Anticholinergic Drugs

Question 1

What do Anticholingergic Drugs Do

Answer 1

Block Cholinergic-induced bronchospasms

Question 2

What are Anticholinergic Agents Only Effective

Answer 2

Cholinergic Blocking Agents are effective only if bronchoconstriction’s exist due to cholinergic activity.

Question 3

What do Beta Adrenergic agents actively stimulate

Answer 3

dilation

Question 4

What’s the only thing Anticholinergic drugs are approved for

Answer 4

COPD

Question 5

Examples for Anticholinergic Agents

Answer 5

Atropine, Ipratropium Bromide, Combivent, Triotropium

Question 6

Atropine, is Tertiary or Quarternary

Answer 6

Tertiary

Question 7

Atrovent & Spiriva are Tertiary or Quarternary

Answer 7

Quarternary

Question 8

What is Terteriary

Answer 8

Drugs that are not fully ionized therefore, they are readily absorbed and cross over the blood brain barrier and cause a systemic affect.

Question 9

What is Quarternary

Answer 9

Drugs that are not easily absorbed, fully ionized and low lipid solubility, therefore cannot pass over the blood brain barrier and do not cause a systemic affect

Question 10

The clinical differences between Aticholinergic’s and B Agonist

Answer 10

Onset begins within minutes, Peak is 1-2 Hours (B agonist peak in 20-30 minutes), Same affect for bronchodilations, however for COPD duration is longer in Ipras (1-2 hours)
(Onset, Peak and Affects on COPD)

Question 11

Nasal Sprays cause local side affects, T/F

What percent is absorbed

Answer 11

T

20% Nasally and 2% Blood

Question 12

What is Synergistic Effect

Answer 12

2 drugs that work better together than as individual drugs

Question 13

Triotropium Blocks what receptors

Answer 13

All M3 Receptors

Question 14

3 Side Effects if Tertiary Drug

Answer 14

Decrease Mucous Clearance, Altered CNS and Increase or Decrease HR, Urinary Retention

Question 15

Side Effects for a Quaternary Drug

Answer 15

Bronchodilation, Dry Mouth & Block Nasal Hypersensitivity

Question 16

Bronchoconstrictions in COPD

Answer 16

due to a mechanisms of the vegally mediated reflex innervation of airway smooth muscles

Question 17

What happens when C-fibers are activated at the Vegas

Answer 17

they are activated and produce afferent nerve impulses to the CNS, then Efferent impulse constrictions, mucus secretions and cough

Question 18

How do Anticholinergics Enter the lungs

Answer 18

At the Hila, from the Vegus Nerve.

Question 19

Where do Parysympathetic Postganglionic fibers terminate

Answer 19

On or near epithelium, submucosal mucous glands, smooth muscles and mast cells

Question 20

What size airways do Anticholinergics Work on

Answer 20

Large and Mid sized airways on the trachea and bronchioles

Question 21

Anticholinergic’s Depends on

Answer 21

tone to be blocked; Healthy there are minimal airway dilation’s for anticholinergic to work b/c of the basal or resting tone

Question 22

T/F - If there aren’t any parasympathetic activity, then anticholinergics have minimal effect

Answer 22

T

Question 23

They inhibit exercise induced asthma, psychogenic bronchoconstrictions caused by Beta Blocks & Cholinergic Agents

Answer 23

True

Question 24

Changes in airway make cough receptors more sensitive

Answer 24

True

Question 25

M3 Receptors Work on What?

Answer 25

Smooth Airway Muscles & Submucosal Glands that cause bronchoconstrictions and secretions

Question 26

Stimulation of M3 Cuase what 3 things?

Answer 26

Release of Intracellular Calcium, Inhibition of cGMP, & Increased Intracellular levels of cGMP

Question 27

Stimulation of cGMP Does What Things

Answer 27

Contraction of Airway Smooth Muscles, Increased Glandular Secretions, Released of Histamine

Question 28

T or F - They block the action of Ach at the M3 receptor in the airway reversing bronchoconstrictions due o cholinergic activity

Answer 28

T

Question 29

Why does Spiriva last for 24 hours

Answer 29

Because they act more slowly on the M1 and M3