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Pharmacology 1 > ANS 1 (Parasympathetic) Cholinergic Antagonists > Flashcards

ANS 1 (Parasympathetic) Cholinergic Antagonists Flashcards

1
Q

Drugs Under Muscarinic Blockers

A 
Atropine /hyoscyamine
Scopolamine/ hyoscine
Hematropine, Cyclopentolate, Tropicamide
Ipratropium bromide
Pirenzepine
Benztropine, Trihexyphenidyl, Oxybutyrin
Dicyclomine
Propantheline
other drugs
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2
Q

prototype anticholinergic

central and peripheral muscarinic (1-5) blocker

A

Atropine / Hyoscyamine

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3
Q

Dose dependent (atropine) : What is the order of its acions?

A

1) Decreased salivary and bronchial secretions
2) dec sweating
3) mydriasis, tachycardia
4) inhibition of voiding
5) dec GI motility
6) dec gastric secretions

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4
Q

SE/AE of Atropine

A 
Mydriasis
Alice in Wonderland (5)
mad as a hatter - hallucinations
Blind as a bat - blurring of visions
dry as a bone
red as a beet - tachycardia, vasodilation 
hot as a hare - fever / hyperthermia
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5
Q

CI of Atropine

A

glaucoma, prostatic hypertrophy( inflamed and block the path of urine), heart disease, obstructive bowel disease

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6
Q

M(1-3) blocker
greater action on CNS and longest duration of axn than atropine
more CNS depression at low doses than atropine
more potent at eye and glands than atropine
Less potent at heart, lungs and GI tract than atropine

A

Scopolamine (hyoscine)

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7
Q

prevents motion sickness (transdermal), nausea and vomiting
blocks short-term memory
causes amnesia and sedation

A

Scopolamine (hyoscine)

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8
Q

produces twilight sleep (when given with morphine) -insensitivity to pain without loss of cosciuosness and to relieve the pain of childbirth
(morphine=w/o pain)
this drug= w/o memory of the pain

A

Scopolamine (Hyoscine)

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9
Q

Produces Mydriasis for opthalmoscopic examination

A

HTC: Homatropine, Tropicamide, Cyclopentolate

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10
Q

M (1-4) blocker
treatment of asthma and COPD
ACh at lungs: bronchodilation, decreased bronchial secretions

A

Ipratropium bromide

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11
Q

treatment of COPD

A

Tiotropium

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12
Q

M1 blocker
selective for muscarinic receptor in the stomach
decrease secretion of acid and pepsin
tx of PUD (dec gastric secretion and acidity)

A

Pirenzepine

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13
Q

M (1-3) blockers

tx of Parkinson’s disease, extrapyramidal disorders

A

TBO

Trihexyphenidyl, Benztropine , Oxybutnin

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14
Q

M (1-3) blocker

tx of hypermotility of bowel

A

Dicyclomine

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15
Q

M (1-3) blocker

adjunct for peptic ulcers to dec acid secretions

A

Propantheline

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16
Q

Other agents that have anticholinergic effects

A

Antihistamines
Antipsychotics
Tricyclic antidepressants (TCA)
Opioids

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17
Q

MOA of NM Blockers/Skeletal muscle relaxants

A

block nicotinic receptors causing paralysis

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18
Q

2 divisions of NM Blockers

A

Competitive Depolarizing

Competitive Non- Depolarizing

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19
Q

Drugs under Competitive Nondepolarizing NM Blockers

A 
Vecuronium
Atracurium, Cisatracurium
Pancuronium
Tubocurarine
Mivacurium
Rocuronium
Pipecuronium, Doxacurium
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20
Q

Drugs (Competitve Depolarizing NM Blockers)

A

Succinylcholine

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21
Q

NM blockers that compete with ACh at nicotinic receptors, prevents depolarization of the muscle cell membrane and inhibit muscular contraction (noncontraction)

A

Nondepolarizing NM BLockers

22
Q
  • adjunct to anesthesia: muscle relaxant, eases intubation and ventilation, eases orthopedic manipulation, controls respiration during chest surgery
  • has short duration 25-40 min
  • very little histamine release
A

Vecuronium

23
Q

useful in mechanical ventilation of critically ill patients
ideal for patients with kidney and liver failure
hs short duration of action(25-40 min) for short surgical procedures
AE: moderate histamine release (hypotension, vasodilation)

