Basic Pharmacology for Nursing Students PDF

Basic Pharmacology I For Nursing Students MSN 213 General Pharmacology Lecture 6 : ANS drugs - Parasympathetic drugs Dr. Dina Ibrahim Abo Youssef Lecturer of clinical pharmacology, October 6 University [email protected] ...

Basic Pharmacology I For Nursing Students MSN 213 General Pharmacology Lecture 6 : ANS drugs - Parasympathetic drugs Dr. Dina Ibrahim Abo Youssef Lecturer of clinical pharmacology, October 6 University [email protected]  CHOLINERGIC RECEPTORS ANTAGONISTS 1- Anti- Muscarinic: Atropine , Hyoscine (Scopolamine) 2-Anti- Nicotinic : as N- M blockers “1-Muscarinic Receptor Blocking Drugs” Atropine Uses : 1- Preanethetic medication a) ↓ vagal tone during operation b) ↓ inhibitory effect of morphine on RC c) ↓ salivary and bronchial secretions 2- Vagotonia (vagal tone): vasovagal attack, carotid sinus syndrome due to excess vagal tone  3- Treatment of physostigmine and Organophosphorus toxicity 4- Heart block (in B blockers, digitalis and myocardial infarction) 5- Antiparkinsonism 6- Bronchial asthma (not preferred due to viscid secretion difficult to expel 7- Intestinal colic, antiemetic, ant diarrhea and peptic ulcer 8- Renal colic 9- Nocturnal enuresis (Emepronium is more better) Toxicity (datura toxicity) A) Exaggerated parasympatholytic effects 1-CVS: tachycardia 2-EYE: mydriatics :blurred vision with ↑ IOP (may precipitate glaucoma) 3)-GIT: constipation 4-Urinary :urine retention especially in prostatic patients 5-Secretion: dry mouth and dry skin (atropine fever, atropine flush) B) CNS: Excitation, hallucination, convulsion followed by coma and respiratory depression. Treatment of atropine toxicity 1- Gastric lavage with tannic acid 2- O2 and artificial respiration 3- Cold fomentation → ice bags or alcohol 4- Sedatives as diazepam and paraldehyde  Hyoscine (Scopolamine) Uses of Hyoscine: 1- Preanethetic medication better than atropine because A) No tachycardia B) Strong Antisecretory C) More CNS depressant and amnesia D) Strong antiemetic and respiratory stimulant 2- Antiparkinsonism 3- Motion sickness (air sickness) prophylaxis 4- Mania as sedative Side effects and contraindications: as Neuromuscular blockers (skeletal muscle relaxant) A- Competitive neuromuscular blockers. 1- ( Tubocurarine)curare 2-Atracurium:drug of Choice in hepatic and renal patient 3- Dantrolene B- Non Competitive neuromuscular Blockers (depolarizing) succinylcholine. clinical uses : 1- During general anesthesia. 2- Spastic condition e.g. tetanus.  Treatment malignant hyperthermia halothane and succinylcholine in some patients produce severe hyperthermia and muscle rigidity which is treated by Dantrolene and cooling. Good Luck