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Pharmacology > Anti-Muscarinics > Flashcards

Anti-Muscarinics Flashcards

1
Q

Anticholinergics include

A

anti-muscarinics and ganglionic blockers

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2
Q

Atropine

A
  • Reverse muscarine or ACh inhibition poisoning
  • long lasting pupil dilation (for ophth exams)
  • anti-diarrheal (mixed with opiod) = lomotil
  • prevent M side effects in patient receiving ChE inh for myesthenia gravis.
  • intestinal spasms/pain
  • reduction of GI secretions
  • alt for amblyopia (pharmacological patch)
  • 3 amine so CNS effects
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3
Q

Scopolamine

A
  • motion sickness
  • cause drowsiness
  • patch
  • 3 amine so CNS effects
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4
Q

Tropicamide

A
  • short acting
  • pupil dilation
  • cyclopentolate and homatropine are similar
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5
Q

Cyclopentolate

A

-Similar to homatropine and tropicamide

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6
Q

Homatropine

A

-Similar to tropicamide and cyclopentolate

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7
Q

Ipratropium

A
  • quart amine
  • administered by inhalation
  • COPD – bronchodilation
  • tiotropium is similar but longer lasting
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8
Q

Tiotropium

A

similar to Ipratropium but longer lasting

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9
Q

Tolterodine

A
  • Antag at bladder mAChRs

- Overactive bladder, nocturia and incontinence

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10
Q

Dicyclomine

A
  • GI mAChRs – so relaxes the intestinal smooth muscle

- Overactive bowel

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11
Q

Glycopyrrolate

A
  • used preop to inh secretion
  • inh sweating
  • inh M overshoot after ChE inhibition (prevent M side effects for patient on neostigmine)
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12
Q

Benztropine

A
  • lipid soluble

- relieves extrapyramidal effects in Parkinson’s patients or antipsychotic patients

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13
Q

What side effects to they block

A

DUMBELS and SLUD

salivation, lacrimation, urination, defecation

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14
Q

effects of increasing doses of atropine

A

0.5- dry mouth and decreased sweating
1- incr HR, very dry mouth and thirst
2- blurred vision, tachycardia and palpitations
5- urinary retention, hot and dry skin, restlessness and fatigue
10- rapid and weak pulse, ataxia, hallucinations, delirium and coma

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15
Q

affects of atropine overdose

A 
hot as a hare (decr sweating, incr temp)
mad as a hatter (confusion, delirium)
red as a beet (flushed face, tachycardia)
dry as a bone (decr secretions, thirsty)
blind as a bat (pupil dilation)
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16
Q

contraindications

A

glaucoma

17
Q

classes of other drugs with anti M activity

A
  • sedating antihistamines
  • tricyclic antidepressants
  • phenothiazine antipsychotics
  • older NMB
  • Quinidine
  • Meperidine
18
Q

Anti-muscarinics

A

so they have symp because allows symp influence to become predominant.
Often distinguished by the duration of action and lack of CNS penetrance

19
Q

ocular effects of atropine

A
  • mydriasis - relaxes the iris sphincter, which allows symp tons to predominate on radial muscle.
  • blocks accommodation- relaxes/paralyzes the ciliary muscle, which increases tension on the ligaments, thereby flattening the lens.
  • inhibits lacrimation
20
Q

cardiac effects of atropine

A
  • standard doses may incr HR and antrioventricular conduction
  • very low doses may initially decrease HR by first blocking presyn Rs
21
Q

respiratory effects of atropine

A
  • bronchodilation

- inhibit secretions

22
Q

GI and urinary tract effects of atropine

A
  • relaxes gastrointestinal tone, (not sphincters) prolonging intestinal transit time.
  • inh gastric acid secretion
  • relaxes detrusor muscle of bladder causing urinary retention.
23
Q

CNS affects of atropine

A
  • first causes stimulation, followed by a sedating effect

- high doses can cause confusion and/or hallucinations

24
Q

other effects of atropine

A

inh sweating, possible leading to hyperthermia

25
Q

short acting mydriatic agents

A

Tropicamide, cyclopenolate, homatropine

26
Q

antiM adverse effects

A

Dry mouth (xerostomia), blurred vision, hot/flushed skin, constipation, difficulty urinating, tachycardia, confusion, sedation

27
Q

diphenhydramine

A

Antihistamine with anti-muscarinic activity

28
Q

tricyclic anti-depressants

A

Class of drug with anti-muscarinic activity

29
Q

chlorpromazine

A

Antipsychotic with anti-muscarinic activity

30
Q

amblyopia

A

Atropine is an alternate treatment to the eye patch

31
Q

low doses of atropine

A

Produce dry mouth and decreased sweating

32
Q

mod doses of atropine

A

Produces increased heart rate, blurred vision, possible urinary retention

33
Q

high doses of atropine

A

Produces rapid and weak pulse, ataxia, hallucinations, delirium and coma

34
Q

The effect of Atropine on bradycardia

A

Blocks M2 receptors allowing B1 receptors to predominate at the cardiomyocyte

35
Q

SLUD

A

Mnemonic for adverse actions of antimuscarinics; blocks salivation, lacrimation, urination, defecation

36
Q

DUMBELS

A

Mnemonic for Diarrhea, Decreased blood pressure, Urination, Miosis, Bronchoconstriction and Bradycardia, Excitation of skeletal muscle, Lacrimation, and Salivation and Sweating

37
Q

oxybutinin

A

Antimuscarinic used for overactive bladder; main side effects are dry mouth and constipation; contraindicated for narrow-angle glaucoma.

Pharmacology (10 decks)

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