Anticholinergics

Question 1

which receptors do anticholinergics effect?

Answer 1

MUSCARINIC RECEPTORS

Question 2

anticholinergic MOA

Answer 2

competitively blocks by binding ACh muscarinic receptor and inhibits the secondary effects

Question 3

Muscarinic receptors

Answer 3

M1 - neuronal
M2 - cardiac (inhibitory)
M3 - glandular

Question 4

CV Effects of anticholinergics

Answer 4

blocking M2 at SA node -> tachycardia

- very helpful in patients with high vagal tone

Question 5

Resp Effects of anticholinergics

Answer 5

inhibits secretions, relaxation of bronchial muscle

Question 6

CNS Effects of anticholinergics

Answer 6

excitation, restlessness, hallucinations

Question 7

GI Effects of anticholinergics

Answer 7

• decreased saliva, gastric secretions

- decreased peristalsis and motility

Question 8

Eye Effects of anticholinergics

Answer 8

mydriasis and cycloplegia

Question 9

GU Effects of anticholinergics

Answer 9

decreased ureter tone => retention

Question 10

Atropine

Answer 10

tertiary amine (crosses BBB)
- VERY potent on heart and bronchial smooth muscle
- most efficacious for treating bradyarrhythmias
- careful in patients with CAD -> may worsen O2 demand/supply balance
DOSE: 0.01-0.02 mg/kg

Question 11

Scopolamine

Answer 11

tertiary amine, patch 
- greater antisialagouge and CNS effects than atropine
- prevents PONV
*worry about sedation
DOSE: 0.1-0.2 mg/kg

Question 12

Glycopyrolate

Answer 12

synthetic quaternary amine
- CANNOT cross BBB (devoid of CNS effects)
- potent inhibitor of secretions
- useful in OR for bradycardia from vagal reflex
- duration of 2-4 hrs
DOSE: 0.005 - 0.01 mg/kg