Anti-Cholinergic Pharmachology

Question 1

MoA of Anti-cholinergic drugs

Answer 1

Interrupt parasympathetic nerve impulses in the CNS & ANS –> prevent ACH receptor binding

Question 2

The cholinoreceptor antagonists consist of?

Answer 2

1. Muscarinic receptor blockers (anti-muscarinic)
2. Nicotinic receptor blockers (anti-nicotinic)

Question 3

Paradoxical effects on Anti-muscarinics depend on?

Answer 3

1) Dosage
2) condition being treated
–> it has opposite effects from muscarinic agents

Question 4

Adverse effects of Anti-cholinergics

Answer 4

1) decreased sweating
2) decreases bronchile secretion (Bronchodilation)
3) increased HR
4) Mydriases (pupil dilation)
5) Constipation
6) Blurred vision
7) decreased salivation
8) Decreased GI motitility and secretions
9) bladder muscle relaxation

Question 5

Category of Atropine

Answer 5

Anti-cholenergic Belladonna alkaloid
–> M2 Antagonist

• M2 Antagonists are found in the SA and NA

Question 6

Indication of Atropine

Answer 6

1)Bradycardia
(by blocking M2 receptors in the SA)
2) Opthalamic applications (Eye drops–> Mydriasis before surgery)

Question 7

MoA of Atropine

Answer 7

Muscarinic recepetor antagonist

Question 8

PK/PD of Atropine

Answer 8

1) Eye –> prod mydriasis and cytoplegis.
2) Respiratory –> it causes
bronchodilation, decreases secretions.
3) GI:
- Stomach –> decreases acid secretion.
- Gut–> decreases motility.
4) Urinary (bladder) –> decreases urgency
in cystitis

Question 9

Adverse effects of Atropine toxicity

Answer 9

1) decreased sweating, salivation, and Lacrimation (Dry as a bone)
2) Hyperthermia (Hot as a pistol)
3) dilatation of the cutaneous vessels of the arms, neck, head and trunk (red as a beet)
4) sedation, amnesia, and delirium (Mad as a hatter)

Question 10

Indication of Pirenzepine

Answer 10

Hyperactive GI disorders

Question 11

MoA of Pirenzepine

Answer 11

1) Muscle relaxation
2) decreases GI secretions

Question 12

Indication of Oxybutynin

Answer 12

Spastic/Hyperactive urinary tract conditions (over urination)

Question 13

PD of Oxybutynin

Answer 13

bladder muscle relaxant

Question 14

MoA of Hyoscine

Answer 14

During diagnostics – e.g. GI
endoscopy for SM relaxation

Question 15

Indication of Hyoscine

Answer 15

Used for:
1) CNS
2) Motion sickness
3) Postoperative nausea and vomiting

Question 16

Indication of Ipratropium and Tiotropium

Answer 16

Asthma and COPD

Question 17

Indication of Cyclopentolate and Tropicamide

Answer 17

Cycloplegics :
1. paralyze ciliary eye muscles (loss of accommodation)
2. alter the shape of lens

Mydriatics:
–> pupil dilation for eye exams/surgery

Question 18

Anti-Muscarinics are contraindicated in?

Answer 18

1) Infants –> danger of Hyperthermia
2) Glaucoma (especially closed-angle glaucoma)
3) Men with Prostatic Hyperplasia (urinary retention)

Question 19

Anti-nicotinic drugs are aka? uses?

Answer 19

Ganglion-Blocking drugs
they were used for Hypertention

Question 20

Examples of Ganglion blocking drugs

Answer 20

1) Hexamthonium
2) Mecamylamine

Question 21

Adverse effects of Orangophosphate toxicity

Answer 21

delayed peripheral nerve degeneration–> progressive wakness and sensory loss

Question 22

Treatment for Orangophosphate AChE inhibitor Insecticides toxicity

Answer 22

Pralidoxime (2-PAM) and Atropine