Cholinergic Antagonist Flashcards
Atropine
三級氨
Class 5 心律不整藥物
散瞳劑
麻醉前給藥
Reduce bronchi secretion
解痙攣劑
Antidote for cholinesterase overdose
有機磷中毒解毒劑
Anti GI & bladder spasm
Treat
假性近視
Bradycardia
Scopolamine
三級氨
Cause
Blocking short-term memory
Treat
Motion sickness 暈車藥
禁忌
青光眼
BPH
心臟疾患
Side effect
視力模糊
口乾
便秘
尿滯留
心跳加快
體溫上升
Tropicamide
散瞳劑 （時效最短
Treat
假性近視
Cyclopentolate
散瞳劑
Treat
假性近視
Ipratropium
M3 blocker
Treat
COPD
Asthma
Rhinorrhea
Tiotropium
M3 blocker
Treat
COPD
Asthma
Rhinorrhea
Dicyclomine
M3 antagonist
止瀉藥
Cause
Reduce GI motility
禁忌
青光眼
BPH
心臟疾患
Side effect
視力模糊
口乾
便秘
尿滯留
心跳加快
體溫上升
Pirenzepine
M1 antagonist
Cause
Reduce GI secretion
Treat
胃潰瘍
禁忌
青光眼
BPH
心臟疾患
Side effect
視力模糊
口乾
便秘
尿滯留
心跳加快
體溫上升
Hexmethonium
Nn blocker
直接阻塞Na 通道
Cause
Decrease BP, increase HR
Treat
Chronic hypertension
Trimethaphan
Nn blocker
Compete with ACh
Non-depolarizing
急救用（IV)
Treat
Emergency hypertension 惡性高血壓
腎上腺髓瘤
高血壓腦病
主動脈剝離
腦出血
Side effect
姿勢性低血壓
尿滯留
口乾
Mecamylamine
Nn blocker
Cross BBB
Non-depolarizing
Treat
Hypertension
Quit smoking addiction
Tubocurarine
Nm blocker
Isoquinoline derivative (release histamine)
Non depolarizing
臨床不用
Cause
Histamine release
Reduce BP
Increase HR
肌肉鬆弛劑
Antidote
AChE inhibitor
Atracurium
Nm blocker
Isoquinoline derivatives
Hofmann elimination
Cause
Release laudonosine leads to seizure, flushing, reduced BP, increase HR, bronchoconstriction
肌肉鬆弛劑
Antidote
AChE inhibitor (neostigmine)
Cisatracurium
Nm blocker
Isoquinoline derivatives
Hofmann elimination
肌肉鬆弛劑
Antidote
AChE inhibitor （Neostigmine)
Mivacurium
Nm blocker
Shortest duration
不能用AChE inhibitor as antidote
Nondepolarizing 肌肉鬆弛劑
Vecuronium
Nm blocker
Steroid derivatives
肌肉鬆弛劑
Antidote
Sugammadex
Rocuronium
Nm blocker
Steroid derivative
肌肉鬆弛劑
Antidote
Sugammadex
Pancuronium
Nm blocker
無histamine 釋放
Cause
BP and HR increase (vagolytic action)
肌肉鬆弛劑
用neostigmine 解毒
Succinylcholine
Depolarizing blocker
Phase I (depolarizing)
Phase II (desensitizing)
Onset fast, duration short
肌肉鬆弛劑
Side effect
Hyperkalemia
Malignant hyperthermia (RyR1 mutation) 用dantrolene 治
不可用neostigmine 解毒，等AChE代謝
孕婦小心使用
Diazepam
GABAa
Open Cl channel
Benzodiazepine (BZD)
Treat
慢性痙攣
鎮靜安眠藥
解痙劑
Baclofen
GABAb
K channel open, Ca channel close
解痙劑
Cause
Decrease glutamate
Decrease substance P
Decrease motor neuron activity
Treat
急性痙攣(落枕)
打嗝
Metoclopromide
Treat
打嗝
Chlorpromazine
H1 D2 M1 blocker
Treat
打嗝
精神分裂 (Amphetamine副作用）
Tizanidine
Alpha 2
Cause
Reduce CNS glutamate
Decrease motor
Little 降血壓
解痙攣藥
Dantrolene
RyR1 blocker
抑制骨骼肌內Ca釋出
Treat
Malignant hyperthermia 惡性高溫
Botulinum toxin 肉毒
不可逆inhibit ACh release
解痙劑
Treat
腦性麻痺
皺紋
食道弛緩不能
Chlorzoxazone
CNS
Treat
急性局部痙攣(落枕）
Side effect
嗜睡
Cyclobenzaprine
CNS
解痙劑
Treat
急性局部痙攣(落枕）
Side effect
嗜睡
Homatropine
睫狀肌麻痹
散瞳 （眼底鏡檢查）
Propantheline
M13 antagonist
Decrease GI action
Treat
胃潰瘍
禁忌
青光眼
BPH
心臟疾患
Side effect
視力模糊
口乾
便秘
尿滯留
心跳加快
體溫上升
Clidinium
Treat
腹絞痛
腸躁症
禁忌
青光眼
BPH
心臟疾患
Side effect
視力模糊
口乾
便秘
尿滯留
心跳加快
體溫上升
Oxybutynin
Treat
尿失禁
Decamethonium
Depolarizing agent
肌肉鬆弛劑
Side effect
心律不整（with halothane)
惡性高溫（用dantrolene 治）
Hyperkalemia
無力肢體麻痺
不可用neostigmine 解毒，等AChE代謝
孕婦小心使用
Hemicholinium
抑制神經吸收choline
ACh釋放 decrease
解痙劑
Tetrodotoxin (TTX)
河豚毒素
抑制鈉離子通道, inhibit AP
解痙劑
