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Side ASide B
What kind of "agent" is a muscarinic agonist?
What kind of "agent" is a muscarinic antagonist?
M1 muscarinic receptors affect what?
the CNS and salivary glands
T/F: M1 muscarinic receptors when activated enhance CNS activity and salivary production
T/F: M1 muscarinic receptors when blocked cause dryness and confusion
What occurs with the Heart Rate with the activation of M2 receptors?
Heart rate decreases
T/F: Blocking the activation of M2 receptors will cause increased Heart Rate.
M2 muscarinic receptors affect what?
M3 muscarinic receptors affect what?
salivary glands, GI smooth muscle, iris sphincter...
T/F: Activation of M3 will cause muscle relaxation
Blocking the M3 receptor will induce muscle relaxation
What are the S&S of cholinergic drugs?
* abdominal cramps, * diarrhea, * excessive mouth secretions, * difficulty breathing, * muscle weakness
What is an example of a muscarinic agonist?
What is the MOA of bethanechol?
direct acting muscarinic agonist (binds reversibly to muscarinic cholinergic receptors causing activation)
What is the use of bethanechol?
indicated for urinary retention, GERD, GI paralysis, post-op distention, NOT for use with a physical UT obstruction
What are some adverse effects of bethanechol?
hypotension, bradycardia, excessive salivation, increased secretion of gastric acid, abdominal cramps, diarrhea, bronchoconstriction...
What are some other muscarinic agonists?
Cerimeine, Pilocarpine, acetylcholine, muscarine
What are some causes of muscarinic poisoning?
shrooms, direct acting muscarinic agonists, cholinesterase inhibitors
What are some S&S of muscarinic toxicity
profuse salivation, lacrimation, visual disturbances, bronchospasm, diarrhea, bradycardia, hypotension, if severe, cardiovascular collapse
What is the antidote to muscarinic toxicity?
Atropine (muscarnic blockin gagent)
If toxicity of a muscarinic antagonist occurs, what are the S&S?
dry mouth, blurred vision, photophobia, hyperthermia, CNS effects, death from respiratory depression
What is an example of of a muscarinic antagonist?
What is the MOA of atropine?
competative blockade at muscarnic receptors. (only action is preventing receptor activation. at high dose, can block nicotinic receptors)
What is Atropine used for? (answer(s) continue onto more than one slide)
increase heart rate, decrease secretions in the salivary, bronchial, and sweat glands, as well as secreting cells in the stomach
What is Atropine used for?
bronchodilation, decreased tone of bladder, and decreased motility of GI tract, dilated pupils, CNS excitation, preanesthetic meds, disorders of eye
What are some adverse effects of atropine?
dry mouth (xerostomia), blurred vision, photophobia, urinary retention, constipation, anhidrosis ~ no sweat, tachycardia, asthma
What are some other muscarinic antagonists?
scopolamine, ipratropiumbromide, antisecretory anticholinergics, dicyclomine, pirenzepine, telezepine,
What are some muscarinic blockers?
antihistamines, phenothizaine, antipsychotics, tricyclicantidepressents
OAB (over active bladder) is categorized by what?
urinary urgency, urinary frequency (8+/day), nocturia (2+/night), urge incontinence
What is used to treat OAB and why?
oxybutin + tolterodine, it blocks muscarinic receptors and inhibits bladder contractions
What are some side effects in the treatment of OAB?
dry mouth, constipation, tachycardia, urinary hesitancy, urinary retention, possibly CNS effects (hallucinations)