Anti-Cholinergic Drugs (Ch. 13)

Question 1

What are 3 common Anti-Cholinergics?

Answer 1

1) atropine
2) glycopyrrolate
3) scapolamine

Question 2

General Effects on CVS

Answer 2

Tachycardia (in SA node)
-> little to no effect on ventricular function or peripheral vasculature
Small doses of Atropine (0.4mg) via IV can cause transient decrease of HR

Question 3

General Effects on Respiratory

Answer 3

Bronchodilation, Antisialogue (inhibiting secretions).

*relaxation of bronchial smooth muscles reduces Raw and increases anatomical deadspace

Question 4

General Effects on Cerebral

Answer 4

Can stimulate, can depress CNS (depending on drug or dose)

• Stimulation: excitation, hallucinations, restlessness
• Depression: sedation, amnesia -> prominent with scapolamine

Question 5

Atropine (aka ipratropium Bromide via MDI)

• Route
• Dose
• Duration
• mechanism
• Side effects on memory

Answer 5

Route: IV or IM
Dose: 0.4-0.6 mg
Duration: 30minutes
*Best for severe bradycardia and bradyarrhytmias
*crosses BBB
*mild post-op memory deficits
*reliable antisialagogue via IM

Question 6

Scapolamine

• Route
• Dose
• Side Effects

Answer 6

Route: IM or transdermal
Dose: 04.-0.6 mg
Side effects: restlessness, dizziness, delirium, drowsiness, amnesia
*Increases CNS effects
*More potent antisialagogue than atropine
*prevents motion sickness
*Transdermal is used to prevent PONV
*lipid solubility allows transdermal absoprtion

Question 7

Glycopyrrolate

• Route
• Dose
• Duration
• mechanism

Answer 7

route: IV or IM
dose: 0.005-0.01 mg/kg (max 0.2-0.3mg in adults)
duration: 2-4 hours
*does not cross BBB
*potent inhibition of GI and Resp secretions -> premed goal
HR increase with IV. NOT IM