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21 Cards in this Set
- Front
- Back
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List antimuscarinic agents
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1) Atropine
2) Cyclopentolate 3) Ipratropium 4) Scopolamine 5) Tropicamide |
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List ganglionic blockers
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1) mecamylamine
2) nicotine |
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List neuromuscular blockers
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1) Atracurium
2) Cisatracurium 3) Doxacurium 4) Metocurine 5) Mivacurium 6) Pancuronium 7) Rocuronium 8) Succinylcholine 9) Tubocurarine 10) Vecuronium |
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What are the characteristics of atropine?
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- tertiary amine
- competitively binds muscarinic receptors (prevenitng ACh from binding) - actions last ~ 4 hrs, days in eye |
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What are the actions of atropine
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EYE: persistent mydriasis (dilation of pupil)
GI: reduce GI motility, doesn't affect gastric acid secretions URINARY: reduce hypermotility states CARDIAC: divergent depending on dose Low: dec. HR/bradycardia - b/c of M1 blockade permitting inc. ACh release High: Inc. HR; M2 receptors on SA node bloacked SECRETIONS: blocks salivary glands, sweat & lacrimal glands |
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What are the therapeutic uses of atropine?
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In opthalmology, to produce mydriasis and cyclopegia prior to refraction
To treat spastic disorder of the GI and lower urinary tract To treat organophosphate poisoning To suppress respiratory secretion prior to surgery |
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What are characteristic of scopolamine
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tertiary amine --> actions on CNS
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What are actions of scopolamine
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anti-motion sickness
blocks short-term memory At low doses - sedation At high doses - excitment may produce euphoria |
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What are therapeutic uses of scopolamine
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prevent motion sickness
In obstetrics, with morphine to produce amnesia and sedation |
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What are characteristics of Ipratropium?
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quaternary atropine derivative - no CNS effect - isolated to pulmonary system
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What is ipratropium used for? (TX)
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treatment of asthma in patients who are unable to take adrenergic agonists
management of COPD |
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What are tropicamine and cyclopentolate used to (TX)?
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Produce mydriasis and cycloplegia prior to refraction
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What are the actions of nicotine
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In low doses: inc BP, HR
high doses: dec. BP, ceases GI and bladder motility because of ganglion blockade |
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What are the characteristics of mecamylamine (and non-nicotine ganglionic blockers)
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nondepolarizing, competitive antagonists
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What is the duration and use of mecamylamine
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duration: 10 hrs
used to lower BP in emergency situations |
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What is the mechanism of action of nondepolarizing (competitive) neuromuscular blockers at LOW doses
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prevent ACh binding at nicotinic receptors thus preventing depolarization of cell and inhibit muscle contraction
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What is the mechanism of action of nondepolarizing (competitive) neuromuscular blockers at HIGH doses
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blockers can block the ion channels of the end plate leading to further weakness, reducing the ability of acetylcholinesterase inhibitors to reverse the actions of nondepolarizing muscle relaxants
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What are therapeutic uses of nondepolarizing NM blockers
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adjuvants in anesthesia
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What is the mechanism of action of depolarizing neuromuscular blockers
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binds to nicotinic receptors and acts like ACh to depolarize the junction. they remain attached for longer periods of time causing constant stimulation and eventually renders the receptor incapable of transmitting further impulses --> resistance to depolarization --> flaccid paralysis
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What are therapeutic uses of depolarizing NM blockers
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for rapid endotracheal intubation during the induction of anesthesia
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What are adverse effects of depolarizing NM blockers
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hyperthermia, apnea, hyperkalemia
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