Muscarinic/cholinergic
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| Bethanechol class, MOA | direct acting muscarinic agonist, cholinergic effect. doesnt cross BBB
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| Bethanechol used for | (post op) urinary retention, ileus bowel obstruction, abdominal distention
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| how doe we treat muscarinc overdose | admin a muscarinic antagonist such as atropine
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| Atropine class, MOA | muscarinic antagonist, crosses BBB
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| atropine indications | (preop)pre-anesthetic to prevent brady, tx eye disorders-mydriasis, tx brady, asthma (bronchodil)
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| SEs of bethanachol | cholinergic SwSLUDV BBHHM
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| SEs of atropine | anticholinergic - opposite of SwSLUDV BBHHM
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| Dosing feature of atropine - low to high | low dose --> decreased secretions, increased HR
High dose --> bronchodil, decreased stomach acid secretions
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| other use for muscarinic antagonists | OAB overactive bladder
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| action of a AChEI is synonomus with | same as a cholinergic agonist (these are indirect acting cholinergics)
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| 3 reversible AChEIs | neostigmine, pyridostigmine, ambenonium
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| neostigimine | reversible AChE inhibitor- oral/IV
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| pyridostigmine | reversible AChE inhibitor-oral
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| ambenonium | reversible AChE inhibitor - oral
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| what are AChEIs indicated for | tx of myasthania gravis
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| what is myasthania crisis | undermedicated, too little ACh-->profound muscle weakness, resp paralysis
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| what is cholinergic crisis | overmedicated AChEI or cholinergic agonist. Too much ACH --> profound muscle weakness, cholinergic SEs (overstim receptors now unresponsive), tx with muscarinic antagonist atropine
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| Two classes of Nm blocking agents | non-depolarizine, depolarizing
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| Indications of Nm blocking agents | want to paralyze pt --> pre-op, intubation, ventilation
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| non-depoarlizing MOA (used most frequently) | blocks ACh at Nm
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| name 5 non-depolarizing Nm blocking agents | atracurium, cistracurium, pancuronium, rocuronium, vercuronium
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| SEs of non-depolarizing Nm blocking agents | unusual HypoTN bwo histamine release-->vasodil. body compensates tachy, some dysrhythmias. Respiratory muscle paralysis
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| atracurium | non-depolarizing Nm blocking agent
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| cistracurium | non-depolarizing Nm blocking agent
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| pancuronium | non-depolarizing Nm blocking agent
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| rocuronium | non-depolarizing Nm blocking agent
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| vecuronium | non-depolarizing Nm blocking agent
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| MOA of depolarizing Nm blocker | sustained depolarization at Nm --> initial short phase contraction-->fatigue bwo receptor exhaustion
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| depolarizing Nm blocker indications | this ultra-short acting drug for pre-op intubation
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| Name a depolarizing Nm blocker | succinylcholine
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