Block 2 (Anticholinergic drugs) Flashcards
Describe the following for Atropine:
What is it?
- drug type
How does it work?
- MOA
What are the clinical uses?
What are the adverse effects?
Drug type:
Muscarinic antagonist (it is competitive at all M receptors)
MOA:
It antagonizes all the M receptors to produce sympathetic/anti-parasympathetic effects
- Mydriasis/cycloplegia
- Bronchodilation
- Less peristalsis
- Urine retention
- Higher HR & AV/SA nodal conduction
Clinical uses:
1) Bradycardia
2) Opthalmic applications (long action)
3) Antispasmodic
4) Antisecretory
5) AChE inhibitor OD
6) Antidiarrheal
Adverse effects:
Higher body temp (hyperthermia in infants)
Tachycardia
Dry mouth
Flushed/dry skin
Cycloplegia (paralyzed accommodation)
Constipation
Urinary retention (in BPH)
Acute angle glaucoma (in elderly)
Disorientation
Drug type:
Muscarinic antagonist (it is competitive at all M receptors)
MOA:
It antagonizes all the M receptors to produce sympathetic/anti-parasympathetic effects
- Mydriasis/cycloplegia
- Bronchodilation
- Less peristalsis
- Urine retention
- Higher HR & AV/SA nodal conduction
Clinical uses:
1) Bradycardia
2) Opthalmic applications (long action)
3) Antispasmodic
4) Antisecretory
5) AChE inhibitor OD
6) Antidiarrheal
Adverse effects:
Higher body temp (hyperthermia in infants)
Tachycardia
Dry mouth
Flushed/dry skin
Cycloplegia (paralyzed accommodation)
Constipation
Urinary retention (in BPH)
Acute angle glaucoma (in elderly)
Disorientation
Describes which medication?
Atropine
What are the clinical uses of atropine?
Clinical uses:
1) Bradycardia
2) Opthalmic applications (long action)
3) Antispasmodic
4) Antisecretory
5) AChE inhibitor OD
6) Antidiarrheal
What are the adverse side effects of atropine?
Adverse effects:
Higher body temp (hyperthermia in infants)
Tachycardia
Dry mouth
Flushed/dry skin
Cycloplegia (paralyzed accommodation)
Constipation
Urinary retention (in BPH)
Acute angle glaucoma (in elderly)
Disorientation
What are the physiological effects of atropine?
Hot as a hare: increased body temperature
Blind as a bat: mydriasis (dilated pupils)
Dry as a bone: dry mouth/eyes/decreased sweat
Red as a beet: flushed face
Mad as a hatter: delirium
Atropine
Cyclopentolate
Homatropine
Scopolamine
Tropicamide
All cause ______ & _______
They can all be used to treat which condition?
Cause:
Mydriasis
Cycloplegia
Rx:
Uveitis
These drugs cause cycloplegia & mydriasis & can be used to treat uveitis
Atropine
Cyclopentolate
Homatropine
Scopolamine
Tropicamide
Solenfenacin
Oxybutynin
Flavoxate & Festerodine
Tolterodin & Trospium chloride
Darifenacin
Are all what type of drug used to treat which condition?
Vesicoselective drugs that can be used to treat overactive bladder syndrome
How do muscarinic antagonists treat Overactive Bladder syndrome/urgency incontinence?
The muscarinic antagonists like Oxybutynin inhibit M3 receptors in the bladder causing smooth muscle relaxation to reduce urination urgency
How do muscarinic agonists treat urinary retention?
Muscarinic agonists like bethanechol act as Ach at M receptors to activate them causing smooth muscle contraction & urination
How do sympathomimetics treat Overactive Bladder syndrome/urgency incontinence?
Sympathomimetics like mirabegron B3 agonists which relax detrusor muscle to increase retention (no peeing)
How do a1-blockers treat BPH?
alpha 1 blockers like tamsulosin inhibit alpha 1 receptors to relax the smooth muscle in the bladder neck & prostate to lessen the urinary obstruction
Describe the following for Oxybutynin:
What is its MOA?
What is its clinical uses?
How is it administered?
MOA:
It has a high affinity for M1/M3 receptors in the salivary glands & bladder
Clinical uses:
1) Urinary frequency/urge incontinence (overactive bladder)
2) Nocturnal enuresis (bedwetting)
Administered orally
Describe the following for Tolterodine:
What is its MOA?
What is its clinical uses?
MOA:
It targets the M3 receptors in the detrusor muscles to relax it (minimal anticholinergic side effects) & it’s then metabolized by CYP3A4
Clinical use:
1) Urinary frequency/urge incontinence (overactive bladder)
When is atropine use contraindicated?
Glaucoma
BPH
Pyloric obstruction (pylorospasm)