Cholinergic Blocking drugs

Question 1

What do cholinergic blocking drugs do

Answer 1

Block the actions of acetylcholine (ACh)

Question 2

MOA of Cholinergic Blocking drugs

Answer 2

Compete with ACh to bind with the muscarinic receptors, inhibiting the nerve transmission

Question 3

Natural plant alkaloid examples (2)

Answer 3

Atropine sulphate and scopolamine hydrobromide

Question 4

Synthetic and semisynthetic ex

Answer 4

Glycopyrrolate, oxybutynin, tolterodine

Question 5

Cardiovascular drug effects (large dose and small dose)

Answer 5

Small dose: decrease heart rate
Large dose: increase heart rate

Question 6

CNS drug effects (small dose and large dose)

Answer 6

Small dose: decrease muscle rigidity and tremors
Large dose: drowsiness, disorientation, hallucinations

Question 7

Eye drug effects

Answer 7

Dilated pupils and decreased accommodation

Question 8

GI drug effects

Answer 8

Relax GI muscle, decrease intestinal and gastric secretions, decrease motility and peristalsis

Question 9

GU drug effects

Answer 9

Urinary retention

Question 10

Glandular drug effects

Answer 10

Decreased sweating

Question 11

respiratory drug effects

Answer 11

Decreased bronchial secretions

Question 12

Indications of CNS

Answer 12

Parkinson’s disease, drug induced EPS reactions

Question 13

Indication of cardiovascular

Answer 13

Low doses: slow the heart rate
High doses: block inhibitory vagal effects on sinoatrial and atrioventricular node pacemaker cells (increases heart rate)

Question 14

What is Atropine used for

Answer 14

Used primarily for cardiovascular disorders
- Diagnosis of sinus node dysfunction
- Symptomatic second-degree heart block
- Severe sinus bradycardia with hemodynamic compromise (advanced life support)

Question 15

Indications Respiratory

Answer 15

• Decreased secretions from the nose, mouth, pharynx, and bronchi
• Relaxed smooth muscles in the bronchi and bronchioles
• Decreased airway resistance
  Bronchodilation
• Used to treat bronchospasms, asthma, COPD

Question 16

Indications of GI

Answer 16

• Blocks PSNS, decreased secretions, relaxation of smooth muscle, decrease GI motility and peristalsis
• Treats IBS, hypersecretory states

Question 17

Indications of GU

Answer 17

• Reflex neurogenic bladder, incontinence

Question 18

Contraindications of cholinergic blocking drugs

Answer 18

Known drug allergy
Angle-closure glaucoma
Acute asthma or other respiratory distress
Myasthenia gravis
Acute cardiovascular instability
GI or GU tract obstruction (e.g., benign prostatic hyperplasia [BPH]) or illness

Question 19

Adverse effects of cholinergic blocking drugs

Answer 19

• Cardiovascular: Increased heart rate, dysrhythmias
• CNS: CNS excitation, restlessness, irritability, disorientation, hallucinations, delirium
• Eye: Dilated pupils (causing blurred vision), increased intraocular pressure
• GI: Decreased salivation, decreased gastric secretions, decreased motility (causing constipation)
• GU: Urinary retention
• Glandular: Decreased sweating
• Respiratory: Decreased bronchial secretions

Question 20

Toxicity and overdose treatment

Answer 20

Cholinergic drug Physostigmine

Question 21

Interactions

Answer 21

Amantadine, antihistamines, phenothiazines, digoxin
These interactions cause additive cholinergic effects

Question 22

Atropine uses

Answer 22

Bradycardia, ventricular asystole, antidote for anticholinesterase inhibitor toxicity or poison, and preoperatively to reduce

Question 23

Atropine contraindications

Answer 23

angle-closure glaucoma, advanced hepatic and renal dysfunction, hiatal hernia associated with reflux esophagitis, intestinal atony, obstructive GI or GU conditions, and severe ulcerative colitis

Question 24

Glycopyrrolate MOA

Answer 24

Blocks the receptor sites that control the production of secretion

Question 25

Glycopyrrolate use

Answer 25

Preoperatively to reduce salivation and excessive secretion in the respiratory and GI tracts

Question 26

Glycopyrrolate Contraindications

Answer 26

hypersensitivity, angle-closure glaucoma, myasthenia gravis, GI or GU tract obstruction, tachycardia, myocardial ischemia, hepatic disease, ulcerative colitis, and toxic megacolon

Question 27

Oxybutynin Uses

Answer 27

overactive bladder and antispasmodic related to spinal cord injury, spina bifida.(Decrease urinary incontinence)

Question 28

Scopolamine Use

Answer 28

Prevent motion sickness and nausea and vomiting from post operation

Question 29

Scopolamine Contraindiction

Answer 29

angle-closure glaucoma, advanced hepatic and renal dysfunction, hiatal hernia associated with reflux esophagitis, intestinal atony, obstructive GI or GU conditions, and severe ulcerative colitis

Question 30

Adverse effect of scopolamine

Answer 30

drowsiness, dry mouth, and blurred vision

Question 31

Using scopolamine with _____ may increase sedation

Answer 31

CNS depressants or alcohol

Question 32

Tolterodine uses

Answer 32

Decreased urinary frequency, urgency, and urge incontinence caused by bladder (detrusor) over-activity

Question 33

Tolterodine vs newer drugs

Answer 33

Newer drugs cause Lower dry mouth incidence becuase it dries the bladder instead

Question 34

Should one use machinery while on it? Why or Why not?

Answer 34

No because of blurred vision

Question 35

causes sensitivity to __

Answer 35

light and may want to wear sunglassess

Question 36

Antidote for atropine

Answer 36

physostigmine