A.10

Question 1

Atropine

Answer 1

MOA: inhibits ALL M-ACh-R fast and effectively; ROA: I.V.; IND: bradycardia, after general anesthesia, Organophosphate intoxication, reduce salivation before surgery; dosing: 0.5mg, max 3mg, lethal dose 100mg; SEs: vagolysis (tachycardia), mydriasis (for ~10 days), CNS: hallucinations, agitations, loss of conciousness

Question 2

Scopolamine

Answer 2

MOA: Non-selective M-R-antagonist; ROA: transdermal patch; IND: motion sickness;SEs: CNS: sedation

Question 3

Butylscopolamine

Answer 3

MOA: Non-selective M-R-antagonist; ROA: p.o; IND; SMC cramps (e.g. stomach cramps); SEs: no CNS effects compared to scopolamine

Question 4

Ipratropium/Tiotropium

Answer 4

MOA: Ipra- Non-selective M-R-antagonist, Tio- M3-R-selective antagonist; ROA: inhaled as spray; DOA: Ipra- 2-4h, Tio- ~25h; structure: Quaternary - cannot cross BBB; IND: COPD, asthma, chronic bronchitis; SEs: Dry mouth, cough

Question 5

Tropicamine, Cyclopentolate

Answer 5

MOA: Non-selective M antagonist; Effect: mydriatic and cycloplegic agent; DOA: Tropic- 6-7h, Cyclo-20h; IND: Ophthalmologic examination; ROA: eye drops

Question 6

Procyclidine, Biperidine, Metixen

Answer 6

IND: Parkinson’s disease (there’s an ↑ACh due to ↓ in DA), antipsychotic,
Extrapyramidal disorders; MOA: non-selective Muscarinic-R-antagonist; Effect: Decreases resting tremor and rigidity; SEs: Atropine-like side effects (dry mouth, blurred vision, mydriasis, constipation); Extra: tertiary amine, can cross BBB

Question 7

Oxybutinin, Solifenacin, Darilfenacin

Answer 7

MOA: M3-antagonists; ROA: p.o, transdermal patch; DOA: 6h; Effect: decrease detrusor muscle spasms; IND: urinary urgency, bladder spasms; SEs: general M-antagonists effects- ↓secretions, mydriasis, cycloplegia, tachycardia