anticholinergics

Question 0

two other names for anticholinergics

Answer 0

parasympatholytics

antimuscarinics

Question 1

where do anticholinergics exhibit their actions?

Answer 1

antagonize ACh at cholinergic post-ganglionic sites AKA muscarinic receptors

Question 2

do anticholinergics in usual doses have an effect on post-ganglionic nicotinic receptors

Answer 2

no, just muscarinic receptors

Question 3

atropine and scopalamine are what kind of anticholinergics

Answer 3

tertiary amines

alkaloids of the belladonna plant

Question 4

glyco is what kind of anticholinergic

Answer 4

• semi-synthetic congener of belladonna alkaloid

- quaternary ammonium derivative

Question 5

can glyco cross the BBB?

Answer 5

No, only the tertiary amines can

Question 6

naturally occurring anticholinergics are esters formed by combining __ acid and an organic base of __ or __

Answer 6

tropic acid + either tropine or scopine

Question 7

structurally, belladonna alkaloids resemble __

Answer 7

cocaine

Question 8

do we Like the dextrorotary or Levorotary forms of anticholinergics

Answer 8

Like = Levorotary

Question 9

which anticholinergics are racemic mixtures?

Answer 9

atropine and scop

Question 10

are synthetic anticholinergics racemic mixtures?

Answer 10

no

Question 11

does glyco contain tropic acid?

Answer 11

nope, mandelic acid, like nelson mandela

Question 12

anticholinergics contain a __ portion that fits in the muscarinic receptor just like ACh

Answer 12

cationic

Question 13

anticholinergics combine __ with muscarinic receptors without eliciting a response and prevent ACh from binding to the receptor

Answer 13

reversibly

competitive antagonist

Question 14

muscarinic receptors are __ protein coupled receptors

Answer 14

G protein

Question 15

avoid __ for glaucoma patients

Answer 15

scop

Question 16

which anticholinergic is given for cardian preops because it decreases metabolic o2 requirements?

Answer 16

scop

“those patients are bombed out of their minds, dancing naked on the bed three days later”

Question 17

can atropine actually slow the HR?

Answer 17

yes, atropine is not a pure antagonist, also has weak agonist effects

Question 18

which anticholinergic has prolonged elimination in ESRD patients?

Answer 18

glyco

Question 19

what is the reversal for restlessness/somnolence due to anticholinergics

Answer 19

physostigmine

Question 20

which is the best antisialogogue?

Answer 20

scop, then glyco

but scop is sedating so glyco given most often

Question 21

dosage of atropine to treat bradycardia

Answer 21

15-70 mcg/kg, has a ceiling effect where no further increase can be obtained

Question 22

are anticholinergics very effective for treating bradycardia in infants and elderly?

Answer 22

not really, they don’t have as much vagal control of the heart compared to teens who faint when you come at them with a gelco

Question 23

will anticholinergics help increase your HR after transplant?

Answer 23

nope, it’s de-innervated so gotta use epi

Question 24

what do anticholinergics due to the airway?

Answer 24

dilate bronchi, decrease resistance, increase dead space

ipratroprium (atrovent) the most common = quaternary ammonium congener of atropine

Question 25

central cholinergic syndrome
red as a \_\_
dry as a 
blind as a
mad as a 
hot as a

Answer 25

red as a beet
dry as a bone
blind as a bat
mad as a hatter
hot as a hare

Question 26

treatment for central cholinergic syndrome?

Answer 26

physostigmine 15-60 mcg/kg