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32 Cards in this Set
- Front
- Back
parasympatholytic definition
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block parasympathetic system (which is what cholinergic antagonists do)
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atropine is selective for m2 t/f
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false it is non-selective
pirenzepine is selective for m1 over m2 |
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antimuscarinics will have little to no effect on ______ but a common side effect is _____
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no effect on ganglia (all nicotinergic)
dry mouth is common |
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antimuscarinic are useful in treating parkinson's, explain
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parkinsons- too much ACH- tremor -so lower amount of ACH
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antimuscarinic effect on eye
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mydriasis- can precipitate glaucoma if person has narrow anterior chamber
cycloplegia |
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antimuscarinic activity on the CV
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-sympathetic dominates but because of blockage of autoreceptors- more ACH is released so bradycardia
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Antimuscarinic effects on CV and on Respiratory system
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CV- not that much- slight tachycardia
slight bronchodilation and reduction in secretion, primarily used during inhalation anesthesia to reduce secretions and prevent laryngospasm |
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antimuscarinic effects on sweat glands
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blocks SYMPATHETIC (only symp muscarinic)
atropine fever |
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antimuscarinics on parkinsons include
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benztropine
biperiden orphenadrine trihexyphenidyl (dec ACH, reduce tremor) |
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antimuscarinic for motion sickness
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scopolamine (large CNS effects like drowsiness
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antimuscarinic for ophthalmologic disorder
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causes cycloplegia (good for measuring refractive error) and mydriasis (ophthalmoscopic examination of retina), do not use if mydriasis is only goal alpha agonists are better and shorter acting
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duration of action: scopolamine
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3-7 d
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duration of action: atropine
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7-10d
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duration of action: homatropine
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1-3d
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duration of action: cyclopentolate
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1d
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duration of action: tropicamide
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.25d
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duration of action: tropicamide + hydroxyamphetamine
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.25d
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respiratory disorder
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atropine or hyoscyamine used during anesthesia to inhibit inc airway secretions. Side effect: exacerbates postoperative urinary retention and intestinal hypomobility
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antimuscarinics in aerosol form used for asthma and COPD including agents:
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-ipratropium,
-ipratropium and albuterol (combines with adrenergic activation), -tiotropium |
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antimuscarinics and CV disorders
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atropine is used for intraoperative bradycardia or bradycardia with MI. Too little will worsten bradycardia so be careful!
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antimuscarinics and GI: effect and clinical drugs
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reduce gastric emptying
atropine hyoscyamine glycopyrrolate can provide relief for diarrhea Lomotil (atropine and diphenoxylate |
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antispasmodics and antimuscarinics
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antimuscarinics for ibs and spastic colon
dicyclomine hyoscyamine |
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genitourinary disorders and antimuscarinics
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relieve urinary urgency and incontinence
oxybutynin tolterodine |
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cholinergic poisoining and antimuscarinics
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use atropine and PAM for cholinesterase regeneration
atropine useful for rapid onset poising in mushrooms, not delayed onset |
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anticholinergic toxicitiy
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blind as a bat (blurry)
dry as a bone (dry mouth) red as a beet (flushing) mad as a hatter (confusion) hot as a hare (hyperthermia can't see (mydriasis) cant pee (urinary retention) |
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contraindications of antimuscarinics
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glaucoma, prostatic hyperplasia (can cause urine retention
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ganglionic blockade
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prevents reflex activity
-stops predominating tone mecamylamine -clinical used for severe hypertension bc it inhibits reflexes |
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antimuscarinic toxicity tx
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physostigmine
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ganglionic blockade and organ system effects
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-stops predominating system which all is parasympathetic except BV, sweat glands and genitourinary tract
CNS- sedation, tremor, choreiform Eye- cycloplegia and mydriasis CV- tachycardia but hypotension (bc of vasodilation and dec peripheral resistance) |
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neuromusclar blocking drugs:
uses categories |
adjuncts to general anesthesia
-depolarizing (activate nicotinic receptor) -non-depolarizing |
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nicotinic ACH receptors states
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-resting (none bound)
-open: -2 molecules of ACh bound and ion channel open -desensitized (ion channel closed and ACh is still bound |
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non-depolarizing neuromuscular blockers administration, excretion
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have to be IM or IV, inactive if orally, excretion by kidney results in longer duration
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