(additional) Anticholinergics

Question 1

Tissue sensitivities to anticholinergics: most

Answer 1

Salivary, bronchial glands

Question 2

Tissue sensitivities to anticholinergics: intermediate

Answer 2

Cardiac, SmM

Question 3

Tissue sensitivities to anticholinergics - least

Answer 3

Gastric parietal cells, urinary system

Question 4

Scopolamine

Answer 4

-Hyoscine, aka buscopan
-“motion sickness” in people
-Xerostomia (dry mouth), decreased gastric emptying, ileus, urine retention, constipation, excitement in cats
-Gas colic, difficult rentals in horses
-SmM relaxation
-Tertiary amine that crosses BBB
-Minimal SmM, more potent sedation/antisialagogue

Question 5

Hyoscyamine

Answer 5

o Tropane alkaloid, levo-isomer of atropine
o Oral vagolytic – give to dogs/cats with bradycardic arrhythmias not candidates for PM

Question 6

Anticholinergic Syndrome

Answer 6

produce symptoms due to entrance into CNS
o Atropine, scopolamine
o Restlessness, hallucinations to somnolence and unconsciousness
o Reflect blockade of muscarinic cholinergic R, inhibition of effects of ACh in CNS

Question 7

Clinical Signs of anticholinergic syndrome

Answer 7

o CS: blind as bat (mydriasis), mad as a hatter (confusion), red as a beat (flushed skin), tachycardia, absent GI sounds, hot as a desert (hyperthermia), dry as a bone (dry mouth, urinary retention), shaking

Question 8

Treatment of anticholinergic syndrome

Answer 8

o PHysostigmine (lipid soluble tertiary amine anticholinesterase drug) = treatment for central anticholinergic syndrome
 H for head
 Edrophonium, neostigmine, pyridostigmine cannot treat - cannot enter CNS
o Can be mistaken for delayed recovery from ax – ventilation may be depressed