Cholinergic Receptor Inhibitors

Question 1

Atropine

Answer 1

Class: Tertiary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Cause mydriasis and cycloplegia
SE: General block of muscarinic functions

Question 2

Scopolamine (Transderm-Scop)

Answer 2

Class: Tertiary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Prevent or reduce motion sickness
SE: General block of muscarinic functions

Question 3

Dicyclomine (Bentyl)

Answer 3

Class: Tertiary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Reduce transient GI hypermotility
SE: General block of muscarinic functions

Question 4

Tolterodine (Detrol)

Answer 4

Class: Tertiary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Treat transient cystitis; postoperative bladder spasms; incontinence
SE: General block of muscarinic functions

Question 5

Tropicamide (Mydriacyl)

Answer 5

Class: Tertiary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses:Mydriasis; cycloplegia
SE: General block of muscarinic functions
Misc: Very rapidly metabolized

Question 6

Benztropine (Cogentin)

Answer 6

Class: Tertiary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Treat manifestations of Parkinson’s disease
SE: General block of muscarinic functions
Misc: Crosses BBB

Question 7

Ipratropium (Atrovent)

Answer 7

Class: Quarternary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Bronchodilation in asthma or COPD
SE: General block of muscarinic functions

Question 8

Tiotropium (Spiriva)

Answer 8

Class: Quarternary amine antimuscarinic
MOA: Blocks muscarinic receptors
Uses: Bronchodilation in asthma or COPD
SE: General block of muscarinic functions
Misc: Longer acting than ipratropium

Question 9

Hexamethonium (Methium)

Answer 9

Class: Ganglionic blocker
MOA: Blocks ganglionic (Nn) receptor
Uses: Hypertensive crisis; “Bloodless” field surgery
Misc: Rarely Used

Question 10

Succinylcholine (Anectine)

Answer 10

Class: Depolarizing blocker
MOA: Overstimulation of nicotinic receptor, leading to desensitization of muscle unit to further ACh stimulation
Uses: Brief procedures (e.g., tracheal intubation, reset dislocated joints)
SE: Respiratory paralysis; disturbance of autonomic function
Misc: Produces flaccid paralysis within 1 minute

Question 11

Tubocurarine (Curare)

Answer 11

Class: Nondepolarizing blocker
MOA: Blocks nicotinic (Nm) receptor
Uses: Muscle relaxant for surgery w/o deep anesthesia
SE: Respiratory paralysis; disturbance of autonomic function
Misc: Lasts 30-60 minutes

Question 12

Mivacurium (Mivacron)

Answer 12

Class: Nondepolarizing blocker
MOA: Blocks nicotinic (Nm) receptor
Uses: Muscle relaxant for surgery w/o deep anesthesia
SE: Respiratory paralysis; disturbance of autonomic function
Misc: Rapidly hydrolyzed, short acting

Question 13

Botulinum toxin A (Botox)

Answer 13

Class: Local paralytic
MOA: Blocks vesicle fusion and ACh release on presynaptic terminal by degrading SNAP-25
Uses: Reduce frown lines and wrinkles; achalasia; strabismus; oromandibular dystonia