Anticholinergics & Methylxanthines

Question 1

What is the action of anticholinergic drugs?

Answer 1

Block ACh from binding to R on certain nerve cells –> inhibits PSNS nerve impulses (responsible for involuntary muscle movements in the GI & GU tracts, lungs, and other parts of the body.

Question 2

Most widely used agent prescribed for COPD or asthma?

Answer 2

Anti-muscarinic agents

Question 3

Muscarinic antagonists inhibit…?

Answer 3

bronchoconstriction

Question 4

Ipratropium

Answer 4

• bronchodilator for maintenance trx of bronchospasm
• Potent atropine analog that is poorly absorbed after aerosol administration and is relatively free of systemic atropine-like effects

Question 5

Tiotropium

Answer 5

• Anti-ACh drug indicated for long-term, once-daily, maintenance trx of bronchospasm assoc w/ COPD, and for reducing COPD exacerbation

Question 6

Aclidinium

Answer 6

• Indicated for long-term maintenance trx of bronchospasm assoc w/ COPD, including chronic bronchitis & emphysema

Question 7

Methylxanthines

Answer 7

• Class of drug derived from purine base xanthine, which is produced by plants and animals.
• Includes Theophylline, Theobromine (found in chocolate), and Caffeine

Question 8

How does Theophylline work in the airways of pts with reversible obstruction?

Answer 8

1. Smooth muscle relaxation (bronchodilation) by blocking the effects of adenosine
2. Suppression of the response of the airways to stimuli (non-bronchodilator prophylactic effects); theophylline inhibits the action of PDE, which converts cAMP –> AMP

Question 9

Theophylline

Answer 9

• Used in the trx of asthma and other lung problems, such as emphysema & chronic bronchitis
• D/T increased risk of exacerbation, use extreme caution in pts with active PUD, seizure disorders, & cardiac arrhythmias.