Anticholinergics

Question 1

What are the generic and brand names of anticholinergics?

Answer 1

• Tiotropium (Spiriva)

* Ipratropium (Atrovent)

Question 2

What is the method of action of anticholinergics?

Answer 2

• Compete with acetylcholine to inhibit muscarinic receptors
• = parasympathetic effects
• ↑ heart rate, ↓ smooth muscle tone, secretions from glands in the respiratory and GI tracts

Question 3

What are the indications for anticholinergics?

Answer 3

• COPD – short acting relieves breathlessness, long acting prevent breathlessness and exacerbations
• Asthma – short acting relieves breathlessness during acute exacerbations, long acting added to high dose inhaled corticosteroid and long acting B2 agonists

Question 4

What are the contraindications for anticholinergics?

Answer 4

• Angel-closure glaucoma (aqueous flow is blocked and pressure rises very quickly) – can cause ↑ in intraocular pressure
• Risk of arrhythmias

Question 5

What are the side effects of anticholinergics?

Answer 5

Dry mouth

Question 6

Which organ eliminates anticholinergics?

Answer 6

Kidney

Question 7

What information should the patient receive before taking anticholinergics?

Answer 7

• Explain inhaler technique

* Chew gum/suck sweets/drink water to overcome dry mouth side effect