NMB reversal agents & anticholinergics 2 Flashcards
Compared to atropine, glycopyrrolate is MORE likely to cause:
a. tachycardia
b. xerostomia
c. sedation
d. mydriasis
b. xerostomia
_____________ & ________________ easily cross lipid membranes, including the BBB, GI tract, & placenta.
atropine & scopolamine
Does glycopyrrolate cross the BBB?
nope it’s ionized
_______________- increases the heart rate the most of all the muscarinic antagonists
atropine
A very small dose of atropine can cause
paradoxical bradycardia
_________________ is most effect at preventing motion sickness, providing sedation, and drying secretions.
Scopolamine
Atropine & scopolamine are naturally occuring
tertiary amines
Why can atropine cause paradoxical bradycardia?
in small doses it is probably due to the inhibition of the presynaptic M1 receptor on vagal nerve endings- blockade turns off the negative feedback loop and allows for continued Ach release & bradycardia
Muscarinic antagonists do not affect the heart rate in patients with
a previous heart transplant (e.g. those with a denervated heart)
Should you still give heart transplant patients a muscarinic antagonist?
yes, because they can experience other cholinergic effects from AchE inhibitors
Which muscarinic antagonist increases heart rate the least?
scopolamine
Which muscarinic antagonist does not prevent motion-induced nausea?
glycopyrrolate
Which neuromuscular blocker is MOST effectively antagonized by sugammadex?
a. mivacurium
b. rocuronium
c. cisatracurium
d. succinylcholine
b. rocuronium
Sugammadex is a
gamma-cyclodextrin that encapsulates the aminosteroid neuromuscular blockers in the bloodstream
Sugammadex has the greatest affinity for
rocuronium