lecture 6 Flashcards
Anti-muscarinic drugs
- Atropine (Prototype)
- Scopolamine (hyoscine)
- Ipratropium
Why does Atropine cause mydriasis
atropine blocks the Muscarinic
receptor (which means it blocks the parasympathetic innervation) in the eye and the
sympathetic innervation remains active. This, in turn, will cause dilation of the pupils
which can be used for eye examination
drug for eye examination
atropine
why atropine cause dryness
because Tissues most sensitive to Atropine are the salivary, bronchial and sweat glands
eye result over taking atropine (4)
- Mydriasis of the eye
- Cycloplegia (paralysis of accommodation; inability to focus on close objects, blurred
vision) - Dry eye (sandy eye) due to the effects on the lacrimal gland.
- Photophobia (no response of the eye).
If I want to induce mydriasis only without cycloplegic effect we use ?
Phenylephrine
Despite its function as a Broncho dilator, Atropine is usually not used to
treat Lung diseases why ?
more selective drug that targets M3
receptor which is Ipratropium bromide
The cause of death in atropine overdose is ?
hyperthemia ( due to decrease all secretions )
in bradycardia condition we use?
Atropine
Side effects of anti-muscarinic medications
- Constipation, blurred vision, xerostomia (dryness of the mouth), hyperthermia, flushing,
dryness of the skin, urinary retention, confusion at high doses.
in parkinson & dystonia diseases we use ?
benztropine
one of atropine side effect is Seizures are controlled by
an antiseizure drug called diazepam
Scopolamine (hyoscine) is given in ?
situations in which we don’t want the patient to memorize something like their surgery
situations in which we don’t want the patient to memorize something like their surgery we give him ?
Scopolamine (hyoscine)
why physostigmine are given in small doses ?
because it has risk to cause paralysis or bradycardia which are life threatening
conditions.
diazepam is ?
antiseizure drug
Ipratropium used for
asthma and CODP
Respiratory disorders we give
Ipratropium
Tropicamide for
Ophthalmologic Disorders: To dilate pupil
Cardiovascular Disorders: Sinus bradycardia. we use
atropine
Anesthetic premedication
Scopolamine/Hyoscine, Atropine
in Cholinergic Poisoning we use
atropine
oxybutynin is used for
To decrease bladder overactivity
To suppress gastric acid secretion
pirenzepine
Gastrointestinal Disorders: As antispasmodic
Scopolamine/Hyoscine
Phentermine side effect
cardiovascular disorders like arrhythmia
→ patient suffer from benign prostate hyperplasia we give him
alpha 1 antigonist
Glucose level will be increased by
- Β2 stimulation at the liver will lead to Glycogenlysis.
2. α2 stimulation will inhibit insulin release.
we management of hypertension by _____ agonist
alpha 2
Anti-muscarinic drugs do have little or no action at:
- Skeletal neuromuscular junctions
- Autonomic ganglia
- Adrenal medulla
Anti-muscarinic drugs are competitive antagonists for the binding of ACH (acetylcholine) to the M (muscarinic) receptors. These drugs are:(3)
- Atropine (Prototype)
- Scopolamine (hyoscine)
- Ipratropium
Another name for Atropine is
Hyoscyamine
Atropine is extracted from
the plant
Atropa belladonna
atropine affect on GIT: -
Relaxes smooth muscles → Decrease peristalsis movement → Constipation and
antispasmodic effect.
Anti-emetic effect found in ?
Scopolamine
Atropine overdose management for:
- Hyperthermia is controlled by:
- Seizures are controlled by:
- severe tachycardia or sever
cooling blankets.
an antiseizure drug called diazepam.
physostigmine
drug that have amnesic effect
Scopolamine
Prevention of motion sickness
(Hyoscine)Scopolamine
To decrease bladder overactivity
oxybutynin
drug used for cardiac arrest
(epinephrine) + dobutamine
drug for cardiogenic shock
dopamine dobutamine or norepinephrine
drug for asthma attack
(beta 2 agonist)
or ach antagonist ( ipratropium )
for anaphylactic shock or allergic reactions
(epinephrine intramuscular)
Alpha 1 action ?
