Anticholinergics

Question 1

KT: anticholinergic bronchodilator

Answer 1

agent that blocks parasympathetic nervous fibers, which allow relaxation of smooth muscle in the airways

Question 2

KT: antimuscarinic bronchodilator

Answer 2

same as anitcholinergic broncodilator—agent that blocks the effectof Ach at the cholinergic site

Question 3

KT: cholinergic/muscarinic

Answer 3

agent that produces the effect of Ach

Question 4

KT: parasympatholytic

Answer 4

blocking parasympathetic nervous fibers

Question 5

KT: parasympathomimetic

Answer 5

producing effects similar to the parasympathetic nervous system

Question 6

Clinical indications for use of an anticholinergic bronchodilator

Answer 6

COPD maintenance

acute exacerbation

Question 7

Clinical indication for anticholinergic and β-agonist bronchodilators

Answer 7

COPD + airway obstruction

Question 8

Atropine

Answer 8

Anticholinergic, Parasympatholytic, Antimuscarinic

Not recommended for inhalation

Question 9

Ipatropium bromide

Answer 9

Anticholinergic, Parasympatholytic, Antimuscarinic
Atrovent HFA - HFA MDI, SVN, Nasal Spray
Onset: 15 min; Peak: 1-2 hr; Duration: 4-6 hr

Question 10

Ipatropium bromide + Albuterol

Answer 10

Combination of a anticholinergic and β2-agonist
Combivent - MDI
Duoneb - SVN
Onset: 15 min; Peak: 1-2 hr; Duration 4-6 hr

Question 11

Tiotropium bromide

Answer 11

Anticholinergic, Parasympatholytic, Antimuscarinic
Spiriva - DPI
Selective for M1 & M3 receptor types
Onset: 30 min; Peak: 1-3 hr; Duration: 24 hr

Question 12

Glycopyrrolate

Answer 12

not something we really use
not approved for inhalation
used parenterally to reverse neuromuscular blockade

Question 13

Aclidinium bromide

Answer 13

Anticholinergic, Parasympatholytic, Antimuscarinic
Tudorza Pressair -DPI
Currently being developed by Forest Laboratories
log-acting anticholinergic bronchodilator

Question 14

Pharmacologic effects of anticholinergics

Answer 14

increased HR, pupil dilation, drying of airways, slows mucus production, inhibits constriction

Question 15

M1 receptor

Answer 15

• parasympathetic ganglia
• facilitate neurotransmission and bronchoconstriction
• cause secretion and rhinitis in nose

Question 16

M2 receptor

Answer 16

• inhibit continued use of Ach

- blockade may enhance Ach release, conteracting bronchodilation

Question 17

M3 receptor

Answer 17

• smooth airway muscle
• cause bronchoconstriction
• cause secretion and rhinitis in nose

Question 18

Side of Effects of Anticholinergics

Answer 18

Dry mouth (most common); Mydriasis; SVN: pharyngitis, dyspnea, flulike symtpoms, bronchitis, upper resp. infection