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Anesthesia Pharmacology > ANS-Antimuscarinics > Flashcards

ANS-Antimuscarinics Flashcards

1
Q

What is Atropen

A

Atropine

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2
Q

Atropine

class/ category

A

Belladonna alkaloid; Anti-muscarinic

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3
Q

Atropine

Uses and MOA

A

Uses
* Treatment of bradycardia
* organophosphate (nerve agent) poisoning
* reversal of NDNMB

MOA
Non-selective, competitive muscarinic antagonist

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4
Q

Atropine

Dosing

A

0.5-1 mg IV every 3-5 min, max total dose 3 mg

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5
Q

Atropine

Onset, peak, duration

A

Onset: 1-2 min

Peak: 2-6 min

Duration: 15-30 min

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6
Q

Atropine

elimination

A

Renal

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7
Q

Atropine

CV effects

A
  • ↑ HR, the most of the antimuscarinics
  • Low doses, < 0.1 mg, associated with paradoxic bradycardia
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8
Q

Atropine

Pulm effects

A
  • Bronchodilator
  • Inhibits bronchial secretions
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9
Q

Atropine

CNS effects

A
  • Crosses BBB, dose-dependent CNS stimulation
  • Mydriasis and cycloplegia, but less than Scopolamine
  • May cause central anticholinergic syndrome
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10
Q

Atropine

GI effects

A
  • ↓ LES and barrier pressure
  • ↓ GI motility and GI secretions (including gastric acid)
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11
Q

Does atropine increase or decrease risk of emergence delirium

A

increase risk of emergence delirium

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12
Q

which medication is the least effective Antisialagogue (of the antimuscarinis

A

atropine

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13
Q

which medications Inhibits SNS innervation of sweat glands and what does it cause

2

A

Atropine and glycopyrrolate, ↑ body temperature

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14
Q

Releative contraindications of atropine and glycopyrrolate

A
  • Narrow-angle glaucoma
  • febrile patients
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15
Q

Atropine should be used causiously with pateints presenting with what?

+5 examples

A

Use caution when tachycardia already present or may be deleterious
Ex.
* CAD,
* aortic stenosis,
* hypertrophic cardiomyopathy,
* pheochromocytoma,
* thyroid storm

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16
Q

What are the toxicity symptoms of atropine

A

Tachycardia;
mydriasis/cycloplegia;
restless/confused;
unable to swallow, urinate, sweat; hot, red skin; fever; hallucinations; delirium; coma; death

17
Q

Do not use which medication for infranodal AV block

give examples

A

Atropine

2nd degree AV block Type II or 3rd degree AV block

18
Q

Caution with benign prostatic hypertrophy, bladder-neck obstruction for which medication?

A

atropine

19
Q

____sturcture meaning it can/cannot cross BBB

A

tertiary amine, CAN

20
Q

what is Robinol

A

Glycopyrrolate

21
Q

Glycopyrrolate

class/ catetory

A

Synthetic Anti-muscarinic

22
Q

Glycopyrrolate

uses, MOA

A

Uses:
* Reversal of NDNMB, antisialagogue
* treatment of bradycardia

Mechanism of Action:
Non-selective, competitive muscarinic antagonist

23
Q

Glycopyrrolate

Dosing

A

Reversal of NDNMB:
0.2 mg of Glycopyrrolate for every 1 mg of Neostigmine IV, slowly over 2-5 min

Antisialagogue or bradycardia:
0.1-0.2 mg IV push

24
Q

Glycopyrrolate

onset, peak, duration

A

Onset: Rapid

Peak: 3-7 min

Duration: 2-4 hr

25
Q

Glycopyrrolate

elimination

A

Renal

26
Q

Glycopyrrolate

CV effects

A

↑ HR, but less than Atropine

27
Q

Glycopyrrolate

pulm effects

A
  • Bronchodilator
  • Inhibits bronchial secretions
28
Q

Glycopyrrolate

CNS effects

A
  • Does not cross BBB, no CNS effect, no sedation
  • No mydriasis or cycloplegia
  • Unlikely to cause anticholinergic syndrome
29
Q

Glycopyrrolate

GI effects

A
  • ↓ LES and barrier pressure
  • ↓ GI motility
  • Inhibits pancreatic and GI secretions, including gastric acid
30
Q

glycopyrrolate has what action on salivation?

A

Antisialagogue - Inhibits salivary gland secretions

31
Q

glycopyrrolate should not be used in tx of which medication, and what are the associated side effects/ patient population?

A

Avoid use for treatment of dexmedetomidine-associated bradycardia in children (risk of profound HTN)

Anesthesia Pharmacology (5 decks)

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