anticholinergic Flashcards
what do anticholinergic drugs do?
cholinergic blocking/parasympatholytic
block acetylcholine action of PNS
Most block muscarinic receptors
A few at high doses block nicotinic receptors
example of anticholinergic drug?
atropine
Atropine is the antidote for a cholinergic crisis
MOA of anticholinergic receptor?
Occupy receptor sites at PNS nerve endings, leaving few free to respond to acetylcholine
CNS- simulation followed by depression
**Heart- increase heart rate
**Bronchodilation and decreased respiratory tract secretions
**Antispasmodic effects on GI
Mydriasis and cycloplegia
Miscellaneous
indications for use of anticholinergic receptors?
GI , genitourinary, ophthalmic and respiratory disorders
Bradycardia and heart block
**Parkinson’s disease
Preoperative use and bronchoscopy
**Anticholinesterase toxicity, mushroom poisoning, or organophosphate pesticide poisoning
contraindications for anticholinergics?
Prostatic hypertrophy Myasthenia gravis Hyperthyroidism Glaucoma Tachydysrhythmias Myocardial infarction Heart failure unless bradycardia is present
what is the antidote for cholinergic overdose? how long is this duration?
atropine. short duration. ocular effects may last for days though
what is belladonna tincture used for?
used s an ingredient in many mixtures for GI antispasmodic
what are homatropine hydrobomide used for?
eye drops to produce mydriasis an cycloplegia (belladonna alkaloid and derivative)
what is hyoscyamine (anaspaz) used for?
GI and GU disorders with spasm, increased secretions nad in motility
what is ipratropium (atrovent) used for?
treats rhunorrhea (nasal spray) **bronchodilator 9inhaled)
what is scopolamine used for?
depresses CNS
Used transdermally for motion sickness.
what is Tiotropium bromide (Spiriva HandiHaler
used for?
**treatment of COPD
what are some centrally acting anticholinergics?
Trihexyphenidyl (Trihexy)
Benztropine (Cogentin)
**
what is Trihexyphenidyl (Trihexy) used for
Parkinson’s Disease and Extrapyramidal reactions
what is benztropine (cogent) used for?
Anticholinergic and antihistaminic effects
**Treats acute dystonic reactions
Supplement antiparkinsonian drugs
what are some urinary antispasmodics?
flavoxate (crisps), oxybytyin**, tolterodine, trospium chloride
what does flavoxate do?
Relieves dysuria, urgency, frequency and pain associated with UTI and GU infections.
what does oxybutynin do? **
Direct antispasmodic effects, increases bladder capacity and decreases voiding
Used for neurological conditions like spinal bifida
what does tolterodine do?
Antimuscarinic anticholinergic agent
Inhibit bladder contraction, decrease detrusor muscle pressure and delay urge to void
what does Trospium chloride (Sanctura) do
newest antimuscarinic, anticholinergic drug for treatment of urinary problems
indications for anticholergics ?
renal or biliary colic, glaucome, GI disorders, parkinson’s, extrapyramidial
what drugs are given for renal or billiard colic? what does this do?
- *Atropine given with morphine to reduce pain of renal and biliary colic
- Decreases spasm-producing effects of opioid
- Little antispasmodic effect on involved muscles
if youre giving an anticholeringic drug for GI disorders are these large or small doses and when do you give them
large at bedtime
if giving anticholinergics for parkinson’s do u start small or go up in dose?
small and gradually inc
do you always give anticholinergics for extrapyramidal reactions?
only if symp
Which anti-cholinergic drugs cross the blood-brain barrier?
a. Anti-parkinson’s drugs b. Scopolomine c. All of the above d. None of the above
. All of the above
Rationale: Anti-cholinergic drugs that cross the blood–brain barrier include: atropine, scopolamine, and anti-parkinson agents.
what does anticholergic overdose syndrome look like? **
Hyperthermia; hot, dry, flushed skin; dry mouth; mydriasis; **delirium; tachycardia; paralytic ileus; and urinary retention. Myoclonic movements and **choreoathetosis may be seen. Seizures, coma, and respiratory arrest may also occur.
tx for anticholergic overdose syndrome?
Treatment involves use of activated charcoal to absorb ingested poison.
Hemodialysis, hemoperfusion, peritoneal dialysis, and repeated doses of charcoal are not effective.
