Anticholinergics

Question 1

Anticholinergics antagonize the effects of ACh at WHAT muscarinic receptors:

Answer 1

• Heart
• Salivary Glands
• Smooth muscle GI and GU tracts

Question 2

T/F: Anticholinergic exert little or no effect at nicotinic receptors called the neromuscular junction and autonomic ganglia.

Answer 2

True

Question 3

What anticholinergics are naturally occurring tertiary amines:

Answer 3

• Atropine

- Scopolamine

Question 4

What anticholinergics are semisynthetic congeners (Quaternary ammonium):

Answer 4

Glycopyrrolate

Question 5

T/F: Tertiary amines cannot cross the BBB.

Answer 5

False

Question 6

Semisynthetic congeners (quaternary ammonium) can cross the BBB:

Answer 6

False

Question 7

T/F: Anticholinergics are competitive antagonists:

Answer 7

True

Question 8

Do anticholinergics prevent the release of ACh or react with it?

Answer 8

NO

Question 9

What are the 5 distnct subtypes of muscarinic cholinergic receptors:

Answer 9

• M1 - CNS and Stomach
• M2 - Lungs and Heart
• M3 CNS, Airway, Smooth muscle, Glandular tissue
• M4 - CNS
• M5 - CNS

Question 10

What muscarinic cholinergic receptor does not act with the CNS:

Answer 10

M2

Question 11

T/F: At small doses anticholinergic drugs can produce heart rate slowing due to direct agonist effect.

Answer 11

True

Question 12

What is the onset of iV atropine:

Answer 12

1 minute (Half life 2-3 hours)

Question 13

What is the onset of IV glycopyrrolate:

Answer 13

2-3 minutes (Half life 1.25 hours)

Question 14

What are anticholinergic uses:

Answer 14

• Preoperative medication
• Sedation
• Antisialagogue
• Prevent vagal reflexes
• Treat reflex-mediated bradycardia
• Combined with anticholinesterase drugs
• Bronchodilitation
• Prevent motion-induced nausea

Question 15

T/F: (Sedation) Atropine is 100x more potent the atropine to decrease activity of the R.A.S.

Answer 15

False (Scopolamine is 100x…)

Question 16

T/F: Atropine has increased incidence of memory deficits compared to glycopyrrolate.

Answer 16

True

Question 17

T/F: Anticholenergic can delay awakening particularly in elderly patients.

Answer 17

True

Question 18

T/F: Atropine and scopolamine do not cross the placenta.

Answer 18

False

Question 19

T/F: (Antisialagogue effect) Scopolamine is x3 more potent than atropine and glycopyrrolate 2x more potent with a longer duration of action.

Answer 19

TRUE

Question 20

T/F: Atropine will blunt the affect of the vagal reflex response.

Answer 20

True

Question 21

What does anticholinergics stop with use of anticholinesterase:

Answer 21

Prevent the parasympathomimetic effects of anticholinesterases