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31 Cards in this Set
- Front
- Back
Atropine
MOA? |
-Non-selective muscarinic antagonist
-High potency |
|
Scopolamine
MOA? |
-Potent muscarinic antagonist
-High CNS activity |
|
Pirenzepine
MOA? |
Selective for M1 subtype receptors
|
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Muscarinic Anagonists
Action on CNS (5) |
-Hallucinations
-Confusion -Restlessness -Irritability -Psychosis like signs |
|
How to prevent muscarinic antagonists from entering the CNS?
|
-Methylate N to get quaternary N
|
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Atropine's effect on CNS?
Dose? |
-Crosses BBB poorly
-Can see CNS effects with high dose |
|
Muscarinic Antagonists
Effect on Cardiovascular Heart (3) |
-Blocks M2 receptor
-Releases vagal inhibition -Increase HR |
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Low dose effect of muscarinic agonists on heart?
|
-May block presynaptic M2 receptor
-May see increased Ach release -Brachycardia |
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Muscarinic Antagonist Effect
Vasculature |
-Little or no effect
-M3 receptors there but no innervation and no Ach present |
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Muscarinic Antagonist Effect
Eye (3) |
-Blocks M on circular and ciliary muscles
-Gives impaired accommodation (cycloplegia) -Impaired mydriasis |
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Muscarinic antagonists contraindicated for which patients? (1)
|
-Patients with closed angle glaucoma
-Will results in loss of drainage from Schlemm and increased pressure -No anticholinergic medication (including antihistamines) |
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Muscarinic Antagonist Effect
GI tract and bladder (2) |
-Decreased tone leading to constipation and urinary retention
-Decreased GI secretions |
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Muscarinic Antagonists Effect
Glands (5) |
-Inhibits secretions
-Decrease lacrimation -Decrease sweating -Decrease salivation -Decrease bronchial secretions |
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Atropine (muscarinic antagonists) Side Effects
|
-Listed in specific body systems
-Plus photosensitivity -Plus CNS signs |
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Treat Atropine CNS side effects with? (1)
|
-Physostigmine
|
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Uses of Muscarinic antagonists
-GI (1) -Medication used? (1) |
-Ulcer patients
-Pirenzepine -Helpful in conjunction with other ulcer medication -NO atropine --> too many associated side effects |
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Uses of Muscarinic Anatgonists
-Eye (1) -Side Effects (2) |
-Eye exams
-Less potent agents -SEs = photophobia and accommodation issues |
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Uses of Muscarinic Antagonists
-Toxicity (1) |
-Cholinesterase Poisening
-Atropine blocks muscarinic effects -Life saving in short term |
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Uses of Muscarinic Antagonists
-Surgery (1) -Effects (3) |
-Adjunct in anesthesia
-Decrease bronchial secretions -Bronchodilation -Anti-vagal effects |
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Scopolamine
-Uses (1) -Effects (4) |
-Anesthetic adjunct
-Drowsiness -Fatigue -Amnesia -Euphoria |
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Scopolamine
-Side effects (2) |
-Patients in pain can have delirium or intense reaction
-Limits use in this condition |
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Pirenzepine
-MOA? -Uses (1) |
-M1 selective
-Ulcers -Used in conjunction with other medications |
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Muscarinic Anatgonists Uses
-CNS? (2) |
-Anti-Parkinson Treatments (not primary treatment but provides some relief for tremor)
-Motion sickness |
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Benztropine
-MOA? -Uses (1) |
-Blocks muscarinic receptors in basal ganglia
-Useful in idiopathic and drug induced Parkinson states |
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Scopolamine (patch)
-Uses in CNS? -Side effects? (2) |
-Motion Sickness
-Very useful -Best given prophylactically -Side effects = Sedation and dry mouth |
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Uses for Muscarinic Antagonists
-Urinary system (1) |
-Overactive bladder
-Symptoms of urgency and urinary frequency -Incontinence -Somewhat effective -Use mild anti-cholinergic and cheap |
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Uses for Muscarinic Antagonists
-Respiratory System (2) |
-Asthma patients
-COPD -Produces bronchodilation |
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Side effect of long-term atropine use in respiratory system?
|
-Effects mucociliary clearance
-Not first line of treatment but can be used adjunctively |
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Ipratropium
-Uses? -MOA? -Administration? |
-Muscarinic antagonist
-Used to produce bronchodilation -Does NOT affect mucociliary clearance -Oral, QID (4 times/day) |
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Tiotropium
-Uses? -Adminstration? -Problem? |
-Produce bronchodilation
-COPD and asthma patients -Inhalant -Long duration (24 hours) -Problem--4 times/day administration |
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Summary of Muscarinic Antagonist uses (8)
|
-Ulcer
-Eye exams -Cholinesterase Poisoning -Adjunct in Anesthesia -Anti-Parkinson Treatments -Motion sickness -Overactive Bladder -Asthma/COPD --> bronchodilation |