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23 Cards in this Set

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  • Back
Atropine
- Muscarinic Antagonist
- Tertiary amine that can penetrate CNS
- blocks iris contraction -> mydriasis
- blocks ciliary contraction -> cycloplegia
- blocks GI secretions and motility
- decreases sweating
- makes you blush
- causes mild tachycardia
– no BP effects - BVs not para innervated
- causes bronchial relaxation
Scopolamine
- Muscarinic Antagonist
- like atropine but more CNS action, esp drowsiness and amnesia
- this suggests central ACh playa a role in memory
- used as patch for motion sickness
Ipratropium
- Muscarinic Antagonist
- Quaternary amine
- inhalate in reversible airway disease if bronchial constriction due to increased para stimulation
Muscarinic Antagonist uses
- before surgery - atropine and scopolamine reduce salivary and respiratory secretions and induce amnesia
- motion sickness
- parkinsons
- intestinal spasms
- for eye exams (atropine)
-
Nondepolarizing ganglionic blockers
- compete w/ ACh at nicotinic R to prevent depol of the post membrane
- like curare at NMJ
Trimethaphan
- Nondepolarizing ganglionic blocker
- a charged sulfonium salt (IV) - diffuses poorly so rapidly metabolized
- response depends on what division dominates
- rarely used due to side effects – maybe for short term control of BP in hypertensive emergencies
depolarizing ganglionic blocker
- initially activates receptor -> depol
– b/c it stays in a depol state, it no longer responds to ACh
- resembles succinylcholine at the NMJ
- no clinical use
Nicotine
- depolarizing ganglionic blocker
- PNS, initial stimulation, then more persistent depression at all autonomic ganglia and adrenal medulla -> hypertension & arrhythmias
- NMJ, brief stimulatory phase, then persistent depol blockade -> SkM paralysis
- CNS - stimulates resp -> tremor and vomiting -> convulsion and death from resp depression
Competitive or Nondepolarizing Neuromuscular Blocking Agents
block ACh receptors at the motor endplate, depressing the amplitude and duration of EPP below the threshold
D-Tubocurarine
- Competitive neuromuscular ACh Blocking Drug
- paralyzes SkM starting w/ the eys and going out
- high dose can disrupt auntonomic ganglia and cause hypotension
- can cause histamine release
- actions enhanced by general anesthetics and Abs
Atracurium
- Competitive neuromuscular ACh Blocking Drug
- shorter duration (35-45 min) than DT
- action ends b/c of metab
- use in anephric patients
- Has some histamine release
Vecuronium
- Competitive neuromuscular ACh Blocking Drug
- Has shorter duration (25-40 min) than DT
- terminated by excretion in bile and kidney
- no histamine release or ganglionic blockade
Mivacurium
- Competitive neuromuscular ACh Blocking Drug
- has less histamine release and is very short acting (~ 16 min.) comared to DT
Succinylcholine
- Noncompetitive (depol)neuromuscular ACh Blocker
- persistent depol of the motor endplate (Phase I block)
- IV -> muscle twitches for 1 min, SkM paralysis for 5
- repeat blockade and it may become a nondepolarizing blockade (Phase II block) where its desensitized to ACh - so try not to do this
- used for Adjuvant in surgical anesthesia, Prevent trauma during electroshock therapy, Aid in setting fractures or intubating
scopolamine trade name
(Isopto Hyoscine Scopace)
ipratropium trade name
(Atrovent)
nicotine trade name
(Nicorette; Habitrol; Prostep)
trimethaphan trade name
(Arfonad)
D-tubocurarine trade name
(curare)
atracurium trade name
(Tracrium)
vecuronium trade name
(Norcuron)
mivacurium trade name
(Mivacron)
succinylcholine trade name
(Anectine; Quelicin)