Cholinergic Receptor Inhibitors Flashcards
Atropine
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Mydriasis; cycloplegia (loss of accommodation)
Toxicities: General block of muscarinic functions
Scopolamine
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Prevent or reduce motion sickness.
Toxicities: General block of muscarinic functions
Dicyclomine
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Reduce transient hypermotility
Toxicities: General block of muscarinic functions
Tropicamide
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Mydriasis; cycloplegia
Toxicities: General block of muscarinic functions
Misc: Very rapidly metabolized.
Tolterodine
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Treat transient cystitis
Post-op bladder spasms
Incontinence
Toxicities: General block of muscarinic functions
Benztropine
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Treat manifestations of Parkinson’s disease
Toxicities: General block of muscarinic functions
Misc. Crosses BBB
Ipratropium
Class: Quaternary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Bronchodilation in asthma or COPD
Toxicities: General block of muscarinic functions
Tiotropium
Class: Tertiary amine antimuscarinic
Mechanism of action: Blocks muscarinic receptors
Therapeutics: Bronchodilation in asthma or COPD
Toxicities: General block of muscarinic functions
Misc: Longer lasting than Ipratropium.
Hexamethonium
Class: Ganglionic blocker
Mechanism of action: Blocks ganglionic Nn receptor and sympathetic tone
Therapeutic uses: Hypertensive crisis
“Bloodless” field surgery.
Toxicities: N/A
Misc: Rarely used
Mecamylamine
Class: Ganglionic blocker
Mechanism of action: Blocks ganglionic Nn receptor and sympathetic tone
Therapeutic uses: Hypertensive crisis
“Bloodless” field surgery.
Toxicities: N/A
Misc: Rarely used
Succinylcholine
Class: Depolarizing blocker
Mechanism of action: Overstimulation of nicotinic receptor leading to desensitization of muscle unit to further ACh stimulation.
Therapeutics: Brief procedures such as intubation or reset of dislocated joints
Toxicities: Respiratory paralysis
Disturbance of autonomic function
Misc: Produces flaccid paralysis within 1 minute
Tubocurarine
Class: Nondepolarizing blocker
Mechanism of action: Blocks nicotinic (Nm) receptor
Therapeutic: Muscle relaxant for surgery without general anesthesia.
Toxicities: Respiratory paralysis
Disturbance of autonomic function
Misc: Lasts 30-60 min
Mivacurium
Class: Nondepolarizing blocker
Mechanism of action: Blocks nicotinic (Nm) receptor
Therapeutic: Muscle relaxant for surgery without general anesthesia.
Toxicities: Respiratory paralysis
Disturbance of autonomic function
Misc: Short acting bc rapidly hydrolyzed.
Botulinum toxin A
Class: Local paralytic
Mechanism of action: Blocks vesicle fusion and ACh release on presynaptic terminal by degrading SNAP-25
Therapeutics: Reduce frown lines and wrinkles
Achalasia
Strabismus
Oromandibular dystonia
