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Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
Anticholinergics
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Anticholinergics

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  • 1. Anticholinergics Most anticholinergic drugs interact with the muscarinic receptors in the brain, secretory glands, heart, and smooth muscle A few can also affect the nicotinic receptors. Glycopyrrolate (Robinul) is an example
  • 2. Mechanism of Action and Effects Act by occupying receptor sites at parasympathetic nerve endings, thereby leaving fewer receptor sites free to respond to acetylcholine Distribution of receptors is broad so effects of anticholinergics will be diffuse.
  • 3. Effects on Body Tissues 1. 2. 3. CNS stimulation followed by depression, can result in coma and death (atropine, antiparkinson’s) Decreased cardiovascular response to vagal stimulation resulting in tachycardia. Increases vagal tone. Ex. Atropine. Bronchodilation and decreased respiratory tract secretions.
  • 4. Indications for Use Uses include GI, ophthalmic and respiratory disorders, bradycardia and in Parkinson’s disease. Used preoperatively
  • 5. Use In GI Disorders Helpful in treating irritable colon or colitis Useful in gastritis, pylorospasm and ulcerative colitis as they slow motility
  • 6. Use in GU disorders Antispasmotic effects seen in overactive bladder and in urinary incontinence
  • 7. Ophthalmology Mydriatic and cycloplegia (paralysis of the ciliary muscle of the eye) for examinations and surgery
  • 8. Respiratory In bronchospasm whether related to asthma or COPD Atrovent very useful for its bronchodilating effects
  • 9. Cardiology Atropine is used to increase heart rate in symptomatic bradycardias and higher blocks
  • 10. Parkinson’s Disease Useful in those with minimal side effects Those who cannot take Levodopa Helpful in decreasing salivation, spasticity and tremors
  • 11. Help prevent vagal stimulation and potential bradycardia Reduce respiratory secretions as well
  • 12. Contraindications Myasthenia gravis Hyperthyroidism Glaucoma Tachydysrhythmias Not in situations whereby delaying of gastric emptying is a concern
  • 13. Individual Anticholinergic Drugs Atropine—prototype. Antidote. Belladonna alkaloid. Ipratropium (Atrovent). Useful in rhinorrhea(persistent watery mucus discharge from the nose). Also excellent bronchodilator. Scopolamine, similar to atropine. Depresses CNS and causes amnesia, drowsiness, euphoria, relaxation and sleep. Also good for motion sickness. Given parenterally, orally and transdermally.
  • 14. Centrally Acting Anticholinergics Benztropine (Cogentin)—temporary use in Parkinson’s disease. Useful for dystonic reactions caused by antipsychotics.
  • 15. Urinary Antispasmotics Flavoxate (Urispas)—relieves dysuria, urgency, frequency, and pain with GU infections Oxybutynin (Ditropan) has direct antispasmodic effects on smooth muscle and anticholinergic effects. Decreases frequency of voiding. Tolterodine (Detrol) is competitive, antimuscuranic anticholinergic that inhibits contraction. More selective for this area than elsewhere in the body.
  • 16. Toxicity of Anticholinergics Anticholinergic overdose syndrome is characterized by: Hyperthermia, delirium( disturbed state of mind), dry mouth, tacycardia, ileus, urinary retention. Seizures, coma and respiratory arrest may occur.

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