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Pharm - Ch. 14

Muscarinic Agonists and Antagonists

QuestionAnswer
What areas of the body does bethanechol affect? Eye, respiratory system, heart and blood vessels, GI and urinary tracts, and secretory activity of exocrine glands
Responses caused by bethanechol on eye Miosis, contraction of ciliary muscle for near vision accommodation
Responses caused by bethanechol on respiratory system Causes bronchial constriction and increased secretion
Responses caused by bethanechol on heart and blood vessels Bradycardia, vasodilation in vascular smooth muscle, leading to hypotension
Responses caused by bethanechol on GI and urinary tracts GI contraction, increased tone/motility of smooth muscle. Contraction of detrusor muscle and relaxation of trigone/sphincter leading to bladder emptying
Responses caused by bethanechol on exocrine glands Increased sweating, salivation, secretions
Main side effects of muscarinic agonist Hypotension, bradycardia, excessive salivation, increased secretion of gastric acid, abdominal cramps, diarrhea. Increased pressure within urinary tract. Bronchoconstriction, dysrhythmias in hyperthyroid patients.
Contraindications and precautions when using muscarinic agonists Patients with low blood pressure/cardiac output, patients with intestinal/urinary tract obstructions, patients with asthma, hyperthyroid patients due to cardiac dysrhythmia
Why is acetylcholine not widely used clinically? Lacks selectivity because it will activate nicotine receptors as well. Rapid destruction by cholinesterase means very short half-life.
Name a muscarinic antagonist Atropine
S/sx of atropine poisoning? Xerostomia, blurred vision, photophobia, hyperthermia, CNS effects (hallucinations, delirium), and skin that is hot, dry, flushed. Death due to respiratory depression secondary to blockade of cholinergic receptors in brain.
Treatment of muscarinic antagonist poisoning? Minimizing intestinal absorption of antimuscarinic agent (swallowing activated charcoal), and administering antidote (inhibitor of acteylcholinesterase.)
Atropine ___ the actions of ACh and muscarinic agonists Blocks
What are the applications of anticholinergic drugs? preanesthetic medication, ophthalmic examinations, reversal of bradycardia, treatment of overactive bladder (OAB), and management of muscarinic agonist poisoning
Created by: choel
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