Pharmacology Chapt. 14 Muscarinic Ag/antag

Front 1

A direct acting muscarinic agonist that binds reversibly to muscarinic cholinegic receptors, causing activation.

Back 1

Bethanechol

Front 2

The therapeutic use for bethnaechol which activates muscarinic receptors that releaxes the trigone & sphincter muscless & increases voiding by contracting the detrusor muscle of the bladder. Should not be used for the tx of an obstruction & bed pan should be handy.

Back 2

Urinary Retention

Front 3

The therapeutic use for bethnaechol used to help treat disorders assoc. w/ paralysis by increaseing motility & tx of GERD.

Back 3

GI

Front 4

The advese effecst of bethnaechol w/in this system can cause hypo-tension(secondary to vaso-dialation) & bradycardia. Contraindicated w/patients having low BP & low CO

Back 4

Cardovascular Syst.

Front 5

The advese effecst of bethnaechol w/in this system can cause excessive salivation, increased secretions of gastric acid, ab cramps, & diarrhea at usual therapeutic doses. High doses causes involuntary defecation. Contraindication in gastric ulcers, obstructions & recent bowel surgery.
(i.e. What System is effected)

Back 5

Alimentary Syst.

Front 6

The advese effecst of bethnaechol w/in the lungs can cause bronchoconstriction, exacerbating this condition.

Back 6

Asthma

Front 7

The advese effecst of bethnaechol where it can cause dysrhythmias in these types of patients.

Back 7

Hyperthyroid Patients

Front 8

Bethnaechol is avaiable in this route from 5,10.25 & 50 mg. 3-4 times/day on empty stomach.

Back 8

Oral

Front 9

Tx of choice for muscarinic agonist poisioning.Produces its effects through competitive blocking at muscarinic receptors of Ach.

Back 9

Atropine

Front 10

Because it's antagonist, Atropine will do this to the HR, because inhibition of cardiac muscarinic receptors will be blocked, resulting in this.

Back 10

Raise HR

Front 11

Because atropine is an antagonist, it will effect these glands, causing a decrease of secretions

Back 11

Exocring Glands

Front 12

By preventing activation of muscarinic receptors of these muscles atropine causes relaxtion of the bronchi, decreased tone & motility of GI & urinary bladder. It has no effect on vascular smooth.

Back 12

Smooth Muscle

Front 13

Blockage of muscarinic receptors on the iris sphincter causes this (i.e. dialation of the pupil).

Back 13

Mydriasis

Front 14

Blockade of muscarinic receptors on the cilliary muscle produces this (i.e. relationtion of the cilliary muscle), thereby focusing the eye for far vision.

Back 14

Cycloplegia

Front 15

In this system, Atropine can cause mild excitation. Toxic doses can cause hallucinations & delerium resembling psycohosis. Extremely high doses result in coma, resp. arrest & death.

Back 15

CNS

Front 16

Doses needed to block muscarinic receptors in the stomach & bronchial are *** than doses needed to block muscarinic receptors at all other loc.

Back 16

Higher

Front 17

This therapeutic use of atropine involving the cardiac effects that can be helpful during surgery. Procedures that stim. baroreceptors of carotid body can initiate reflex slowing of the heart resulting profound bradycardia. Since reflex is mediated by muscarinic receptors on heart, pre-tx can prevent dangerous drop in HR.

Back 17

Pre-Anesthetic Medication

Front 18

Important to note that not all muscarinic receptors are equally senstive to blockade by either atropine or most other anticholinergics. Some sites require more **** than others for muscarinic blockade.

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Dose Dependancy

Front 19

Atropine may be admin by which routes.

Back 19

All Routes
(Eye, oral, IV, IM, subQ)

Front 20

Following this adimin of atropine, the drug is rapidly absorbed & distributes throughout all tissues including CNS.
(i.e Which Route)

Back 20

Oral

Front 21

Elimination of atropine is by a combonation of **** metabolism & **** excretion.

Back 21

Hepatic/Urinary

Front 22

Atropine has a half-life of how many hrs?

Back 22

3-Hours

Front 23

By blocking muscarinic receptors in this organ, atropine can cause "mydriasis & paralysis of cilary muscles. Both helpful during surgery & examination.

Back 23

Disorders of Eye

Front 24

Atropine can accelerate HR in patients w/this type of heart condition, due to the blockade of cardiac muscarinic receptors,whereby preventing the PNS from slowing the heart.

