ANS 1 (Parasympathetic) Cholinergic Antagonists Flashcards by Kristine Bianca Dagala

Drugs Under Muscarinic Blockers

Atropine /hyoscyamine
Scopolamine/ hyoscine
Hematropine, Cyclopentolate, Tropicamide
Ipratropium bromide
Pirenzepine
Benztropine, Trihexyphenidyl, Oxybutyrin
Dicyclomine
Propantheline
other drugs

How well did you know this?

Not at all

Perfectly

prototype anticholinergic

central and peripheral muscarinic (1-5) blocker

Atropine / Hyoscyamine

How well did you know this?

Not at all

Perfectly

Dose dependent (atropine) : What is the order of its acions?

1) Decreased salivary and bronchial secretions
2) dec sweating
3) mydriasis, tachycardia
4) inhibition of voiding
5) dec GI motility
6) dec gastric secretions

How well did you know this?

Not at all

Perfectly

SE/AE of Atropine

Mydriasis
Alice in Wonderland (5)
mad as a hatter - hallucinations
Blind as a bat - blurring of visions
dry as a bone
red as a beet - tachycardia, vasodilation 
hot as a hare - fever / hyperthermia

How well did you know this?

Not at all

Perfectly

CI of Atropine

glaucoma, prostatic hypertrophy( inflamed and block the path of urine), heart disease, obstructive bowel disease

How well did you know this?

Not at all

Perfectly

M(1-3) blocker
greater action on CNS and longest duration of axn than atropine
more CNS depression at low doses than atropine
more potent at eye and glands than atropine
Less potent at heart, lungs and GI tract than atropine

Scopolamine (hyoscine)

How well did you know this?

Not at all

Perfectly

prevents motion sickness (transdermal), nausea and vomiting
blocks short-term memory
causes amnesia and sedation

Scopolamine (hyoscine)

How well did you know this?

Not at all

Perfectly

produces twilight sleep (when given with morphine) -insensitivity to pain without loss of cosciuosness and to relieve the pain of childbirth
(morphine=w/o pain)
this drug= w/o memory of the pain

Scopolamine (Hyoscine)

How well did you know this?

Not at all

Perfectly

Produces Mydriasis for opthalmoscopic examination

HTC: Homatropine, Tropicamide, Cyclopentolate

How well did you know this?

Not at all

Perfectly

M (1-4) blocker
treatment of asthma and COPD
ACh at lungs: bronchodilation, decreased bronchial secretions

Ipratropium bromide

How well did you know this?

Not at all

Perfectly

treatment of COPD

Tiotropium

How well did you know this?

Not at all

Perfectly

M1 blocker
selective for muscarinic receptor in the stomach
decrease secretion of acid and pepsin
tx of PUD (dec gastric secretion and acidity)

Pirenzepine

How well did you know this?

Not at all

Perfectly

M (1-3) blockers

tx of Parkinson’s disease, extrapyramidal disorders

TBO

Trihexyphenidyl, Benztropine , Oxybutnin

How well did you know this?

Not at all

Perfectly

M (1-3) blocker

tx of hypermotility of bowel

Dicyclomine

How well did you know this?

Not at all

Perfectly

M (1-3) blocker

adjunct for peptic ulcers to dec acid secretions

Propantheline

How well did you know this?

Not at all

Perfectly

Other agents that have anticholinergic effects

Antihistamines
Antipsychotics
Tricyclic antidepressants (TCA)
Opioids

How well did you know this?

Not at all

Perfectly

MOA of NM Blockers/Skeletal muscle relaxants

block nicotinic receptors causing paralysis

How well did you know this?

Not at all

Perfectly

2 divisions of NM Blockers

Competitive Depolarizing

Competitive Non- Depolarizing

How well did you know this?

Not at all

Perfectly

Drugs under Competitive Nondepolarizing NM Blockers

Vecuronium
Atracurium, Cisatracurium
Pancuronium
Tubocurarine
Mivacurium
Rocuronium
Pipecuronium, Doxacurium

How well did you know this?

Not at all

Perfectly

Drugs (Competitve Depolarizing NM Blockers)

Succinylcholine

How well did you know this?

