Week 02 Cholinergic Antagonists Flashcards
(23 cards)
Responses of blocking the Muscarinic receptors?
EYE - mydriasis, blurre vision;
SKIN - reduced sweating, flushing;
GI - reduced motility and secretions (constipation);
CARDIO - increased heart rate (high doses);
RESPIRATORY - bronchial dilation and decreased secretion;
GU - urinary retention
What do cholinergic antagonists block?
Muscarinic receptors of the parasympathetic nerves
Name a few Muscarinic Antagonists
Atropine 阿托品
Scopolamine (Scopace) 莨菪碱
Ipratropium (Atrovent) 异烟酰异丙肼
Trihexyphenidyl (Artane) 三己芬迪，苯海索，安坦
Side effects?
dry mouth, dry eyes, blurred vision, constipation, urinary retention
3 groups of Cholinergic Antagonists?
1) Muscarinic Antagonists;
2) Ganglionic Blockers;
3) Neuromuscular Blocking Agents
Atropine
阿托品, Muscarinic Antagonist Functions: * pre-anesthetic to prevent respiratory secretions * treat Parkinsonism * treat severe bradycardia 心动过缓 * treat enuresis 遗尿
Scopolamine (Scopace)
东莨菪碱（可用作镇静剂）, Muscarinic Antagonist
Functions:
* prevent motion sickness
- usually administered using a transdermal patch
Cholinergic antagonists antagonize the effect of __________
Acetylcholine
Ipratropium (Atrovent)
异丙托铵（支气管扩张药）, Muscarinic Antagonist
Functions:
* treat chronic obstructive pulmonary disease (COPD) by inducing bronchodilation
Trihexyphenidyle (Artane)
三己芬迪，苯海索，安坦, Muscarinic Antagonist
Function:
* treat Parkinsonism
Definition of Muscarinic Antagonists
- 1 of the 3 groups of Cholinergic Antagonists
- most useful type/group of cholinergic antagonists
- block muscarinic receptors of the PARASYMPATHETIC nerves
Definition of Neuromuscular Blockers
- 1 of the 3 groups of Cholinergic Antagonists
- block the effects of Acetylcholine by interacting with NICOTINIC receptors at the Neuromuscular junction
- produce SKELETAL muscle relaxation
- clinically useful during surgery for producing COMPLETE Muscle Relaxation
- interfere with transmission of EFFERENT impulses to skeletal muscles
- classified as DEPOLARIZING & NON-DEPOLARIZING (competitive) blockers due to their mechanism of action
Explain the mechanism of action of Neuromuscular Blockers, i.e. why are they classified as depolarizing/non-depolarizing (Competitive) blockers?
- DEPOLARIZING blocker - binds to receptor –> opens the ion channel –> depolarization of the end plate.
- Unlike acetylcholine, the Neuromuscular Blockers REMAIN Attached to the receptor –> provide constant stimulation –> thus receptor cannot transmit further impulses
- NON-DEPOLARIZING (competitive) blocker binds to the receptor, but does NOT open the ion channel
Name a few Neuromuscular Blockers
- SUCCINYLCHOLINE (Anectine) 琥珀胆碱;肌肉松弛剂
- Vecuronium (Norcuron) 维库溴胺;”万可松”
- d-Tubocurarine (Curare)
- Mivacurium (Mivacron) “美维松”
- Rocuronium (Zemuron)罗库溴铵
Succinylcholine (Anectine)
Neuromuscular Blocker, 琥珀酰胆碱（用作肌肉松驰剂） Function: * ideal for intubation because of rapid onset and short duration * adjunct to anesthesia * Only DEPOLARIZING agent
Vecuronium (Norcuron)
Neuromuscular Blocker, “万可松”，”诺库隆”
Functions:
* adjunct to anesthesia
* muscle relaxant, eases intubation
Mivacurium (Mivacron)
Neuromuscular Blocker, 米库氯铵, “美维松”
Function:
* useful for SHORT surgical procedures (rapid recovery)
d-Tubocurarine (Curare)
Neuromuscular Blocker “右旋筒箭毒碱?”
Function:
* a small dose prior to succinylcholine, prevents Fasciculation 肌束震颤
Rocuronium (Zemuron)
Neuromuscular Blocker 罗库溴铵
Function:
* useful for Tracheal Intubation in patients with Gastric contents (rapid onset of action)
Definition of Ganglion Blocker
- block the action of acetylcholine at the NICOTINIC receptors of all AUTONOMIC GANGLIA of Both Sympathetic and Parasympathetic systems
- blocking the entire output of the Autonomic Nervous System
- rarely used clinically
Name a few Ganglion Blockers
- Nicotine
- Trimethaphan 咪噻吩
- Mecamylamine (Inversine) “美加明”
Trimethaphan
Ganglion Blocker, 咪噻吩
(短效神经节阻滞剂，可能为当前临床惟一使用的神经节阻滞剂, 此类药物副作用很多)
Function:
* Short term treatment of hypertension
Mecamylamine (Inversine)
Ganglion Blocker “美加明”
Function:
* treatment of moderate to severe hypertension
(为神经节阻断药，属于非去极化竞争性拮抗剂，用于重症高血压)
