Exam 1 Anticholinergic Drugs

Question 1

Antimuscarinic classes

Answer 1

-tertiary amines
-quarternary amines

Question 2

Anticholinergic mech

Answer 2

-block M receptor
-little effect on N receptors

Question 3

Tertiary amine antimuscarinics

Answer 3

-Atropine
-Scopolamine
-Homatropine
-Tropicamide
-Benztropine
-Trihexyphenidyl

Question 4

Quarternary amine antimuscarinics

Answer 4

-Ipratropium
-Titropium

Question 5

Atropine and Scopolamine

Answer 5

-belladonna alkaloids
-M NONselective

Question 6

Atropine and Scopolamine use

Answer 6

-treat GI/urinary conditions
-treat motion sickness
-dilate eyes

Question 7

Atropine structure

Answer 7

-ring
-COO
-ring with Nitrogen bridge

Question 8

Scopolamine structure

Answer 8

-atropine but O bridge near N
-more lipophilic than ATROPINE
-3’ amine

Question 9

Scopolamine use

Answer 9

-motion sickness

Question 10

Scopolamine side effects

Answer 10

-dry mouth
-blurred vision
-sedation
-psychosis

-high CNS access

Question 11

Homatropine and Tropicamide mech

Answer 11

-short-acting
-Tropicamide is shorter acting
-Homatropine less toxic

Question 12

Homatropine and Tropicamide use

Answer 12

-Mydriasis in optical settings
-Cycloplegia

Question 13

Benztropine and Trihexyphenidyl use

Answer 13

-treat parkinsons
-adjunct therapy with L-dopa
-similar potency to atropine

Question 14

Benztropine structure

Answer 14

-3’ amine
-N bridge with methyl group on N

Question 15

Ipratropium mech

Answer 15

-M3 ANTAGONIST
-blocks constriction
-opens airways

Question 16

Ipratropium use

Answer 16

-treat COPD, asthma
-enhances B-agonists in COPD

Question 17

Ipratropium side effects

Answer 17

-poor absorption
-toxic dose: hypotension and muscle weakness (ganglionic and neuromuscular blocks)

Question 18

Tiotropium uses

Answer 18

-treat GI disorders (spasms/ulcers)
-glycopyrrolate

Question 19

Glycopyrrolate use

Answer 19

-pre-op to REDUCE secretions

Question 20

Glycopyrrolate problems

Answer 20

-charge N makes crossing gut hard

Question 21

Tolterodine mech

Answer 21

-no selectivity
-a lil selective for M3

Question 22

Tolterodine use

Answer 22

-overactive bladder

-may lower constipation and confusion

Question 23

Neuromuscular blocking drugs

Answer 23

-Tubocurarine
-Succinylcholine
-Botulinum toxin (indirect)

Question 24

Tubocuraine mech

Answer 24

-N competitive ANTAgonist

Question 25

Tubocurarine use

Answer 25

-skeletal relaxation during anesthesia

Question 26

Succinylcholine mech

Answer 26

-Depolarizing blockade
-initially N agonist to initiate depolarization
-persistant depolarization
-rapid onset
-choline increases BP
-paralysis

Question 27

Succinylcholine structure

Answer 27

2 ACh

Question 28

succinylcholine use

Answer 28

-skeletal muscle relaxant during anesthesia
-electroconvulsant therapy

Question 29

Succinylcholine problems

Answer 29

-muscle soreness
-avoid in hyperkalemia (heart failure)
-malignant hypothermia
-prolonged paralysis in ppl with shitty plasma cholinesterase

Question 30

Botulinum Toxin mech

Answer 30

-indirect
-inhibits ACh release

Question 31

Botulinum toxin use

Answer 31

-dystonia (spasms)
-cerebral palsy
-hyperhidrosis

Question 32

Botulinum toxin problems

Answer 32

-spread from injection site

Question 33

Ganglionic blocking drugs

Answer 33

-HexamethoniumH

Question 34

Hexamethonium mech

Answer 34

-N ANTAGONIST in ANS ganglia
=blocks ALL PSNS and SNS activity

Question 35

Hexamethonium effects

Answer 35

-hypotension (SNS)
-decrease sweat (SNS)
-dry mouth
-mydriasis
-constipation
-urinary retention