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Pharm 2 > Class 2 Deck 1 > Flashcards

Class 2 Deck 1 Flashcards

1
Q

What do anticholinergic do?

A

Antagonize effects of ACh at muscarinic receptors

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2
Q

Where do anticholinergic drugs mainly work?

A
  • Heart
  • Salivary glands
  • GI
  • GU
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3
Q

anticholinergic drugs can be classified as what 2 things? and name the main drugs in the class.

A
  • Natural tertiary amines (Atropine & Scopalamine)

- semisynthetic quarternary amines (Glycopyrrolate)

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4
Q

Tertiary amines have what characteristics? Quaternary amines?

A
  • Neutral charge will cross BBB and Placenta

- Positive charge will not cross BBB and placenta

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5
Q

How do anticholinergic drugs work?

A
  • Competitive agonists

- Reversibly bind with muscarinic receptor and prevents ACh from binding

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6
Q

Muscarinic cholinergic receptors have 5 subtypes, what are they?

A
  • M1 = CNS and stomach
  • M2 = Lungs and Heart
  • M3 = CNS, airway, smooth muscle, glandular tissue
  • M4 = CNS
  • M5 = CNS
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7
Q

How do you overcome the effect of anticholinergic drugs?

A

-Increase ACh

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8
Q

Which of the muscarinic receptors are most sensitive?

A

=M3>M2>M1

= A dose to affect M1 will also affect M2/3

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9
Q

At small doses all anticholinergic drugs can produce what and why?

A
  • Decreased HR

- Direct agonist effects

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10
Q

Out of all the anticholinergics, scopolamine has the greatest effect on what 4 things.

A
  • Sedation
  • Antisialagogue
  • Mydrasis (pupil dilation)
  • Prevent motion induced nausea.
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11
Q

Which anticholinergic drug has the greatest effect to increase HR?

A

-Atropine

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12
Q

What type of anticholinergic can be used in the oral form?

A

-Tertiary (atropine & scopolamine)

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13
Q

What is the onset time and duration of action for atropine and glycopylorate?

A
  • Atropine onset = 1 minute
  • Glycopyrrolate onset = 2-3 minutes
  • Both of duration of 30-60 minutes
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14
Q

Because they are lipid soluble _______ amines will penetrate the CNS while _______ will not.

A
  • Tertiarry (atropine & scopolamine)

- Quarternary (glycopyrrolate)

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15
Q

How does scopolamine produce sedation? and how is it different than versed?

A
  • Decrease activity to the RAS

- Has retrograde amnestic properties

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16
Q

Which anticholinergic can cause delayed arousal in the 1st 30 minutes after anesthesia?

A

-Atropine

17
Q

What problems can anticholinergic cause when used as a sedative?

A
  • Restlessness to somnolence
  • Delayed awakening w/ elderly
  • Inhaled anesthetics can potentate CNS effects
18
Q

How do you reverse the sedative effects of anticholinergics?

A

Physostigmine

19
Q

anticholinergic should be used with caution in which two patient types?

A
  • Glaucoma (Icrease IOP)

- Preggos (cross placenta)

20
Q

Put the 3 anticholinergic drugs in order of potency for antisialagogues?

A
  • Scopolamine 3x more potent than atropine

- Glyco - 2x more potent than atropine

21
Q

What drug should be used if you want antisialagogue and sedation? Just antisialagogue?

A
  • Scopoalmine

- Glycopyrrolate

22
Q

What drug is used to blunt vagal response in pediatric patients upon intubation?

A

-Atropine

23
Q

What is the drug of choice for intraop bradycardia? and how does it work?

A
  • Atropine

- Blocks ACh on SA node

24
Q

How do anticholinergic drugs bronchodilate? and how is it given?

A
  • mostly medium/large airways
  • Antagonism of ACh effects on airway smooth muscle
  • Given via aerosol
25
Q

What are the symptoms of central anticholinergic syndrome? and how is it treated?

A
  • Restlessness
  • Hallucinations
  • Somnolence
  • Unconsiousness
  • Treated with physostigmine
26
Q

How do you treat anticholinergic OD?

A

Physostigmine

27
Q

How does anticholinergic drugs place one at a greater risk for reflux?

A

-Decreased barrier pressure (Decreased lower esophageal sphincter pressure)

28
Q

What do vasoactive drugs do?

A
  • Direct effect on heart and vasculature

- indirect effects of the nervous system

29
Q

How do vasoconstrictors increase smooth muscle contraction?

A
  • Alpha 1 receptor agonist through G proteins

- Protein kinase C and inositol triphosphate release intracellular calcium

30
Q

What vasoconstrictor has a direct affect on smooth muscle?

A

-Angiotensin

31
Q

What are the 2 types of vasoconstrictors?

A
  • Pure Alpha 1 agonists (Phenylephrine)

- Mixed Alpha 1 and Beta (Ephedrine)

32
Q

What are the 3 naural catecholamines?

A
  • Epinepherine
  • NorEpi
  • Dopamine

Pharm 2 (23 decks)

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