Cholinergic Antagonists and Their Types

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Questions and Answers

What is the duration of the action of atropine as a mydriatic and cycloplegic?

  • 5-7 days
  • 10-14 days
  • 7-10 days (correct)
  • 3-5 days

Why is atropine used as preanaesthetic medication?

  • To decrease the effect of general anaesthetics
  • To prevent nausea and vomiting
  • To prevent vagal bradycardia during anaesthesia (correct)
  • To increase respiratory secretions

What is atropine used to treat due to increased vagal activity?

  • Sinus bradycardia and partial heart block (correct)
  • Hypertension
  • Tachycardia
  • Hypotension

What is a side effect of atropine?

<p>Decreased secretions (A)</p> Signup and view all the answers

What is ipratropium used for?

<p>To decrease bronchoconstriction and bronchial secretions in COPD and asthma (B)</p> Signup and view all the answers

What is the general term for agents that bind to cholinoceptors and prevent the effects of acetylcholine?

<p>Cholinergic antagonist (D)</p> Signup and view all the answers

Which type of cholinergic antagonist drug does not block nicotinic receptors?

<p>Antimuscarinic agents (C)</p> Signup and view all the answers

What is the effect of low doses of atropine on heart rate?

<p>A slight decrease in heart rate (B)</p> Signup and view all the answers

What is the effect of atropine on body secretions?

<p>A decrease in saliva, bronchial secretions, and sweat (B)</p> Signup and view all the answers

What is the duration of atropine's general actions?

<p>About 4 hours (C)</p> Signup and view all the answers

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Study Notes

Cholinergic Antagonists

  • Cholinergic antagonists bind to cholinoceptors and prevent the effects of acetylcholine (ACh) and other cholinergic agonists.
  • There are three types of cholinergic antagonist drugs: antimuscarinic agents, ganglionic blockers, and neuromuscular-blocking agents.

Antimuscarinic Agents

  • Antimuscarinic agents block muscarinic receptors, causing inhibition of muscarinic functions.
  • They do not block nicotinic receptors, and therefore have little or no action at skeletal neuromuscular junctions (NMJs).

Atropine (Antimuscarinic Agent)

  • Atropine is an alkaloid with a high affinity for muscarinic receptors.
  • It binds competitively and prevents ACh from binding to muscarinic receptors.
  • Atropine acts both centrally and peripherally, with general actions lasting about 4 hours.
  • Effects of atropine:
    • CNS: confusion, delirium
    • GI: decrease motility and acid secretions (without interfering with hydrochloric secretion)
    • Heart rate: increase at high doses, decrease at low doses
    • Body secretions: decrease saliva, bronchial secretions, and sweat (leading to elevated body temperature)
    • Eye: mydriasis (cycloplegic), allowing for measurement of refractive errors without interference by the accommodative capacity of the eye

Therapeutic Uses of Atropine

  • As a mydriatic and cycloplegic: used topically for producing mydriasis and cycloplegia, lasting 7-10 days
  • As a preanaesthetic medication:
    • Preventing vagal bradycardia during anaesthesia
    • Preventing laryngospasm by decreasing respiratory secretions
    • Acting as an antisecretory agent to block secretions in the upper and lower respiratory tracts before surgery
  • As an antispasmodic: useful in dysmenorrhoea, intestinal and renal colic
  • In poisoning:
    • Life-saving drug in organophosphorous poisoning
    • Drug of choice in some types of mushroom poisoning
    • Used in curare poisoning with neostigmine to counteract the muscarinic effects of neostigmine
  • As a vagolytic: used to treat sinus bradycardia and partial heart block due to increased vagal activity

Side Effects of Atropine

  • Blurred vision
  • Decreased secretions
  • Hyperthermia
  • Constipation
  • Urinary retention
  • Delirium
  • Hallucinations

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