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Unit 1 Pharm II > Muscarinic antagonists > Flashcards

Muscarinic antagonists Flashcards

1
Q

muscarinic antagonists generally

A

block the effects of ACh at M1, M2, M3, antagonizing parasympathetic stimulation

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2
Q

atropine and scopolamine are found in

atropine is also found in

A

belladonna plant

jimson weed

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3
Q

atropine CNS effects

A

NONE except at toxic doses.

therefore mostly has peripheral effects

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4
Q

scopolamine CNS effects

A

enters CNS easily –> sedation, amnesia, euphoria (can be abused)

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5
Q

scopolamine is well absorbed ________, and is used for _________

A

through the skin

transdermal patch for motion sickness

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6
Q

at low doses of atropine, the main effects are

A

dry mouth, decreased sweating

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7
Q

as atropine dose is increased effects include

A

tachycardia, blurred vision, palpitations

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8
Q

at moderately high (but not high enough to penetrate CNS) doses, atropine causes

A

urinary retention, hot and dry skin, restlessness, fatigue

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9
Q

when toxic doses of atropine penetrate the CNS, it causes

A

ataxia, hallucinations, delirium, coma, rapid and weak pulse

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10
Q

common drugs that block muscarinic receptors and might be seen in poisoning

A

antihistamines, antidepressants, and antipsychotics

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11
Q

low doses of scopolamine CNS effects

A

drowsiness, amnesia

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12
Q

toxic doses scopolamine effects

A

excitement, agitation, hallucinations, coma

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13
Q

why would scopolamine be used for pre-anesthesia

A

sedation, amnesia, decrease sedations

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14
Q

situations where DA receptors are blocked or DA is reduced causing imbalance of ACh/DA in the corpus striatium

A

Antipsychotic drugs

Parkinsons

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15
Q

3 antimuscarinics used to restore the ACh/DA balance in the corpus striatum

A

trihexyphenidyl, benztropine, diphenhydramine

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16
Q

in the elderly, antimuscarinic drugs cause

A

memory impairment, delirium, dementia

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17
Q

risks of long term antimuscarinic use

A

Alzheimer’s

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18
Q

antimuscarinic effects on the eye

A 
block circular muscle --> mydriasis
block ciliary muscle --> cycloplegia
block reflex to light --> photophobia
block lacrimation --> dry eyestac
(used for eye exams)
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19
Q

loss of accommodation is called

A

cycloplegia

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20
Q

contraindications to the use of antimuscarinics, and why

A

narrow angle glaucoma

blockage of ciliary muscle –> closed trabecular system –> increased intraocular pressure

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21
Q

antimuscarinics cause tachycardia because

A

Presynaptic M2 autoreceptors are blocked –> increased NE

Postsynaptic M2 autoreceptors are blocked –> vagal effects (reflex bradycardia) removed

22
Q

tachycardia due to antimuscarinics is most noticeable in ________ and least noticeable in ________ due to __________

A

healthy young adults
elderly, babies
they have little vagal tone

23
Q

drug used to prevent vagal bradycardia when visceral organs are being handled during surgery

A

glycopyrrolate

24
Q

drug used in MI to decrease bradycardia or MI block

A

atropine

25
Q

reflex vagal discharge

A

due to pain, stimulation of carotid sinus, pressure on the eyeballs, irritation of the larynx during intubation —-> and AV node depression —> bradycardia, decreased CO

26
Q

used to reverse reflex vagal discharge

A

atropine

27
Q

used to reverse bradycardia produced by muscarinic agonists/cholinesterase inhibitors

A

atropine

28
Q

used to block decrease in blood pressure seen with IV muscarinic agonists at M3 receptors

A

atropine

29
Q

M3 receptors on endothelial cells cause vasodilation by

A

releasing nitric oxide in response to a muscarinic agonist

30
Q

toxic doses of atropine cause _______ because _______

A

vasodilation in the face

happens to offload excess heat since sweating is blocked

31
Q

antimuscarinics, pre-anesthia respiratory effects

A

inhibit secretions of salivary gland/respiratory tract

decrease laryngospasm

32
Q

compounds use in the lung are

A

quaternary ammonium compounds, inhaled w/o systemic absorption.

33
Q

ipratropium and tirtropium are

A

bronchodilators for asthma, COPD

34
Q

antispasmodics

A

drugs that decrease motility and secretions in GI tract

35
Q

commonly used antispasmodic

A

dicyclomine

36
Q

treatment of diarrhea that has low potential for abuse because of side effects with higher doses

A

atropine (blocks GI)
+
diphenoxylate (opioid, synergistically blocks GI)

37
Q

name for atropine + diphenoxylate

A

lomotil

38
Q

diphenoxylate is an

A

opioid

39
Q

drug to decrease bladder overactivity

A

tolterodine

40
Q

tolterodine is the preferred drug for bladder control in the elderly in whom muscarinic blockade can cause delirium because

A

M3 specific –> few side effects

No CNS effects

41
Q

drugs that are similar to tolterodine

A

fesoterodine, darifenacin, solifenacin

42
Q

drug used to prevent bladder spasm after prostate surgery

A

oxybutnin

43
Q

drug used to prevent bladder spasm after prostate surgery that causes less dry mouth

A

tropspium

44
Q

use for glycopyrrolate (outside the OR)

A

decrease muscarinic effects of AChE inhibitors in MG patients

45
Q

contraindication of antimuscarinics in old men

A

BPH due to increased urinary retention

46
Q

what’s that weird saying for atropine poisoning

A

dry as a bone, blind as a bat, mad as a hatter, red as a beet

47
Q

who’s sensitive af to atropine poisoning and why

A

infants/children due to sensitivity to hyperthermia

48
Q

symptoms of atropine poisoning

A

dry mouth, mydriasis, tachycardia, decreased bowel sounds, hot flushed skin, agitation, delirum

49
Q

scopolamine poisoning, for added fun, causes

A

atropine poisoning effects + toxic psychosis (it enter CNS)

50
Q

treatment for atropine poisoning and reasoning

A

systemic physostigmine, it gets into the CNS

51
Q

treat direct acting muscarinic agonist poisoning with

A

atropine (also organophosphate poisoning)

Unit 1 Pharm II (18 decks)

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