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30 Cards in this Set
- Front
- Back
What are cholinolytic agents?
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Block cholinergic transmission
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Muscarinic antagonists agents
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Atropine
Scopolamine Tropicamide Cyclopentolate Ipratropium bromide Tiotropium bromide Tolterodine Oxybutynin Darifenacin Solifenacin Dicyclomine Hyoscyamine |
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Muscarinic antagonists MOA
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competitive, reversible muscarinic blocker
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What is the order of blockade of MOA?
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Salivary, bronchial, sweat glands
Iris, ciliary muscle, heart Bladder, gut gastric acid secretion |
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What is the problem in using M antagonists to treat ulcers?
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Need high concentrations and too many side effects
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What are the therapeutic uses of muscarinic antagonists?
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Mydriasis
Cycloplegia Acute rhinitis Asthma/COPD Preanesthetic medication Sedative/amnesia effects Hyperactive carotid sinus Vagal induced heart block Ulcers Irritable bowel syndrome GI spasm parathion/mushroom poisoning motion sickness urinary incontinence |
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What other drugs can cause mydriasis?
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Alpha 1 agonists
Phenylephrine |
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What agents are used for mydriasis and cycloplegia?
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Tropicamide--short
Atropine--long Scopolamine--long |
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How does a muscarinic antagonist work on acute rhinitis?
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Atropine blocks M receptor on nasopharyngeal glands --> decreased secretion in the respiratory tract
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What is the advantage of using ipratropium bromide as opposed to atropine?
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Less systemic absorption and less side effects
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What muscarinic antagonist agents are used for asthma/COPD?
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Ipratropium bromide--short DOA
Tiotropium bromide--long DOA |
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How does a muscarinic antagonist work on the lungs for asthma/COPD?
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Ipratropium blocks M on lung --> bronchodilation
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Why is advantageous for ipratropium bromide use in COPD?
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An increase in cholinergic tone is a major reversible component in COPD and usually less side effects than beta agonists.
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Why use a muscarinic antagonists prior to general anesthesia?
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Atropine --> less secretions in respiratory tract
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What can a therapeutic dose of scopolamine do?
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CNS depression, depression, amnesia, fatigue, and dreamless sleep
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Atroprine has no effect on ventricuar arrhythmias. Why?
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Few M receptors in the ventricles.
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What muscarnic agents are used for IBS?
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Dicyclomine
Hyoscyamine |
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Why would you add a subtherapeutic dose of atropine to an opiod antiadiarrhea medication?
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Prevent drug abuse
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Will Atropine treat most of the symptoms of poisoning by inocybe mushrooms?
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Yes
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Will Atropine treat most of the symptoms of poisoning by parathion?
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No...will need 2-PAM to block the nicotinic receptors
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How does scopolamine used in motion sickness?
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Vestibular apparatus (in inner ear) --> scopolamine --> M receptor --> blocks vomit center in medulla --> prevent motion sickness
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What muscarinic antagonists are used for urinary incontinence?
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Tolterodine
Oxybutynin chloride Darifenancin Solifenacin Trospium chloride |
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How does muscarinic antagonists work for urinary incontinence?
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Rem: ACh on M (detrusor muscle-contracts) and ACh on M (trigone muscle-relax) --> micturation --> block M receptors --> decrease urinary frequency
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What are the CNS adverse effects of muscarinic antagonists?
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Sedation or excitement
Disorientation, memory disturbances, dizziness, restlessness, hallucinations, delirium, and confusion |
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CNS effects in muscarinics...
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Scopolamine > Atroprine >>>> Ipratroprium
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Muscarinic antagonist contraindications
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NAG
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Effects of nicotine?
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--Stimulation is followed by depression
--Increase in HR/BP --NVD --Stimulation and tremors |
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Ganglionic blocker agents
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Trimethaphan
Mecamylamine |
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What is the MOA of ganglionic blockers?
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nicotinic receptor antagonists
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What is the clinical use of ganglionic blockers?
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Obsolete--Mecamylamine was d/c then reintroduced --> nicotine withdrawl and Tourette's
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