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Pharmacology > Antimuscarinics > Flashcards

Antimuscarinics Flashcards

0
Q

What is the mechanism of action of Atropine?

A

“Competitively and reversibly bind to muscarinic receptors to inhibit binding of Ach allowing sympathetic response to dominate
Antagonizes histamine and serotonin.”

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1
Q

What is the drug classification of Atropine?

A

“Anticholinergic (muscarinic receptor antagonist)

Tertiary amine = crosses BBB”

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2
Q

What are the indications of Atropine?

A

“Treatment of PEA and bradycardia - vagolytic
antisialagogue
Treat muscarinic effects of Acetylcholinesterase Inhibitors
Biliary and ureteral spasm from opioids
Bronchodilation
Pupillary dilation”

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3
Q

What is the onset, DOA, E 1/2T, VD, and Metabolism of Atropine?

A 
"Onset = 1 min
DOA = 30-60mins
E1/2t = 2-3 hrs
Vd 1.5L/kg
40% PB"
Hepatic and  Urine 18% unchanged
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4
Q

What is the adverse effects of Atropine?

A 
"Blurry vision
Pupillary dilation
↑IOP
Delirium
Sedation/hallucinations/disorientation
Dry mouth
Increased HR and CO
Urinary retention and constipation
Anticholinertic syndrome = physostigmine (also crosses BBB)"
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5
Q

What are the contraindications of Atropine?

A 
"hypersensitivity
glaucoma
CAD
Pheo
Thyrotoxicosis
Hperpyrexia
Mobitz II
GI obstruction
AchE therapy (myestheia gravis)"
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6
Q

What is the dosage of Atropine?

A

“0.4-1mg bradycardia
0.2-0.4 mg IV pre-op
2mg in 5ml NS via Nebulizer
(0.01mg/kg) 7-10mcg/kg reversal (edrophonium 0.5-1mg/kg IV)
1mg IV Q3-5ming to total 0.04mg/kg (3mg) for resuscitation”

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7
Q

What is the drug classification of Scopolamine?

A

“Anticholinergic (muscarinic receptor antagonist)

Tertiary amine that crosses BBB”

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8
Q

What is the mechanism of action of Scopolamine?

A

Competitively and reversibly bind to muscarinic receptors to inhibit binding of Ach (SA node) preventing the action on parasympathetic systems and allowing sympathetic response to dominate

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9
Q

What are the indications of scopolamine?

A

“Pre op sedation
Antisialagogue
Bronchodilation
Biliary and ureteral smooth muscle relaxation
Production of mydriasis
Prevention of NV/motion sickness
Treatment of bradycardia (less potent than atropine)”

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10
Q

What is onset, DOA, Half time, and metabolism of scopolamine?

A

“Onset = 10 mins
DOA = 2 hrs
E1/2t = 4.8 hrs (3-7 days for full recovery)’
Hepatic and Urine

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11
Q

What are the adverse effects of Scopolamine?

A 
"v-fib
Increased HR
Orthostatic hypotension
Sedation
Delayed awakening
Increased IOP
Blurry vision
Dry mouth constipation
Fatigue and weakness!"
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12
Q

What are the contraindications of Scopolamine?

A 
"Hypersensitivity
Liver dissase
Change in MS
Glaucoma
CAD
Pheochromocytoma
Thryoidtoxicosis
Myesthenia gravis
Caution with the elderly"
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13
Q

what is the dosage of scopolamine?

A
  1. 3-0.5 mg or 5 mcg/kg IM (pre-op)

1. 5mg transdermal (5mcg/hr *72 hrs nausea)

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14
Q

What is the drug classification of Glycopyrrolate?

A

“Anticholinergic (muscarinic receptor antagonist)

Quaternary Amine”

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15
Q

What is the Mechanism of Action of Glycopyrrolate?

A

Reversible competitive blockade of Ach at muscarinic receptors. Allows sympathetic response to dominate.

16
Q

What are the indication of Glycopyrrolate?

A

“Antisialagogue ↑↑ (decrease salivary, tracheobronchial, and pharyngeal secretions and reduce volume and acidity of gastric secretions)
Moderate ↑HR (treat vagal reflex bradycardia) during induction and intubation
Antagonize muscarinic effects of NMR reversal by AchE inhibitors”

17
Q

What is the onset, DOA, E 1/2t, VD, and metabolism of glycopyrrolate?

A 
"Onset = 3-5mins
DOA = 2-4 hrs
E1/2 t = 1.5hrs
Vd = 0.4L/kg"
Hepatic with 85% unchanged in the urine
18
Q

what are the adverse effects of Glycopyyrolate?

A 
"Blurred vision
Dry mouth
PVC and tachycardia
Dysrhytmias
N/V
Ileus constipation
Malignant hyperthermia!
Head ache"
19
Q

What are the contraindications of Glycopyrrolate?

A 
"Hypersensitivity
Infants
CAD
Renal disease!
Hyperthyroid
Hx MH
pheochromocytoma"
20
Q

What is the dosage of Glycopyyrolate?

A

0.1-0.2 mg IV (pre-op and brady)

Pharmacology (17 decks)

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