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SRNAPharmacology II > Anticholinergic Drugs > Flashcards

Anticholinergic Drugs Flashcards

1
Q

Anticholinergic drugs class

A

Competitive antagonists for Ach at muscarinic cholinergic receptors for in heart, salivary glands and smooth muscle of GI

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2
Q

Tertiary amine drug (2)

A

Atropine and Scopolamine

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3
Q

Quarternary amine drug

A

Glycopyrrolate

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4
Q

Which one types are unionized and cross BBB

A

Atropine

Scopolamine

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5
Q

Anticholinergic ONLY WORK at

A

MUSCARINIC receptors.

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6
Q

MOA of anticholinergic

A

combine reversibly with muscarinic receptors and

Prevent access of ACH to receptor site

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7
Q

Five subtypes of muscarinic

A

M1, M2, M3, M4, M5

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8
Q

Atropine affects

A

All Ms receptors

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9
Q

M1 found in

A

CNS and stomach

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10
Q

M2 found in

A

CNS and heart

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11
Q

M3 found in

A

Salivary glands
Airway smooth muscles
SALIVATION

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12
Q

M4 found in

A

CNS and heart

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13
Q

M5 found in

A

CNS

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14
Q

Effects on M2

A

Bradycardia

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15
Q

With those agents, doses needed to affect the heART.

A

Larger doses to affect the heart.

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16
Q

FIRST EFFECTS OF ANTICHOLINERGIC IS ON

A

SALIVARY GLANDS

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17
Q 
*****Comparative effects : Greatest and least effect
Sedation\_\_\_\_\_\_\_\_\_\_
Antisialagogue \_\_\_\_\_\_\_\_\_
Heart
Smooth muscle
A

Compare

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18
Q

Greatest SEDATIVE PROPERTY

A

SCOPOLAMINE

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19
Q

NO sedative

A

GLYCOPYRROLATE

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20
Q

If you don’t want any HR increase or stimulation

A

GLYCOPYRROLATE

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21
Q

GREATEST effects on heart

A

ATROPINE

22
Q

You don’t want Any IOP (avoid in glaucoma)

A

GLYCOPYRROLATE

23
Q

Worst effect on IOP (increase)

A

SCOPOLAMINE

24
Q

Motion- induced sickness BEST

A

SCOPOLAMINE

25
Q

Motion sickness WORST

A

GLYCOPYRROLATE

26
Q

100 times more potent than atropine as a sedating

A

SCOPOLAMINE

27
Q

Not to be use in elderly, why?

A

SCOPOLAMINE; increase confusion, agitation

28
Q

Fastest onset of action

A

1 minute

DOA 30-60 minutes

29
Q

Does glycopyrrolate cross BBB? why not?

A

No; quaternary compound

30
Q

Atropine metabolism and excretion

A

liver

urine

31
Q

Anticholinergic use (2)

A

Prevent bradycardia

Sedative and antisialalogue effects

32
Q

Less effect on pupil size_______

A

Glycopyrrolate

33
Q

They can use as _______

A

Bronchodilators because they BLOCK parasympathetic NS

34
Q

Dose of scopolamine for sedation

A

0.3-0.5mg IM

35
Q

Central anticholinergic syndrome

A

ranging from restlessness to somnolence
Elderly patients more sensitive
ESPECIALLY with SCOPOLAMINE

36
Q

What can potentiate anticholinergic syndrome

A

VA

37
Q

What agent to reverse CNS effects of tertiary amine?

A

PHYSOSTIGMINE 15-60mcg/kg

38
Q

Anticholinergic can

A

Decrease barrier pressure

39
Q

Atropine and glycopyrrolate can

A

Decrease LES pressure

40
Q

TREATMENT of REFLEX-MEDICATED BRADYCARDIA

A

Atropine 15-70 mcg/kg IV

most rapid onset

41
Q

Atropine use with _______reversal agent

A

EDROPHONIUM

42
Q

Glycopyrrolate use with _______reversal agent

A

NEOSTIGMINE

43
Q

ATROVENT

A

Derivative of atropine
Quarternary compound
slow onset of action
Less effective than albuterol

44
Q

Anticholinergic in the eye causes

A

MYDRIASIS and CYCLOPLEGIA

45
Q

Patients with GLAUCOMA should not be given

A

SCOPOLAMINE

46
Q

Anesthesia implications : SCOPOLAMINE

A

Effective in tx of N/V associated with morphine PCA and epidurals

47
Q

Prophylactive TD scopolamine

A

applied evening before decreases nausea associated with laparoscopy in GA.

48
Q

Symptoms of Anticholinergic OVERDOSE

A 
Dry mouth
Blurred vision
Photophobia
TACHYCARDIA
Dry flushed ksin
Rashes
49
Q

Treatment of OVERdose is

A

Physostigmine 15-60 mcg/kg IV

50
Q

Symptoms CNS overdose

A

CNS

Seizures, coma and medullary ventilatory center paralysis

SRNAPharmacology II (32 decks)

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