Anticholinergic

Question 1

What are the tertiary amines- antimuscarinic Drugs? Why do these drugs cause drowsiness? What population is susceptible to this effect?

Answer 1

Atropine
Scopolamine (use 4 motion sickness)
Solifenacin (use for overactive bladder/urge incontinence)

They cross the BBB and effect the CNS. Very old and young patients are prone to this effect.

Question 2

What are the quaternary ammonium - antimuscarinic drugs? What are their routes of administration? What lung disease are they used to treat?

Answer 2

Glycopyrrolate (oral inhalation, topical, IM, IV & oral)
Ipratropium (oral and nasal inhalation)

Treats COPD

Question 3

What are the ganglionic blocking drugs?

Answer 3

Mecamylamine blocks the Nm and Nn receptors

Question 4

Which drug is prototypical?

Answer 4

Atropine

Question 5

Administration of an anti-muscarinic drug does what to the system?

Answer 5

Turns of the parasympathetic response. Tachycardia, increase in contractility, vasodilation (only at high dose=atropine flush), decrease GI motility and secretion, decrease sweating, and decrease gland secretion

Question 6

What drug is used for Parkinson’s disease?

Answer 6

An antimuscarinic drug like Benztropine

Question 7

What are the routes of administration for atropine?

Answer 7

Ophthalmic, IM, IV, Intraosseous, and endotracheal

Question 8

What type of poisoning can antimuscarinic drugs reverse?

Answer 8

anticholinesterase poisoning. Atropine is the drug of choice for this type of poisoning

Question 9

Which antimuscarinic drug comes in oral and nasal inhalation and treats runny nose?

Answer 9

Ipratropium

Question 10

What drug treats the following?
Treat axillary hyperhidrosis (excessive sweating)
COPD
Treat chronic drooling
Reduce secretions during anesthesia
Reversal of bradycardia
Reversal of muscarinic effect of cholinergic agents used for
neuromuscular blockade reversal

Answer 10

Glycopyrrolate

Question 11

What is the Beer Criteria?

Answer 11

States that antimuscarinic drugs should not be given to the elderly (over 65) because they are prone to cross into the CNS which causes CNS depression (drowsiness, the brain is too tired to tell the lungs to breathe)

Question 12

What does Mecamylamine do?

Answer 12

Reverses the normal parasympathetic tone. The blood vessels and sweat glands are under the control of the sympathetic tone and the resting state is vasoconstriction and sweating. Mecamylamine reverse these effects and causes vasodilation and anhidrosis

Question 13

Name the 5 direct drugs antimuscarinic drugs

Answer 13

1. Atropine
2. Scopolamine
3. Solifenacin
4. Glycopyrrolate
5. Ipratropium

Question 14

What sign would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker?

Answer 14

Postural hypotension occur with ganglion blockers but not muscarinic blockers

Question 15

What are some natural anti-cholinergic substances?

Answer 15

Belladonna, jimsonweed, deadly nightshade