Anticholinergic Bronchodilator Flashcards
What is a anticholinergic bronchodilator
Agent that blocks parasympathetic nervous fibers allowing relaxation of smooth muscles
What is antimuscarinic bronchodilator
Agent that blocks the effect of acetylcholine at cholinergic site
Parasympatholytic
Blocks parasympathetic fibers
Muscarinic
Agent that produces the effect of Ach or an agent that mimics ach
What is the indication for anticholinhergic bronchodilator and combined anticholinergic b- agonist bronchodilator
COPD maintenance
COPD maintenance and additional relief of airflow obstruction. Also in severe asthma that is not responsive to B- agonist therapy alone
What are the types of anticholinergic agents
Ipratropium bromide (Atrovent)
1.Combivent- combination of albuterol and ipratropium bromide
2.Duoneb
3.Combivent Respimat- contains a parasympatholytic and sympatholytic agents
4.Umeclidinium
What are the specific anticholinergic agents
- Aclidinium bromide (Tudorza pressair)
- Tioteopium bromide ( spiriva )
- Umeclidinium bromide ( incruse ellipta)
- What is ipratropium bromide ( Atrovent HFA), its indication, and how it’s administered *
Ipratropium bromide is an anticholinergic that can be administered via aerosolization. Nonselective antagonist of M1 M2 M3 muscarinic receptor
Indicated treatment for
- maintenance therapy for COPD
- allergic rhinitis
- non allergic rhinitis
- viral rhinitis aka variations of cold
Available as:
MDI, SVN and Nasal spray
What ways can combivent ( albuterol and ipratropium) be delivered
Nebulizer, MDI and soft mist inhaler
Chemical structures of two naturally occurring belladonna (deadly nightshade) alkaloids are:
Tertiary ammonium compounds
Quaternary ammonium compounds
Poorly absorbed in bloodstream
Better for inhalation
Less affects compared to tertiary ammonium compounds
Mucociliary slowing, bronchodilation and increased heart rate are all results of what
Anticholinergic agents
What’s the comparison of cholinergic antagonism (antimuscarinic) with cholinergic effects (muscarinic effects)
Cholinergic effect:
Decreased heart rate
Miosis- eye contraction
SLUD
Secretion of mucous
Bronchoconstriction
Anticholinergic effect:
Increased HR
Mydriasis- eye dilation
Urinary retention
Constipation
Mucociliary slowing
Unable to constrict
What are the cardiac effects of tertiary (atropine)
With slow dose= minor slowing of HR
Large dose= increased HR
An inappropriately high dosage of anticholinergic tertiary ammonium compound like atropine could give you these side effects
Blurred vision
Pupil dilation
Coma
Hallucination
Prevent lens thickening
