Anticholinergic Drugs

Antimuscarinic (Non-selective)

100

What drug is clinically used for...

- Mydriasis/cycloplegia

- Bradycardia

- Treats acetylcholinesterase toxicity

- Decrease urinary urgency in cystitis 

and; uses physostigmine to reverse overdose 

Atropine

200

Which drug is clinically used for treating Parkinson disease and drug-induced Parkinsonism? 

Benztropine

300

What is the drug Trospium clinically used for?

 Treating an overactive bladder by relaxing the bladder muscles

400

What is the duration of mydriasis and cycloplegia induced by Tropicamide, Cyclopentolate, Homatropine, and Atropine?

Tropicamide: Mydriasis (1/4th of a day); Cycloplegia (+)

Cyclopentolate: Mydriasis (1 day); Cycloplegia (++)

Homatropine: Mydriasis (3 days); Cycloplegia (+++)

Atropine: Mydriasis (7-10 days); Cycloplegia (++++)

500

What are the clinical uses for Glycopyrolate?

- Reduces secretions for...

^{+ Drooling due to neurological conditions}

^{+ Airway secretions for undergoing anesthesia}

^{+ Paired w/ neostigmine to reverse paralysis in anesthesia}

- Peptic Ulcers

Antimuscarinic (Non-selective)

100

What are the main adverse anticholinergic side effects?

Fever 

Flushing

Dry mouth 

CNS effects 

Blurry vision 

Constipation 

Urinary retention 

Tachycardia

200

What are the two derivatives of atropine that are used to produce mydriasis/cycloplegia in topical form?  

Homatropine & Tropicamide

300

Which drugs are clinically used for irritable bowel syndrome by reducing G.I. motility and spasms?

Hyoscyamine and Dicyclomine

400

What other drug reduces bladder spasms and urges urinary incontinence, but should not be given to elderly patients due to risk of delirium?

Oxybutynin

500

Scopolamine is used for which clinical application?

Anti-motion sickness via transdermal patch

Antimuscarinic - M3 Selective

100

Which three drugs are muscarinic antagonists on M3 receptors to help with urinary urgency and incontinence?

Darifenacin, Solifenacin, Tolterodine

200

Which drug acts on the M3 receptor for urinary urgency issues/incontinence, but is considered a non-selective antagonist?

Tolterodine

300

What form are the drugs (Darifenacin, Solifenacin, Tolterodine) used for treatment?

Orally

400

How long does Darifenacin, Solifenacin, Tolterodine last in the body? 

12-24hr

500

What are the adverse side effects of Darifenacin, Solifenacin, and Tolterodine?

Excessive parasympatholytic effects

Antimuscarinic - M1 Selective

100

What is the clinical use for Pirenzepine and Telenzepine?

-Not clinically used anymore

-Previously used for Peptic Ulcer disease

200

Which drugs are muscarinic antagonists acting on M1 receptors?

Pirenzepine and Telenzepine

300

What are the adverse side effects of Pirenzepine and Telenzepine?

Excessive parasympatholytic effects

400

How is Pirenzepine and Telenzepine administered?

Oral

Ganglion Blocking Agents/Antimuscarinic (Bronchodilation)

100

Which medications block Nn receptors?

Hexamethonium, Mecamylamine, Trimethaphan

200

What is the clinical use for Hexamethonium, Mecamylamine, Trimethaphan?

 - Used in experiments to identify drug properties

- not clinically used

300

What are the adverse effects of Hexamethonium, Mecamylamine, Trimethaphan?

Autonomic dysfunction everywhere

^{- hypotension}

^{- anhidrosis}

^{- constipation}

^-tachycardia

^{- dry mouth} 

^{- blurred vision}

400

Which drugs are clinically used for bronchodilation in asthma and for COPD treatment via inhalation?

Ipratropium, Tiotropium, Aclidinium, Umeclidinium

500

Which drug is a partial antagonist at Nn and used clinically for smoking cessation?

Varenicline

Mecamylamine

^{- not FDA approved for smoking cessation, but has been investigated}