In the absence of neuromuscular blockers, acetylcholinesterase inhibitors may produce what?
Fasiculations
At doses greater than usual clinical doses, anticholinesterase drugs have been reported to produce some form of what?
neuromuscular blockade
In what 3 ways can Anticholinesterase Drugs be classified?
- Reversible inhibition
- Formation of carbamyl esters
- Irreversible inhibition
What is the onset of action for the Anticholinesterase Drugs?
- Edrophonium 1-2 minutes
- Neostigmine 7-11 minutes
- Pyridostigmine up to 16 minutes
What drug should be used with edrophonium and why?
-Atropine, because edrophonium works so fast and glycopyrolate is slower onset.
What are the muscarinic effects of Anticholinesterase Drugs?
- Bradycardia
- Salivation
- Bronchoconstriction
- miosis
- hyperperistalsis
- PONV
What 2 Anticholinesterase Drugs that produce marked inhibition of plasma cholinesterase? Why is this important?
- Neostigmine
- Pyridostigmine
- Prolongs succs
What are the 4 clinical uses of Anticholinesterase Drugs?
- Reversal of neuromuscular blockade
- Treatment of CNS effects
- Treat myasthenia gravis
- Treatment glaucoma
Name the Anticholinesterase Drugs in order of fastest to slowest.
Edro-neo-pyrido
Anticholinesterase Drug potency depends on what 4 things?
- NMB drug being antagonized
- Speed of spontaneous recovery
- Depth of NMB when reversal is initiated
- End point selected
3 things to know about physostigmine.
- Tertiary amine (crosses BBB)
- Antagonizes CNS effects of certain drugs
- Dose 15-60mcg/kg
What drugs can physostigmine reverse?
- Anitcholinergic drugs
- Opiods
- Benzos
- Anesthetics
What are the muscarinic effects of Anticholinesterase Drug overdose?
- Miosis
- Salivation
- Bronchospsam
- Bradycardia
- ABD cramps
- loss of bowel bladder control
What are the nicotinic effects of Anticholinesterase Drug overdose?
Skeletal muscle weakness (paralysis/apnea)
What are the CNS effects of Anticholinesterase Drug overdose?
- Confusion
- Ataxia
- Seizure
- Coma
- Depressed ventillation
How to treat Anticholinesterase Drug overdose.
- Atropine (antimuscarinic)
- Pralidoxime (Acetylcholinesterase reactivator)
-
Class 1 Deck 116
-
Class 1 Deck 216
-
Class 2 Deck 132
-
Class 2 Deck 242
-
Class 3 Deck 17
-
Class 4 Deck 129
-
Class 4 Deck 244
-
Class 5 Deck 145
-
Class 5 Deck 215
-
Class 6 Deck 143
-
Class 6 Deck 227
-
Class 7 Deck 144
-
Class 7 Deck 228
-
Class 8 Deck 146
-
Class 8 Deck 242
-
Class 9 Deck 156
-
Class 10 Deck 164
-
Class 11 Deck 145
-
Class 11 Deck 243
-
Class 11 Deck 315
-
Class 12 Deck 153
-
Class 12 deck 233
-
Class 13 Deck 162
