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Pharm2 Lect 7

Pharm2 Cholinolytics

QuestionAnswer
Competitive, reversible Muscarinic Antagonists: 1.Atopine. 2.Scopolamine. 3.Tropicamide. 4.Cyclopentolate. 5.Ipratropium. 6.Tiotropium bromide. 7.Tolterodine. 8.Fesoterodine. 9.Oxybutynin chloride. 10.Darifenacin HBr. 11.Solifenacin. 12.Trospium chloride. 13.Dicyclomine. 14.Hyoscyamine.
Contraindications for Competitive, reversible M Antagonists 1.Narrow Angle Glaucoma.
Competitive, reversible Muscarinic Antagonists: Atropine 1.Mech of action: block M receptors on iris sphincter, ciliary muscle, nasopharyngeal & oral glands. 2.Bioav: Long, central & peripheral effector sites. 3.Treats: cholinergic crisis, mydriasis, cycloplegia, hyperactive carotid sinus, vagal-ind heart blo
Competitive, reversible Muscarinic Antagonists: Scopolamine 1.mech of action: blocks M rec on iris sphincter, ciliary m, oral glands, vomit center in medulla. 2.Bioav: Long. 3.treats: Mydriasis, cycloplegia, pre-op med causes CNS depression.
Competitive, reversible Muscarinic Antagonists: Ipratropium bromide 1.mech of action: Blocks M rec on bronchioles. 2.Bioav: Short (4X day) 3.Treats: Asthma/COPD. **Better than B2 agonist for COPD.
Adverse effects of Atropine, Scopolamine, Ipratropium bromide? Rank their effect on CNS Scopolamine > Atropine >>> Ipratropium bromide. 1.Sedation OR excitement. 2.Disorientation. 3.Memory loss. 4.Dizziness. 5.restlessness. 6.Hallucinations. 7.Delirium & confusion.
Competitive, reversible Muscarinic Antagonists: Tropicamide 1.Mech of action: Blocks M rec on Iris sphincter & ciliary muscle. 2.Bioav: Short. 3.Treats: mydriasis, cycloplegia
Competitive, reversible Muscarinic Antagonists: Cyclopentolate Blocks m receptors
Competitive, reversible Muscarinic Antagonist used to treat an overactive bladder OR urge incontinence from detrusor overactivity? 1.Tolterodine. 2.Fesoterodine. 3.Oxybutynin. 4.Darifenacin HBr. 5.Solifenacin. 6.Tropsium Chloride. **Dec urinary freqency
Competitive, reversible Muscarinic Antagonists used to treat ulcers, irritable bowl syndrome, & GI spasm 1.Dicyclomine. 2.Hyoscyamine.
Blockade order of Competitive, reversible muscarinic antagonist 1.Salivary, bronchial, & sweat glands. 2.Iris, ciliary m, & heart. 3.Bladder & Gut, 4.Stomach acid secretion (to treat with M ant b/c too many side effects).
Two drugs that cause Mydriasis? Pupil dilation: 1.M antagonist (Tropicamide-short duration, atropine & scopolamine- Long duration). 2.A1 agonist.
Which Competitive, reversible M antagonist is used to treat acute rhinitis. Atropine. **Dec secretions in respiratory tract.
Key difference b/w Ipratropium bromide & Tiotropium bromide Duration of action: 1.Ipratropium: Short (4X daily). 2.Tiotropium: Long (1X day). **Both are inhaled.
Competitive, reversible Muscarinic Antagonist: Tiotroium bromide 1.Mech of action: blocks M rec in bronchiole smooth muscle. 2.Bioav: Long (once per day).
Which be better for Asthma: Ipratropium or B2 agonist? B2 since there may only be minimal PNS activation of M receptors causing the bronchoconstriction (could be more from histamine).
Which be better for COPD: Ipratropium or B2 agonist? Ipratropium=B2 b/c there is more PNS activation of M receptors causing the dilation. **Ipratropium has less side effects
Which competitive, reversible Muscarinic antagonist has the more powerful sedative effect? Scopolamine. Then Atropine.
Why does atropine inc SA node HR & AV node conductance but has no effect on ventricular arrhythmia? B/c M receptors are not present in the ventricles. **Atropine also wont be able to reset a re-entry.
What competitve, reversible muscarinic antagonist is used to treat motion sickness Scopolamine. **Inhibits vomit center in medulla.
Effects of Nicotine N agonist: 1.CNS stimulation & Tremor. 2.Inc HR & BP. 3.GI NVD. **stimulation is followed by depression.
Ganglionic Blockers (Nn antagonists) 1.Trimethaphan. 2.Mecamylamine. **Obsolete.
Created by: WeeG
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