anti-muscarinic drugs

Question 1

anti -muscarinic drugs are good for ..

Answer 1

blocking “DUMBBLLSS” symptoms

(“two dumb-fucks sitting on motorcycle and squeezing dumbells”)

Question 2

name the anti-muscarinic drugs

Answer 2

Muscarinic antagonists
Atropine
(“alice in wonderland”)

Scopolamine
(“seasick seal sailor outfit holding telescope”)

M3 Antagonists
Ipratropium /Tiotropium
(“cat-ipa-tio tropillar” caterpillar sitting on mushroom”)

Oxybutynin
(“Ox butler”)

Tolterodine
(“Turtle butler”)

M1 Antagonists
Benztropine
(“BENZ Parked in M1”)

Trihexyphenidyl
(“car with 3 hexagons parked in M1”)

Question 3

Atropine

(“alice in wonderland”)

Answer 3

from Belladona flower (“alice holding pink flower”) or Jimms weed(“Jimms weed tea bag incup next to alice”)

-antimuscarinics block M2 therefore block Parasympathetic activity on heart leading to elevated HR and AV conduction
(“crazy queen holding heart with jewel nodes “)

• increases heart rate (anti-M) and useful for bradycardia (“bunny elevates heart watch”)
• increase AV conduction (anti-M) and is useful for treatment of AV blocks

(“heart shield” resembels block “falling heart shields because of anti-M effect”)

• can cross BBB and and has CNS effects
  (“CNS hat on sick sea sailor”)

Question 4

Scopolamine

(“Sea Sick Seal sailor holding telescope “)

Answer 4

-can cross BBB (Anti-M) and has CNS effects
(“Sick Seal Sailor’s hat says CNS on it “)

• to treat motion sickness/ vestibular nausea
  (“sea sick sailor”)

-administered in for of transdermal patch
(“sea sick seal sailor has eyepatch on”)

-antimuscarinics cause mydriasis and *cycloplegia
(“sea sick sailor holding telescope with dilated pupil”)

Question 5

Ipratropium/Tiotropium-M3 antagonists

(“Cat-ipa-tio-tropillar” blue caterpillar smoking hookah sitting on mushroom)

Answer 5

• inhaled antimuscarinic bronchoDILATORS (“Caterpiller inhaling Shisha smoke”)
• useful in management of COPD since they act as bronchodilators as well as reduce secretions

(blue bloater- “blue caterpillar “ pink puffer -“pink shisha”)

-Tiotropium dissociates slower therefore is used as a long lasting bronchodilator
(“long lasting TIOoo smoke rings”)

Question 6

Oxybutynin/Tolterodine-M3 antagonists

(“Ox butler / Turtle butler”)

Answer 6

-useful in treatment of Bladder spasms as well as Urinary incontinence

(“ox butler Turning off Bladder”)

Question 7

Benztropine - M1 antagonist
(“BENZ car parked in M1)

Trihexyphenidyl-M1 antagonist
(“Car with 3 hexagons parked in M1”)

Answer 7

-M1 receptors are found in nerves and CNS
(M1 Parking spots below “Parking Center” sign)

-useful in treatment of tremors and rigidity seen in Parkinson’s disease

(BENZ and TRIHEX cars parked under the sign “PARKING CENTER” having “Shakey Antenas” to resemble tremors and rigidity of parkinson’s)

-antimuscarinics are useful in treatment of extrapyramidal side effects caused by antipsychotic drugs such as

• Dystonia
• ​Akathisia
• ​Parkinsonism

(falling cone next to M1 cars saying “EXTRA PARKING”)

Question 8

What are the side effects of antimuscarinic drugs ?

Answer 8

-elevated HR
(“bunny elevates heart watch”)

-dry mouth/eyes
(“Dry as a cracker” , crackers on the table )

-blurred vision due to Mydriasis/Cycloplegia
(“blind as a bat” bat flying over kettle shaped like dilated eye with high pressure steam coming out “)

• decreased outflow of AQH increase intraocular pressure thus increase risk for
  acute angle Glaucoma

(“high pressure steam from kettle towards already blind bat”)

• CNS Effects (“mad as a hatter” hatter’s hat says “M1”)
• Sedation
• ​Agitation
• ​Hallucination
• ​Coma