Cholinergic Antagonists - Drugs

Question 1

What are the types of cholinergic agonists

Answer 1

Muscarinic blockers

NMJ blockers

Question 2

Examples of muscarinic blockers

Answer 2

Atropine
Scopolamine
Ipratropium
Benztropine (and other tropines) 
Prienzepine

Procyclidine
Trihexy phenidyl HCL
Hyocine butylbromide 
Mebeverine 
Tolterodine 
Oxybutynin
Darifenacin

Question 3

What anti muscarinic drug has no atropine s/e

Answer 3

Mebeverine

Question 4

What antispasmodic drug has no anti cholinergic effect

Answer 4

Drotaverine

Question 5

Atropine is to —— as OPC is to ——

Answer 5

Hyperthermia

Hypothermia

Question 6

Does atropine cross bbb

Answer 6

Yes and do causes CNS symptoms

Question 7

What is the related effects of atropine to HR in terms of dose

Answer 7

At low dose- low HR

At high dose- High HR

Question 8

Scopolamine

Answer 8

An antimuscarinic agent used for motion sickness

Has same effects as atropine and an added s/e of short term memory blockage.

Question 9

What other muscarinblocker is used for motion sickness

Answer 9

Hyocine butylbromide in hospital but scopolamine is the DOC in exam

Question 10

Muscarinic blockers that cross bbb

Answer 10

Atropine

Scopolamine

Question 11

Location of M1, M2, M3

Answer 11

M1 - CNS and enteric nervous system Gq
M2 - heart Gi (atria, av node, sa node)
M3 - eye, glands, beta cell of pancreas, bronchi, and urinary bladder Gq

Question 12

Ipratropium ?

Answer 12

Same as atropine

Doc for bronchial asthma and COPD
Used in acute excercabation of asthma along with B2 agonist

tiotropium is also used but has a longer duration.

Question 13

Pirenzepine

Answer 13

Used in treatment of PUD as it acts of M1 to reduce gastric secretion

Question 14

Which muscarinic blocker is used to treat tremor(acute dystonia) in Parkinson dx

Answer 14

Benztropine
Procyclidine
Trihexyphenidyl HCL

Question 15

What anti muscarinic drugs are recognized for urinary urgency and bladder spasms after a urology surgery

Answer 15

Tolterodine
Oxybutynin
Darifenacin

Question 16

What muscarinic blockers are promoted for urinary incontinece

Answer 16

FA- OXYBUTYNIN

Tolterodine
Darifenacin

Question 17

What are the signs of anti cholinergic poisoning

Answer 17

CNS effects - headache restlessness ataxia, hallucinations

Hyperthermia

Speech and swallowing disturbances
Cardio acceleration, pupillary dilation

Question 18

Antidote for atropine poisoning

Answer 18

Physostigmine

Sedate pt with benzodiazepines

Question 19

Nicotinic/ganglion ice blockers are

Answer 19

Nicotine
Hexamethonium
Trimethaphan
Mecamylamine

Question 20

Tx of Tourette syndrome

Answer 20

Mecamylamine

Also used in malignant HTN and for smoking cessation

Question 21

Muscarinic antagonist that produces mydriasis and cycloplegia

Answer 21

• Atropine
• Homatropine
• tropicamide

Question 22

Glycopyrrolate

Answer 22

Muscarinic antagonist

• reduce airway secretions preop
• reduce peptic ulcer, and drooling

Question 23

Muscuranic antagonist for irritable bowl syndrome?

Answer 23

Hyoscyamine
Dicyclomine

They are antispasmodic

Question 24

Muscarinic antagonist for overactive bladder

Answer 24

SOFT

S- solifenacin
O- Oxybutynin
F- flavoxate
T- Tolterodine

Question 25

Major side effects of atropine?

Answer 25

• hyperthermia in infants : low sweat
• acute angle closure glaucoma in elderly: mydriasis
• urinary retention in BPH men
• cycloplegia
• tachycardia
• dry flushed skin
• disorientation