Not at all

Perfectly

NM blockers that compete with ACh at nicotinic receptors, prevents depolarization of the muscle cell membrane and inhibit muscular contraction (noncontraction)

Study These Flashcards

Nondepolarizing NM BLockers

adjunct to anesthesia: muscle relaxant, eases intubation and ventilation, eases orthopedic manipulation, controls respiration during chest surgery
has short duration 25-40 min
very little histamine release

Study These Flashcards

Vecuronium

useful in mechanical ventilation of critically ill patients
ideal for patients with kidney and liver failure
hs short duration of action(25-40 min) for short surgical procedures
AE: moderate histamine release (hypotension, vasodilation)

Study These Flashcards

Atracurium

No histamine release

Study These Flashcards

Cisatracurium

has vagolytic actions used when elevated heart rate is desired AE: tachycardia No histamine release

Pancuronium

Competitive nondepolarizing nm blockers | Prevents fascications associated with succinylcholine administration

Tubocurarine

Competitive nondepolarizing nm blockers Useful for short surgical procedures, has short duration of action (15-20 min) Hydrolyzed by plasma AChE

Mivacurium

Conpetitive nondepolarizing nm blocker Useful for tracheal intubation in patients with gastric contents Rapid onset: 1-3 min Duration: 15-60 min

Rocuronium

Competitve nondepolarizing nm blockers adjunct to anesthesia in long surgery cases Long duration in px with renal dysfunction AE: prolonged nm blockade Duration: 40-240 min

Pipecuronium | Doxacurium

prevents the fasciculations associated with succinylcholine (which is a competitive depolarizing) administration AE: hypotension, bronchospasm

Tubocurarine

useful for short surgical procedures (15-20 mins duration)more rapid recovery from blockade hydrolyzed by plasma AChE

Mivacurium

useful for tracheal intubation in patients with gastric contents rapid onset (1-3 min) duration (15-60 min) minimal cardiovascular effect

Rocuronium

adjunct to anesthesia in long surgery cases long duration in px with renal dysfunction AE: prolonged nm blockade duration: 20-240 min

Pipecuronium, Doxacurium

NM blockers drug interaction: | overcome the action of nondepolarizing blockers (as antidote?)

NM blockers drug interaction w/ Cholinesterase Inhibtior ( Neostigmine, Edrophonium, Physostigmine)

NM blockers drug interaction: | ehance NM blockade by exerting a stabilizing axn at the NMJ

NM blockers drug interaction w/ halogenated hydrocarbon anesthetics

NM blockers drug interaction: | inhibit ACh release from cholinergic nerves by competing with Ca ions

NM blockers drug interaction w/ aminoglycoside antibiotics

NM blockers drug interaction: may increases nm block of nondepolarizing and depolarizing blockers ; dec muscular contraction

Ca channel blockers

Drug/s for competitve nondepolarizing nm blocker

Succinylcholine

T/F : competitve depolarizing nm blocker effects are reversible by AChE

False

Phase of nondepolarizing nm blocker : - opening of the Na channel associated with the nicotinic receptors - fasciculations/contractions

Phase 1

Phase of nondepolarizing nm blocker : - gradual repolarization as the sodium channel closes or is blocked /relaxation - resistance to depolarization - flaccid paralysis

Phase 2

Order of paralysis of Succinylcholine

1) fasciculations in chest and abdomen 2) neck, arms, legs 3) facial, pharynx, larynx 4) respiratory muscles

Useful when rapid endotracheal intubation is required during induction of anesthesia Onset= 30-60 sec Duration= 3-5 min

Succinylcholine

Condition wherein there is a muscle rigidity and hyperpyrexia? Treatment for this condition?

Malignant hyperthermia Tx: dantrolene ( blocks release of ca from sarcoplasmic reticulum if muscle cells) and rapidly cooling the patient

Given in prereversal stage of reversing nm blockade | - to prevent bradycardia, salivation, other muscarinic effect

Atropine or glycopyrrolate

Low dose of nicotine

Ganglionic stimulation Depolarization Inc bp and heart rate Inc motor activity if bowel

High dose of nicotine

Ganglionic blockade Dec bp Ceases Git and bladder activity

Competitive nicotinic ganglionic blocker | Tx of moderately severe to severe htn

Mecamyline

Short acting competitive nicotinic ganglionic blocker | Tx of hypertensive emergencies caused by pulmonary edema or dissecting aortic aneurysm

Trimethaphan

Blockade is by occupying sites in or on the nicotinic ion CHANNEL First drug effective for htn management

Hexamethonium

ANS 1 (Parasympathetic) Cholinergic Antagonists Flashcards

(50 cards)