A

Atracurium

24
Q

No histamine release

A

Cisatracurium

25
Q

has vagolytic actions
used when elevated heart rate is desired
AE: tachycardia
No histamine release

A

Pancuronium

26
Q

Competitive nondepolarizing nm blockers

Prevents fascications associated with succinylcholine administration

A

Tubocurarine

27
Q

Competitive nondepolarizing nm blockers
Useful for short surgical procedures, has short duration of action (15-20 min)
Hydrolyzed by plasma AChE

A

Mivacurium

28
Q

Conpetitive nondepolarizing nm blocker
Useful for tracheal intubation in patients with gastric contents
Rapid onset: 1-3 min
Duration: 15-60 min

A

Rocuronium

29
Q

Competitve nondepolarizing nm blockers adjunct to anesthesia in long surgery cases
Long duration in px with renal dysfunction
AE: prolonged nm blockade
Duration: 40-240 min

A

Pipecuronium

Doxacurium

30
Q

prevents the fasciculations associated with succinylcholine (which is a competitive depolarizing) administration
AE: hypotension, bronchospasm

A

Tubocurarine

31
Q

useful for short surgical procedures (15-20 mins duration)more rapid recovery from blockade
hydrolyzed by plasma AChE

A

Mivacurium

32
Q

useful for tracheal intubation in patients with gastric contents
rapid onset (1-3 min)
duration (15-60 min)
minimal cardiovascular effect

A

Rocuronium

33
Q

adjunct to anesthesia in long surgery cases
long duration in px with renal dysfunction
AE: prolonged nm blockade
duration: 20-240 min

A

Pipecuronium, Doxacurium

34
Q

NM blockers drug interaction:

overcome the action of nondepolarizing blockers (as antidote?)

A

NM blockers drug interaction w/ Cholinesterase Inhibtior ( Neostigmine, Edrophonium, Physostigmine)

35
Q

NM blockers drug interaction:

ehance NM blockade by exerting a stabilizing axn at the NMJ

A

NM blockers drug interaction w/ halogenated hydrocarbon anesthetics

36
Q

NM blockers drug interaction:

inhibit ACh release from cholinergic nerves by competing with Ca ions

A

NM blockers drug interaction w/ aminoglycoside antibiotics

37
Q

NM blockers drug interaction: may increases nm block of nondepolarizing and depolarizing blockers ; dec muscular contraction

A

Ca channel blockers

38
Q

Drug/s for competitve nondepolarizing nm blocker

A

Succinylcholine

39
Q

T/F : competitve depolarizing nm blocker effects are reversible by AChE

A

False

40
Q

Phase of nondepolarizing nm blocker :

  • opening of the Na channel associated with the nicotinic receptors
  • fasciculations/contractions
A

Phase 1

41
Q

Phase of nondepolarizing nm blocker :

  • gradual repolarization as the sodium channel closes or is blocked /relaxation
  • resistance to depolarization
  • flaccid paralysis
A

Phase 2

42
Q

Order of paralysis of Succinylcholine

A

1) fasciculations in chest and abdomen
2) neck, arms, legs
3) facial, pharynx, larynx
4) respiratory muscles

43
Q

Useful when rapid endotracheal intubation is required during induction of anesthesia
Onset= 30-60 sec
Duration= 3-5 min

A

Succinylcholine

44
Q

Condition wherein there is a muscle rigidity and hyperpyrexia?

Treatment for this condition?

A

Malignant hyperthermia

Tx: dantrolene ( blocks release of ca from sarcoplasmic reticulum if muscle cells) and rapidly cooling the patient

45
Q

Given in prereversal stage of reversing nm blockade

- to prevent bradycardia, salivation, other muscarinic effect

A

Atropine or glycopyrrolate

46
Q

Low dose of nicotine

A

Ganglionic stimulation
Depolarization
Inc bp and heart rate
Inc motor activity if bowel

47
Q

High dose of nicotine

A

Ganglionic blockade
Dec bp
Ceases Git and bladder activity

48
Q

Competitive nicotinic ganglionic blocker

Tx of moderately severe to severe htn

A

Mecamyline

49
Q

Short acting competitive nicotinic ganglionic blocker

Tx of hypertensive emergencies caused by pulmonary edema or dissecting aortic aneurysm

A

Trimethaphan

50
Q

Blockade is by occupying sites in or on the nicotinic ion CHANNEL
First drug effective for htn management

A

Hexamethonium

Pharmacology 1 (3 decks)

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