anti-musc drugs

antimusc drugs

all drugs competitively block muscarinic receptors

atropine/scopolamine (block all M)

teritary anti- no Nn blocking
(will cross BBB)
Quatery - can block Nn

atropine

LD - heart (M2) - lacrima, salivary/sweat glands
ID - iris, ciilary, CNS (depress)
HD - intestial, bronchial, bladder, CNS EXCITE

M1

for brain.

antimusc pharmoky

GI - decreased secretion
dec, tone, amp, peristal
rlx - LES

mild rlx gallbladder and bile ducts

GenitoU - rlx pelves, calyces, urters
rlx detrusor m

used in PARKisons]

SA node - LD (decrease HR)
ID - tachycardia

CardioVasc - vessles TD (no effect)
HD - dialation of BV (to remove heat)

anti musc pharm...cont

resp - bronch SM rlx
eye - rlx of sphincter
rlx cilary muscle, low outflow of aq humor
- decreased lacrimal glands

Skin - decreased section of sweat glands (HOT FEVER in kids)

pharmokinteics

oral bio
atropine 50%
ipratorium >1%

distribution - tert - all tissues
quatt...no CNS

biotransformation 50% atropine, 90% scoplolamine by liver

excretion - 60^ kidney

1/2 life = atropine & scopolamine 3 hrs

glycopyrrolate - 10 hours

toxicity

allergic - skin rashes/fever
poisoing - 5mg leathal children

due to perp/central receptor blockage

if posioned...

symptoms appear in 30 mins
death - resp failure
diagnosis - use Physotigmine if no musc activation then it is antimusc drug

treatment - physotig (last ditch)...use DIAZEPAM and control temp with ICE bags...tepid baths

signs of poisining

mydiasis (no near vision)
difficulty speaking
dry hot red skin
dry mouth
hard to urinate
tachycardia/palpiatations/arrhytmias
fatigue/ataxia

therapeutic uses

GI - IBS (diarrhea)
motion sickness (scopolamine)
saialorrhea - heavy salivary flow

urnary system - urge incontinance, renal colic

resp - asthma/COPD (ipratropum)

CVS - resusciatation (due to vagal hyperactivty)

sinus/nodal bradycardia
AV block
pre-op use block cardiovagal reflex

CNS - PARKINSONS (Trihexyphenidyl)

scopolamine

motion sickness
-preanesthici medications

benztropine

parkinsons

darifanacin

urinary urge incontiance
neurogenic bladder

glycopyrrolate

visceral hypermotility

ipratopium

bcronospastic disorders

atropine

visceral hypermobilty (teritary amine)
excess salivation
CVasc disorders
cholineasase inhibitor OD

ganglionic drugs

simulating - NICOTINE
BLOCKing - MECAMYLamine

ggl drugs

block both pns and sns...
no value to them..
unpredicitable

nicotine- tolerance

nausea/voming - under go tachyphylaxis
...tolerance lost overnight

oral 30%
smoking 90%
transdermal 80-90%

1/2 life 2 hours,
distributes to all tissues, smoked nicotine reaches brain faster then IV

predom tone and then blocked
heart

P - tachycardia

predom tone and then blocked
arterioles

S adernergic - vasodialation/hypotension

predom tone and then blocked
veins

S a
-vasodialtion/pooling/ dec C.o.

predom tone and then blocked
iris

P - mydrasiss

predom tone and then blocked
ciliary muscle

p - cycloplegia

predom tone and then blocked
GI

P - decreased motlity and tone

predom tone and then blocked
uninary bladder

P - reduced secretion

predom tone and then blocked
exocrine gland

p - reduced secretion

predom tone and then blocked
sweat glands

S c - reduced secretion (anhydrosis)

predom tone and then blocked
erection

P - impaired

predom tone and then blocked
ejaculation

S a - impaired ejaculation