Anti-Nicotinic Drugs (Anticholinergic Drugs) Flashcards
What type of agents are NN selective anti-nicotinic drugs?
Ganglionic blockers
What type of agents are NM selective anti-nicotinic drugs?
Neuromuscular Blockers
What are the two types of Neuromuscular blockers?
NM antagonist (non-depolarizing) and NM agonist (depolarizing)
Name the MOA, clinical uses, effect on SKM, and effect in anti-ChE administration during block for Competitive Neuromuscular (non-depolarizing) Blocking agents
MOA: Occupy ACh binding sites on NM receptor, no efficacy
Clinical Uses: Muscle paralysis during surgery
Effect on SKM: Flaccid paralysis
Effect of an anti-ChE
administered during
block: Depolarization of end plate → reversal of block
Name the MOA, clinical uses, effect on SKM, and effect in anti-ChE administration during block for Depolarizing Neuromuscular Blocking agents
MOA: Occupy ACh binding sites on NM receptor, open ion channel, maintains depolarized state of end plate –> NaV channels in inactivated state
Clinical Uses: Muscle paralysis during surgery
Effect on SKM: Transient fasciculations followed by flaccid paralysis (depolarization blockade)
Effect of an anti-ChE
administered during
block: Prolongation of depolarized state maintains NaV channels in an inactivated state→ augmented block
What are the two types of anticholinergic drugs?
Anti-nicotinic and Anti-muscarinic drugs
What is the MOA for Muscarinic Antagonists?
Reversible blockade of muscarinic receptors
What are the effects on organ systems and their clinical uses for Muscarinic Antagonists?
CNS:
* If drug passes BBB: amnesia, agitations, hallucinations,
prevent vestibular disturbances
Clinical use: Motion sickness
Cardiovascular system:
* Blockade of M2 receptors on SA nodal cells –> tachycardia
* The removal of vagal tone to the heart may facilitate AV
conduction –> increased conduction velocity
Clinical use: Bradycardia, AV conduction block
Respiratory system:
* Bronchodilation, decreased secretions
Clinical use: COPD, asthma
Nasopharyngeal glands:
* decreased secretions
Clinical use: Rhinorrhea
Genitourinary tract:
* Detrusor relaxes –> urinary retention
Clinical use: Overactive bladder,
urinary urgency
What are the major clinical uses for Muscarinic Antagonists?
Bradycardia
AV block
Anti-ChE toxicity
Motion sickness
Overactive bladder
enuresis
neurogenic bladder
COPD
rhinorrhea
What are the adverse effects of Muscarinic Antagonists?
Dry mouth (Xerostomia)
increased Body temperature (decreased sweating, “atropine fever”)
Urinary retention
Constipation
Blurred vision
Tachycardia
What are the contraindications for Muscarinic Antagonists?
Urinary and GI obstruction
–Glaucoma
What type of toxicity occurs with Muscarinic Antagonist?
Atropine intoxication
