Pharm Exam 2-Part 3

Front 1

Muscarinic Antagonist Prototypes

Back 1

Atropine is the prototype that doesn't cross the BBB until high doses are reached.
Scopolamine is similar, comes from the same plant but readily enters the CNS

Front 2

Scopolamine

Back 2

Systemically it will enter the CNS and cause amnesia/sedation. Medically it is used in patch form to prevent motion sickness

Front 3

Homatropine and Tropicomide

Back 3

Atropine derivatives with shorter duration. - Used to dilate the pupil

Front 4

Ipratropium and tiotropium

Back 4

I for inhaled - Quat-amines - not orally absorbed and don't cross BBB. Inhaled for asthma/COPD

Front 5

Atropine + Diphenoxylate

Back 5

Atropine slows down your GI tract to help prevent diarrhea and it is used in combination with Diphenoxylate an opioid to make you feel better about your diarrhea

Front 6

Tolterodine

Back 6

Tolterodine - "I tolt you to hold it until we get there, I'm not stopping for you to use the bathroom again!" Muscarinic Antagonist treats urinary urgency

Front 7

Oxybutinin

Back 7

Used to prevent bladder spasm after prostate surgery

Front 8

Low dose Atropine (0.5 mg)

Back 8

Dry mouth
&
decreased sweating

Front 9

Increased dose of Atropine

Back 9

Tachycardia
Blurred vision
Palpitations

Front 10

high moderate dose

Back 10

Decreased GI activity
&
Urinary Retention

Front 11

High Dose Atropine

Back 11

CNS effects- stimulation causing restlessness and irritability--> depression --> confusion--> coma - at lower doses it doesn't cross the BBB

Front 12

Uses for Scopolamine

Back 12

may cause euphoria, some abuse potential. Used pre-anesthetically to cause sedation, amnesia, and dry bronchial/salivary secretions

Front 13

Use of antomuscarinic drugs in Parkinson's?

Back 13

Parkinson's patients have decreased dopamine antimuscarinics will restore the acetylcholine/dopamine balance in the corpus striatum

Front 14

Cholinergic antagonists in the eye

Back 14

Block activation of iris sphincter--> mydriasis also causing loss of accommodation to near vision or cycloplegia Tropicamide is a short acting drug used for this in eye examinations. Decreased ciliary muscle tone also decreases aqueous humor drainage especially in narrow angle glaucoma

Front 15

Antimuscarinic drugs in the heart low dose

Back 15

low dose = slight bradycardia may occur due to increased ACh release following blockade of presynaptic M2.

Front 16

Moderate Atropine in the heart

Back 16

affects postsynaptic M2 receptors at the SA node decreasing vagal tone --> tachycardia. This will also block presynaptic M2 receptors and remove tonic inhibition causing an increase in NE release

Front 17

Pain can cause a reflex Vagal discharge

Back 17

Atropine can be used to reveres these effects

Front 18

Ipratropium

Back 18

Quat-ammonium (limits effects to lungs) used for bronchodilation in acute asthma attacks and patients with COPD

Front 19

Solifenacin

Back 19

Overactive bladder treatment with little effect on salivation

Front 20

Atropine Poisoning

Back 20

Dry as a bone
Blind as a bat
Mad as a hatter
Red as a beet

Front 21

drug classes with anticholinergic effects

Back 21

Tricyclic antidipressants, antihistamines, antipsychotics

Front 22

Poisonous mushrooms

Back 22

some mushrooms contain muscarine and lead to vomiting, diarrhea, vasodilation, tachycardia/bradycardia, sweating, salivation, and possibly bronchoconstriction
Treated with IV atropine