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Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
Antimuscarinic Agents 2 Power Point Presentation
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Antimuscarinic Agents 2 Power Point Presentation

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  • 1. Comparison between Atropine & Hyoscine Hyoscyamys niger Depressant (amnesia, fatigue, drowsiness, N-REM sleep) Excitation More potent on eye & secretory glands Shorter +++ Atropa belladonna Excitatory Excitation (mild) Excitation (strong) More potent on heart, bronchial muscle & intestines Longer ++
    • Chief source
    • CNS effect
    • low dose
    • high dose
    • 3. Anticholinergic property
    • 4. D.o.A
    • 5. Antimotion sickness
    Hyoscine Atropine
  • 2.
    • Quaternary compounds
    • They have some common features:-
    • Oral absorption is incomplete.
    • Do not penetrate brain & eye – central & ocular effects are not seen after parenteral/oral administration.
    • Slow elimination & most of them are longer acting than atropine.
    • They have higher nicotinic blocking property.
    • At clinical doses, ganglionic blockade may occur – postural hypotension, impotence are additional s/e.
    • At high doses NMB (neuromuscular blocking) may also occur.
  • 3.
    • Hyoscine butylbromide
    • 20- 40mg oral, i.m, s.c, i.v
    • It is less potent & longer acting than atropine.
    • Used for esophageal & G.I spastic conditions.
    • Ipratropium bromide
    • 40-80 μ g by inhalation.
    • It acts selectively on bronchial muscle without altering volume or consistency of respiratory secretions.
    • It doesn’t depress mucociliary clearance by bronchial epithelium (atropine does it)
  • 4.
    • It has a gradual onset and late peak (at 60-90min) of bronchodilatory effect in comparison to inhaled sympathomimetics – more suitable for regular prophylactic use.
    • Action lasts 4-6hrs.
    • It acts on receptors located mainly in the larger central airways. (primary site of action for sympathomimetics are peripheral bronchioles)
    • It is more effective in COPD.
  • 5.
    • s/e (local)
    • Dryness of mouth
    • Scratching in trachea
    • Cough
    • Bad taste
    • Nervousness
    • Propantheline
    • 15-30mg oral
    • Most popular anticholinergic were used for peptic ulcer and gastritis.
    • Higher ganglion blocking activity is believed to aid antisecretory effects.
    • It also delays gastric emptying.
    • Action lasts 6-8hrs.
  • 6.
    • Oxyphenonium
    • 5-10mg (children3-5mg) oral
    • Similar to Propantheline
    • For peptic ulcer and g.i hypermotility.
    • Clidinium
    • 2.5-5mg oral
    • It is used in combination with Benzodiazepines for nervous dyspepsia, gastritis, irritable colon.
  • 7.
    • Pipenzolate methylbromide
    • 5-10mg (children 2-3mg) oral
    • For flatulent dyspepsia, infantile colics and other g.i spasm.
    • Isopropamide
    • 5mg oral
    • For hyper acidity, nervous dyspepsia, irritable bowel and other g.i problems, specially when associate with emotional/mental disorders.
  • 8.
    • Glycopyrrolate
    • 0.1-0.3mg i.m, 1-2mg oral
    • It is a potent and rapidly acting antimuscarinic agent.
    • No central effects.
    • Used for preanesthetic medication and during anesthesia.
  • 9.
    • Tertiary amines
    • Dicyclomine
    • 20mg oral
    • Weak anticholinergic property
    • It has direct smooth muscle relaxant action (antispasmodic).
    • It also has antiemetic property.
    • Used in motion sickness, morning sickness, dysmenorrhoea and irritable bowel
    • Dicyclomine shows less s/e.
  • 10.
    • Oxybutynin
    • 5mg BD/TDS oral, children above 5yr 2.5mg BD.
    • It has high affinity for receptors in urinary bladder & salivary glands (selective M 1 /M 3 subtypes).
    • It has additional smooth muscle relaxant and local anesthetic property.
    • Used in neurogenic bladder, spina bifida and nocturnal enuresis.
    • Flavoxate
    • Its properties and uses are similar to Oxybutynin
  • 11.
    • Drotaverine
    • 40-80mg TDS
    • Non-anticholinergic smooth muscle antispasmodic.
    • M/A
    • This leads to elevation of intracellular cAMP/cGMP causes smooth muscle relaxation.
    • For intestinal, biliary and renal colics, irritable bowel syndrome, uterine spasms etc.
    • It can be administered orally as well as parenterally.
    5 `AMP/5`GMP Phosphodiesterase-4 Drotaverine inhibition cAMP/cGMP
  • 12.
    • s/e
    • Headache
    • Dizziness
    • Constipation
    • Flushing
    • Fall in B.P on i.v inj
  • 13.
    • Mydriatics
    • Mydriasis occurs either due to the contraction of dilator pupillae (e.g.:- α 1 adrenergic agonists) or by the relaxation of sphincter pupillae of eye (e.g.:- antimuscarinics)
    • Homatropine
    • 1%, 2% eye drops.
    • It is 10 times less potent than atropine.
    • Instilled in eye, it acts in 45-60min
    • Mydriasis lasts 1-3days, while accommodation reverse in 1-2 days.
    • It is used in adults. Children has high ciliary muscle tone hence it produces unsatisfactory cycloplegia.
  • 14.
    • Cyclopentolate
    • 0.5%, 1% eye drops.
    • It is potent & rapidly acting agent.
    • Mydriasis & cycloplegia occur in 30-60min and last about a day.
    • It is preferred for cycloplegic refraction.
    • Children may show transient behavioral abnormalities due to absorption of the drug after passage into the nasolacrymal duct.
    • It is used in iritis & uveitis.
  • 15.
    • Tropicamide
    • 0.5%, 1% eye drops.
    • It has the quickest (20-40min) and briefest (3-6hrs) action.
    • It is used for refraction testing in adults and as a short acting mydriatic for fundoscopy.

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