Cholinergic Antagonist

Question 1

Mechanism of action of cholinergic antagonists

Answer 1

Bind to receptors

Question 2

Nicotinic selective cholinergic antagonists

Answer 2

Nicotine
Trimethaphan
Mecamylamine
Neuronmuscular blockers

Question 3

Muscarinic selective cholinergic antagonists

Answer 3

Atropine
Ipratropium
Scopolamine

Question 4

Muscarinic selective chol. antagonists in order of CNS distributions (low to high)

Answer 4

Ipratropium<Scopolamine

Question 5

CHOl. Antagonists block which functions?

Answer 5

SLUD: 
Salivation
Lacrimation
Urination
Defacation

Question 6

medical uses of cholinergic antagonists

Answer 6

Ophthalmology
Asthma
COPD
Cholinergic OD
GI hypermotility/Urinary incontinence
Motion Sickness
Parkinsons

Question 7

Mydriasis

Answer 7

Increase in pupil size due to radial muscle contraction (cholinergic antagonists)

Question 8

Miosis

Answer 8

Reduction in pupil size due to circular muscle contraction (cholinergic agonists)

Question 9

Accommodation

Answer 9

Contraction of ciliary muscle (near vision) = outflow of aqueous humor outflow by pulling trabecular meshwork –> reduce IOP (cholinergic agonists)

Question 10

Cyclospasm

Answer 10

Excess accommodation caused by marked contraction of ciliary muscle (cholinergic agonists)

Question 11

Cycloplegia

Answer 11

Weakening of contraction of ciliary muscle leading to a loss of accommodation

Question 12

Drugs used to induce mydriasis in eye exams

Answer 12

Atropine

Phenylephrine

Question 13

Atropine

Answer 13

Muscarinic receptor antagonist

Used to get mydriasis, cycloplegia (circular muscle, ciliary muscle)

Treat forms of GI hyper motility/incontinence

Counteract excess cholinergic muscarinic activity

Question 14

Adverse side effects of Atropine

Answer 14

Blind, dry, red, hot, mad

Kids especially susceptible to thermogenic effects

Question 15

Contraindications for Atropine

Answer 15

Glaucoma

Question 16

Manifestations of asthma

Answer 16

Increased mucus
Swelling of bronchial tube lining
Bronchoconstriction
Coughing
Wheezing
SOB

Question 17

Drugs used in asthma patients

Answer 17

Epinephrine
B2 Adrinergic Agonists
Ipratropium

Question 18

Diseases involved with COPD

Answer 18

Chronic bronchitis

Emphysema

Question 19

Drugs used in COPD patients

Answer 19

Ipratropium
Epinephrine
B2 adrenergic receptor agonists
etc

Question 20

Ipratropium

Answer 20

Competative muscarinic antagonist

TX: COPD, Asthma, Facilitate B2 Adrenergic agonist effects/those who cant tolerate them

Question 21

MOA of Ipratropium

Answer 21

Antagonism of musc receptors in bronchiolar SM: BRONCHODILATION

Antagonism of musc receptors in bronchiolar sub mucosal glands: deacrease mucus secretion

Question 22

Distribution of Ipratropium in CNS

Answer 22

LITTLE CNS penetration

Question 23

Drug used in GI/Urinary disorders

Answer 23

Atropine

Question 24

Drug used in motion sickness

Answer 24

Scopolamine

Question 25

Scopolamine selectivity

Answer 25

Competative musc antagonist

Question 26

Scopolamine indications

Answer 26

Prevent nausea/vomiting in motion sickness Pre-anesthetic agent high CNS

Question 27

Manifestations of cholinergic OD

Answer 27

DUMBBELSS unable to walk, chest tightness, voiding Loss of consciousness, seizures, death

Question 28

Drugs used to treat organophosphate poisoning/cholinergic OD

Answer 28

Atropine | Pralidoxime

Question 29

Ganglionic blocker MOAs

Answer 29

block output of ANS at the ganglia by: 1. competative/stabilizing (trimethephan & mecamylamine) 2. depolarizing blockade (nicotine)

Question 30

Trimethephan selectivity

Answer 30

Competitive, non-depolarizing nicotinic receptor antagonist

Question 31

Trimethephan indications

Answer 31

RARE Controlled reduction of BP during surgery Treatment of hypertensive emergencies

Question 32

Mechanism of Trimethephan

Answer 32

Block ganglionic nicotinic receptors --> vasodilation

Question 33

Mecamylamine selectivity

Answer 33

Competitive, non-depolarizing nicotinic receptor antagonist

Question 34

Mecamylamine indications

Answer 34

RARE Management of mod-sev HTN Nicotine anti-craving tx

Question 35

Mechanism of Mecamylamine

Answer 35

Block ganglionic nicotinic receptors--> vasodilation

Question 36

Nicotinic selectivity

Answer 36

Depolarizing nicotinic receptor antagonist