b. Sedation c. Prevent motion sickness d. Increase HR |
a
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_______________ is essential for effective binding of the anticholinergics to the acetylcholine receptors.
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Ester linkage
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______________ relax the bronchial smooth musculature, which reduces airway resistance and increases anatomic dead space.
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Anticholinergics
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___________ has particularly potent effects on the heart and bronchial smooth muscle and is the most efficacious anticholinergic for treating bradyarrhythmias.
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Atropine
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______________ is a more potent antisialagogue than atropine and causes greater central nervous system effects
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Scopolamine
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Because of a quaternary structure, _____________ cannot cross the blood–brain barrier and is almost always devoid of central nervous system and ophthalmic activity.
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glycopyrrolate
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Anticholinergics are esters of an _________ combined with an organic base. The ester linkage is essential for effective binding of the anticholinergics to the acetylcholine receptors
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aromatic acid
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Blockade of ___________ in the sinoatrial node results in tachycardia.
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muscarinic receptors
This effect is especially useful in reversing bradycardia due to vagal reflexes |
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anticholinergics
Respiratory 2 |
inhibit the secretions of the respiratory tract mucosa
Relaxation of the bronchial smooth musculature reduces airway resistance |
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anticholinergics
Cerebral |
a spectrum of central nervous system effects ranging from stimulation to depression, depending on drug choice and dosage. Stimulation may present as excitation, restlessness, or hallucinations. Depression can cause sedation and amnesia. Physostigmine, a cholinesterase inhibitor that crosses the blood–brain barrier, promptly reverses these actions
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anticholinergics
Gastrointestinal |
Salivary secretions are markedly reduced by anticholinergic drugs. Gastric secretions are also decreased, but larger doses are necessary.
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Ophthalmic
Anticholinergics |
Anticholinergics cause mydriasis (pupillary dilation) and cycloplegia (an inability to accommodate to near vision); acute angle-closure glaucoma is unlikely following systemic administration of most anticholinergic drugs
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Genitourinary
Anticholinergics |
Anticholinergics may decrease ureter and bladder tone as a result of smooth muscle relaxation and lead to urinary retention, particularly in elderly men with prostatic hypertrophy
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Anticholinergics
Thermoregulation |
Thermoregulation
Inhibition of sweat glands may lead to a rise in body temperature (atropine fever). |
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the most efficacious anticholinergic for treating bradyarrhythmias
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Atropine
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Scopolamine
Clinical dosages usually result in |
drowsiness and amnesia
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scopolamine is best avoided in patients with
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closed-angle glaucoma.
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glycopyrrolate cannot cross the blood–brain barrier because
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Because of a quaternary structure,
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Glycopyrrolate duration of action
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Glycopyrrolate has a longer duration of action than atropine (2–4 h versus 30 min after intravenous administration).
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effectively reverses central anticholinergic toxicity.
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Physostigmine, a tertiary amine, is lipid soluble and effectively reverses central anticholinergic toxicity.
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