Muscarinic Antagonists Flashcards
Muscarinic Antagonist net effect
Sympathetic tone will take over
Atropine and scopolamine
Naturally occuring, alkaloid esters of tropic acid
Tertiary well absorbed throug hthe skin and pass through BBB
Ipratropium
Not naturally occurring
Quaterynary amine that does not cross BBB, used for astham and COPD
Tolterodine and oxybutynin
used to control enuresis in overactive bladder
Therapeutics of antimuscarinics
Optho Premedicant Parkinsons Motion Sickness ER Prior to birch IBS COPD and asthma
Atropine
Affinity to muscarinic receptors (binds competitively)
Crosses BBB…uses M1-M3
Tx of mushroom poisoning or organophosphate exposure and to reduce pulmonary and salivary secretions prior to surgery
Cardio effect of atropine
Decrease in HR initially followed by tachycardia
Aropine GI, UT, Resp
Decrease secretions and kotility (constipation)
Decrease PNS tone and retain urine
Bronchoilation and decrease secretion
Atropine ocular, salivary, swating CNS
Mydriasis or blurred vision with increased intraocular pressure…DONT use in glaucoma
Slaviary secretion is extremely sensitive and decreased**
Sweating decreased and increased body temp
Depression, drowsiness, etc.
Scopolamine
High affinity to muscarinic but crosses the BBB more than atropine***
More CNS effects so good sedative and preanesthetic med
Good motion sickness
Causes dry mouth
Similar to dramamine
Oxybutynin
Overactive bladder/bladder spasms/urinary incontinence
M1, but Mostly M3
Dry mouth if oral…may use a gel
Tolterodine
Synthetic
M2, but mostly M3 used only at bladder…less side effects than oxybutinin
Increases bladder capicty and decrease spasms after uro surgery
Mirabegron
Overactive bladder/bladder spams/urinary incontinenece
B3 agonist working at bladder smooth wall muscles to allow relaxation of detrusor and more complete filling
Ipratropium
Inhaled bronchodilator
Blocks all Ms
Good for COPD
B2 receptor agonists work better
This also elevates mucociliary clearance
Muscarinic antagonists adverse
MAD as a hatter HOT as a pistol BLIND as a bat RED as a beet DRY as a bone