- vasoconstriction
- Increased peripheral resistance.
- increased blood pressure.
- Mydriasis (available at radial muscle).
- Closure of internal sphincter of the bladder (urinary retention).
patient suffer from benign prostate hyperplasia
alpha 1 antagonist
Alpha 2 action on: NE ACh insulin platelets
- inhibition of norepinephrine release.
- inhibition of ACh release.
- inhibition of insulin release (at pancreatic cell).
- enhancement of platelet aggregation
id we want to decrease blood pressure so we use ____ in management of hypertension.
alpha 2agonist
alpha 1 agonist drugs used for ?
nasal decongestion
treat ophthalmic hyperemia.
phenylephrine used for
nasal decongestion
phenylephrine is ____ _/agonist
used for ?
adrenergic agonist
nasal decongestion
alpha 1 blocker drugs used for ?
treatment of benign prostatic hyperplasia
HTN
clonidine is ____ _/ agonist for ?
alpha 2
hypertension treatment
yohimbine is ____ _/ agonist for___?
alpha 2 antagonist
→ research drugs
Beta 1 available in heart and its stimulation will:
- increase the heart rate (positive Chronotropy )
- Increase force contraction ( positive Intropy)
- Increase AV conduction ( positive dromotropic )
_______receptor stimulation will increase renin release
beta 1
_____ blocker should be avoided in patients suffering from bronchial asthma
beta2
_______ receptor + drug used in the management of bronchial asthma
beta 2 (aulbutamol -salmetrol formetrol )
drug for
management of
cardiogenic shock
Dobutamine
Direct Acting Adrenergic Agonists drugs
- Catecholamine (Epinephrine// Norepinephrine// Dopamine// Isoprotereno)
- Phenylephrine (a1)
- Clonidine.(a2)
- Dobutamine(beta1)
Indirect-Acting Adrenergic Agonists drugs
- cocaine.
2. Amphetamine
Amphetamine used for
ADHD children
cocaine is ?for?
indirect adrenergic receptor
for local anesthetic
local VasoContraction
why Non-catecholamines have Longer half-lives
because they aren’t inactivated by COMT or MAO
Non-catecholamines example
Phenylephrine
clondine
dobutamine
panadol Cold + flu and non-drowsy
used on it
Phenylephrine
Patients can't be treated by local anesthesia with epinephrine are patients suffering from: Tachycardia (heart rate exceeds the normal), hypertension and angina so we give them ?
plain local anesthetic drug
indication as dentistry for epinephrine is
Gingival retraction cords: (gingivectomy)
local anesthetic
anaphylaxis(as antihistamine)
The usage of neuromuscular blockers:
- During surgery complete muscle relaxation __recover quickly and completely after surgery
- to give less dose than that needed for general anesthesia thus reducing its risk for respiratory and CVS depression.
- In facilitating intubation.
- Endotracheal intubation
Naloxone can be given via ?
endotracheal intubation
pancuranium is \_\_\_\_\_\_\_\_\_\_ _/agonist \_\_\_\_\_ blocker \_\_\_ \_\_/polarizing action ? over come by ? direct / indirect nicotinic receptor?
competetive antagonist NM non DEpolarizing inhibit muscular contraction. Without receptor stimulation _ paralysis increasing Ach direct
succinylcholine is an \_\_\_\_\_ _/agonist \_\_\_\_ blocker / enhancer \_\_\_ depolarizing action on nicotic receptor
competitive
NM
-
shortest duration of action of all muscle relaxants.
succinylcholine onset of action ?why ?
5min because of AChE
succinylcholine SIDE EFFECT ?
apnea(AChE deficient patient) & Malignant hyperthermia
succinylcholine causes a apnea in which case ?
AChE deficiency
succinylchole side effects can be over come by ?
dantrolene & Cooling of the patient
dantrolene used for ?
decreasing the calcium level
Therapeutic use of succinylcholine ?
➢ Endotracheal intubation.
➢ commonly used as the sole muscle relaxant during electroconvulsive therapy
drug that decrease the release of acetylcholine
• Botulinum toxin
