Anticholinergics

Question 1

effects

Answer 1

sedative, antisialogogue, mydriatic
-block cholinergic-parasympathethomimetic effects
[SLUDE+brady+bronchoconstriction+pupillary constriction
-salivation, lacrimation, urination, defecation, erection]–blocked by anticholinergics

Question 2

scopolamine/atropine/glyco

Answer 2

• sedative: scopolamine 100 x more than atropine
• antisialogogues: scopolamine and glyco 3 x more potent than atropine
• glyco does not corss BBB

Question 3

placenta/bbb

Answer 3

• scopolamine and atropine cross placenta, but fetal heart rate not changed
• physostigmine crosses BBB, antagonizes scopolamine

Question 4

barbiturate-anticholinergic premed

Answer 4

-high incidence of excitement

Question 5

atropine vs scopolamine

Answer 5

• atropine better bronchodilator, greater tachcyardia

- scopolamine better antisialogogue, more sedating

Question 6

central anticholinergic syndrome

Answer 6

• overdose of anticholinergics
• caused by atropine/scopolamine b/c cross BBB, not glyco
• rx with physostigmine
• fever, blurred vision, photophobia, tachycardia, restlessness, somnolence

Question 7

ipratropium

Answer 7

• MDI, treats bronchospasm due to beta antagonists
• more effective than beta agonists in COPD/emphysema
• added bronchodilatory effect when combined with beta-2 agonists
• blocks cGMP–effects on mucociliary activity and mucous secretion are minimal, minimal systemic absorption