Back 24

Bradycardia

Front 25

By blocking muscarinic receptors in intestine, atropine can decrease both "tone & motility" of intestine. Can be beneficial in conditions char. by excessive intestinal motility & bowl movement frequency.
(i.e.what two things)

Back 25

Hypertonicity/Hypermotilty

Front 26

Atropine is specific for this use by agents that activate muscarinic receptors. By blocking these receptors, atropine can reverse all signs of overdose & toxicity.

Back 26

Antedote

Front 27

Because atropine can suppress GI secretions, it can be used to tx this. However, it's not the first tx choice, rather it's reserved for cases in which symptoms can't be relieved by preferred meds.

Back 27

Peptic Ulcers

Front 28

By blocking bronchial muscarinic receptors of bronchial receptors, atropine "can" promote dialation in pt with this condition; but can also cause drying & thickening of secretions. Has a very limited role in this tx.

Back 28

Asthma

Front 29

This condition is char. by intense ab. pain brought on by passage of a gallstone in bile duct. In some cases, atropine may be combined w/morphine to relax bilary tract smooth muscle & relieve discomfort.

Back 29

Billary Colic

Front 30

Blockade of muscarinic receptors on salivary glands can inhibit salivation, causing this to happen. Can impede swallowing. Pt should chew gum, hard candy or sip fluids.

Back 30

Dry Mouth
(Xerstomia)

Front 31

Blocade of cilliary muscles & sphincter of iris can paralyze these muscles, which can cause this to happen, due to the eye's inability to focus for far vision. Also sensitivity to light.

Back 31

Blurred Vison/Photophobia

Front 32

Paralysis of iris sphincter can cause this sort of pressure to rise. Anti-cholinergic drugs are contraindicated for glaucoma pt. Also for people whom may be predisposed to glaucoma, including people over 40

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Intraocular Pressure

Front 33

Blockade of muscarinic receptors here reduces pressure in bladder; but increases tone of sphincter & trigone. Effects can cause hesitency or urgency. Cath or tx w/muscarinic agonist may be required. Can be minimized w/frequent voiding.

Back 33

Urinary Tract

Front 34

Muscarinic blockade decrease tone & motility of intestinal smooth muscle, causing this to happen. Can be minimized by increasing fiber & fluids. Contraindicated for pt with intestinal atony.

Back 34

Constipation

Front 35

Blockade of muscarinic receptors on sweat glands can promote this adverse efeect to happen. This might lead to overheating.

Back 35

Anhidrosis

Front 36

Blockade of muscarinic cardiac receptors removes parasympathetic influence on the heart, causing this type of HR condition to happen. Caution must be taken with pt w/ this pre-existing condition.

Back 36

Tachycardia

Front 37

In patients w/this condition, anti-muscarinic drugs can lead to bronchial plugging. Muscarinic AN-tagonist can be used to tx; but can also be harmful to pt w/this condition.

Back 37

Asthma

Front 38

Anti-histamines, phenothiazine anti-psychotics & tricyclic anti-depressants should not be combined w/this drug, because their anti-cholinergic actions will greatly enhance the anti-muscarinic effects.

Back 38

Atropine

Front 39

Atropine sulfate is available in 0.4 mg orally & in solution of 0.05 & 1mg/mL for IM, IV & subQ. Ave. adult dose is 0.5mg. This is ref to what three categories.

Back 39

Prep,Doseage & Administration

Front 40

This is a pre-filled auto injector indicated fro IM therapy of poisoning. 0.5mg for kids(15-40lbs) 1mg for kids 40-90lbs & 2mg for adults. Site may be lat. thigh.

Back 40

Atro-Pen

Front 41

Symptoms of this include dry mouth, blurred vision, photophobia, hyperthermia, CNS effects of (hallucination & delerium) as well as hot,dry & flushed skin.

Back 41

Toxicology of Muscarinic Antagonist.

Front 42

Tx of poisioning can be given by this route. Absorbtion can be reduced by using activated charcoal, while monitoring I/O & observing side-effects.

Back 42

Oral

Front 43

Tx of choice for anti-muscarinic poisoning.

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Physostigmine

Front 44

Symptoms of this include dry mouth, blurred vision, photophobia, hyperthermia, CNS effects of (hallucination & delerium) as well as hot,dry & flushed skin.

Back 44

Muscarinic Antagonist Poisioning

Front 45

Tx of poisioning can be given by this route. Absorbtion can be reduced by using activated charcoal, while monitoring I/O & observing side-effects.

Back 45

Oral

Front 46

Tx of choice for anti-muscarinic poisoning.

Back 46

Physostigmine