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23 Cards in this Set
- Front
- Back
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Atropine
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- 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 |
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Scopolamine
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- 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 |
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Ipratropium
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- Muscarinic Antagonist
- Quaternary amine - inhalate in reversible airway disease if bronchial constriction due to increased para stimulation |
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Muscarinic Antagonist uses
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- before surgery - atropine and scopolamine reduce salivary and respiratory secretions and induce amnesia
- motion sickness - parkinsons - intestinal spasms - for eye exams (atropine) - |
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Nondepolarizing ganglionic blockers
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- compete w/ ACh at nicotinic R to prevent depol of the post membrane
- like curare at NMJ |
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Trimethaphan
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- 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 |
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depolarizing ganglionic blocker
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- 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 |
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Nicotine
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- 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 |
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Competitive or Nondepolarizing Neuromuscular Blocking Agents
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block ACh receptors at the motor endplate, depressing the amplitude and duration of EPP below the threshold
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D-Tubocurarine
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- 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 |
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Atracurium
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- 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 |
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Vecuronium
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- 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 |
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Mivacurium
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- Competitive neuromuscular ACh Blocking Drug
- has less histamine release and is very short acting (~ 16 min.) comared to DT |
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Succinylcholine
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- 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 |
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scopolamine trade name
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(Isopto Hyoscine Scopace)
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ipratropium trade name
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(Atrovent)
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nicotine trade name
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(Nicorette; Habitrol; Prostep)
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trimethaphan trade name
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(Arfonad)
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D-tubocurarine trade name
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(curare)
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atracurium trade name
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(Tracrium)
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vecuronium trade name
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(Norcuron)
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mivacurium trade name
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(Mivacron)
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succinylcholine trade name
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(Anectine; Quelicin)
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