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Pharmacology I > Lecture 13 - Cholinergic Antagonists > Flashcards

Lecture 13 - Cholinergic Antagonists Flashcards

1
Q

What are the muscarinic antagonists? (six)

A 
Atropine 
Scopolamine 
Glycopyrrolate 
Oxybutynin 
Ipratropium 
Tropicamide
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2
Q

What are the non-depolarizing NMJ blocking agents? (five)

A 
D-tubocurarine 
Pancuronium 
Vecuronium 
Cisatracurium 
Atracurium
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3
Q

What are the depolarizing NMJ blocking agents? (one)

A

Succinylcholine

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4
Q

What does atropine come from?

A

Belladona/nightshade

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5
Q

What does scopolamine come from?

A

angels trumpet

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6
Q

What is the general distribution of atropine?

A

Only gets into CNS with very high doses

Mostly peripheral effects

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7
Q

About how long does atropine last in dogs?

A

30 min

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8
Q

What is the general distribution of scopolamine?

A

CNS!

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9
Q

What effects do you see with scopolamine?

A

Euphoria + Sedation + Amnesia

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10
Q

What determines the effects of atropine at a certain organ?

A

Dose
Prevailing tone
Distribution of M receptors

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11
Q

How do rabbits react to atropine?

A

Resistant, have special enzyme to metabolize quickly

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12
Q

How do goats, cattle, and horses react to atropine?

A

Can eat the plant, but injected atropine can be VERY toxic

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13
Q

How do swine react to atropine?

A

very sensitive, can’t even eat it

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14
Q

What are the general CNS effects of atropine?

A

Confusion + Coma

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15
Q

What are the toxic CNS effects of scopolamine?

A

Hallucinations + Delirium + Coma

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16
Q

What is the normal state of the eye?

A

PNS - slightly rounded lens + slightly constricted pupil

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17
Q

What does muscarinic antagonist do to the eye?

A

PNS decreased
Pupil dilated - via circular muscle
Lens flattens - via ciliary muscle

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18
Q

What is mydriasis?

A

Dilation

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19
Q

What is miosis?

A

Constriction

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20
Q

What side effects do you see with muscarinic blocked in the eye?

A

Photophobia + Blurry vision + Dry eyes

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21
Q

What type of muscarinic receptor is on the heart?

A

M2

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22
Q

What does M2 do at the heart?

A

ACh stimulates M2 on the heart at SA node
Pre-synaptic M2 decreases NE
Both decrease heart rate

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23
Q

What does muscarinic blockade due to the heart?

A

Tachycardia

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24
Q

When is atropine used in relation to the heart?

A

Cardiac arrest

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25
Q

What do cholinergic antagonists do to respiration?

A

Reverse bronchoconstriction
–or–
Bronchodilation

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26
Q

When is a cholinergic antagonist used in regards to respiration?

A

RAO or Heaves

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27
Q

What cholinergic antagonist is used for heaves?

A

Ipratropium

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28
Q

What does muscarinic blockade do in the GI tract?

A

Decrease motility + secretions

Decrease tone of bile duct

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29
Q

What does muscarinic blockade do to the bladder?

A

Decrease bladder motility

Decrease tone of ureter

30
Q

What does muscarinic blockade do to the uterus?

A

Depress hypertonicity

31
Q

What is a cholinergic antagonists used for during surgery?

A

Decrease secretions

32
Q

What is a common side effect with cholinergic antagonists?

A

Dry mouth

33
Q

What is the general effect of cholinergic antagonist in regards to secretions?

A

Dry eyes + Lack of sweating

34
Q

What is used to reverse bradycardia in sx?

A

Atropine

35
Q

What is used to prevent/treat post-operative bradycardia ?

A

Glycopyrrolate

36
Q

What is something you have to watch out for with Glycopyrrolate?

A

Colic in horses

37
Q

What is used for decreasing GI hypermotility + spasms?

A

Glycopyrrolate + Propantheline

38
Q

What is used to decrease bladder activity + incontinence?

A

Oxybutynin

39
Q

What is used to treat anterior uveitis?

A

Atropine

40
Q

What is used in corneal ulceration treatment to decrease pain?

A

Atropine

41
Q

What is used to cause mydriasis for intraocular exam?

A

tropicamide

42
Q

How does tropicamide act differently in horses?

A

lasts for up to 12 hours

43
Q

What is used to decrease respiratory secretions in surgery?

A

Atropine + Glycopyrrolate

44
Q

What is used in treatment of organophosphate poisoning?

A

Atropine

45
Q

What are the common side effects with cholinergic antagonists?

A 
Dry mouth 
Decrease secretions 
Tachycardia with possible arrhythmias 
Mydriasis + Cycloplegia 
Decreased GI motility
46
Q

What is the phrase for atropine overdose?

A

Dry as a bone
Blind as a bat
Mad as a hatter

47
Q

What do you see with atropine overdose specifically?

A 
Hot + Dry 
Constipated + Urinary retention 
Dilated pupils + blurred vision 
Tachycardia 
Aggitation + Delirum 
Cardiovascular + respiratory collapse
48
Q

What is used to treat atropine overdose?

A

AChE inhibitors

Physostigmine to increase CNS ACh

49
Q

What are the two types of Neuromuscular blockers?

A

Depolarizing
– and –
Non-depolarizing

50
Q

What do the depolarizing NM blockers do?

A

Stimulate a muscular contraction before blocking the receptor

51
Q

What do the non-depolarizing NM blockers do?

A

Competive antagonists

Direct blockade of channel occurs with no contractions

52
Q

What are NM blockers used for?

A

paralysis with surgery

53
Q

What is the onset of action for non-depolarizing NM blockers?

A

1 to 6 minutes

54
Q

What is the distribution of non-depolarizing NM blockers in the CNS? Why?

A

Not able to get to CNS

Highly ionized

55
Q

What can reverse non-depolarizing NM blockers?

A

Cholinesterase inhibitors to increase ACh levels enough to overcome blocker

56
Q

What is the most common non-depolarizing NM blocker to use?

A

Atracurium

57
Q

What is atracurium broken down by?

A

Plasma cholinesterase

58
Q

How does cisatracurium compare to atracurium?

A

More potent

Less likely to cause histamine release

59
Q

What are the long acting non-depolarizing drugs?

A

d-tubocurarine

pancuronium

60
Q

What are the intermediate non-depolarizing drugs?

A

Vecuronium
Atracurium
Cisatracurium

61
Q

What is the duration of the long action non-depolarizing drugs?

A

2 to 3 hours

62
Q

What is the duration of the intermediate non-depolarizing drugs?

A

30 to 90 minutes

63
Q

What is the progression of paralysis with the non-depolarizing drugs?

A

Small muscles
Larger muscles
Deglutition + Laryngeal + Abdominal intercostal muscles
Respiratory muscles

64
Q

How long does succinylcholine last?

A

5 ot 10 minutes

65
Q

What is succinylcholine used for?

A

Short procedures

66
Q

What animals are resistant to succinylcholine?

A

Horse + Pigs

67
Q

What ion is important to watch out for with use of succinylcholine?

A

K+

68
Q

What does succinylcholine do in regards to K+?

A

Increases release of K+, leading to hyperkalemia in dogs who are already sick = cardiac arrest

69
Q

What effect does tetracylines + aminoglycosides have on ACh release?

A

Decreased

reverse with Ca but NOT neostigmine

70
Q

What effect does Polymixins have on ACh?

A

Decrease post-synaptic sensitivity

71
Q

What effect does clindamycin have on muscle?

A

Inhibits, cannot be reverse with Ca or neostigmine

Pharmacology I (21 decks)

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