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Anticholinergic Drugs

by Pravin Shukle, MD
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    Let's move on to anticholinergics. Cholinergic receptor antagonists can be anti-nicotinic, and these are ganglion blockers like hexamethonium, neuromuscular junction blockers like curare or tubocurarine, and brain anti-nicotinic drugs like varenicline. Let's talk about the ganglionic neurons. Remember I was telling you that gangs go out and smoke, so ganglionic neurons are nicotinic. So these drugs do act at the ganglia. These were the first of the antihypertensive drugs ever developed. These drugs are 60, 70, 80 years old. Hexamethonium is that prototypical agent. There are others like mecamylamine, not used anymore, and trimethaphan, which has some of the derivatives being used in clinical practice today, but trimethaphan itself isn't being used. You don't need to know the last two, but definitely know hexamethonium. What about toxins causing paralysis? I mentioned briefly before about curare, it was found in the deep jungle in the Amazon rain forest, and it was being used as a paralytic on the ends of arrows by some native tribesmen. So that's how we came to know about curare. We also use drugs that are anti-nicotinic that work in the brain. Varenicycline is a partial agonist of nicotine, and it's very effective in reducing the dependency upon cigarette. It works about 60 to 70 % of the time when used correctly. Let's move on to the smooth muscle and neuromuscular neurons. Now, the smooth muscles neuromuscular neurons are muscarinic. The other types of end organs are sweat glands, which are also muscarinic. How do I remember that? Musky smell means sweat and muscles. So that's how I tend to remember that smooth muscle and neuromuscular neurons are muscarinic. What are these antagonists? Anti-muscarinic antagonists, the nonselective one is atropine, I already told you that it is used as an antidote in sarin gas exposure. It's also...

    About the Lecture

    The lecture Anticholinergic Drugs by Pravin Shukle, MD is from the course ANS - Pharmacology.


    Included Quiz Questions

    1. nicotinic cholinergic.
    2. muscarinic cholinergic.
    3. nicotinic adrenergic.
    4. muscarinic adrenergic.
    1. nicotinic muscarinic antagonist.
    2. nicotinic cholinergic antagonist.
    3. nicotinic muscarinic agonist.
    4. nicotinic cholinergic agonist.
    1. probably a nicotinic cholinergic blocker.
    2. probably a muscarinic cholinergic blocker
    3. probably an adrenergic blocker.
    4. probably a calcium channel blocker.
    1. muscarinic cholinergic blocker
    2. nicotinic cholinergic blocker.
    3. adrenergic blocker.
    4. calcium channel blocker.
    1. has developed an acute dystonia due to a drug reaction. The antidote is benztropine, a central anticholingergic agent.
    2. has developed an acute dystonia due to a drug reaction. The antidote is bisoprolol, a central anticholingergic agent.
    3. has developed an acute dystonia due to a drug reaction. The antidote is biguanide, a central anticholingergic agent.
    4. has developed an acute dystonia due to a drug reaction. The antidote is betamethasone, a central anticholingergic agent.
    1. increased erectile function in patients with erectile dysfunction.
    2. decreased airway secretions
    3. pulseless electrical activity in codes.
    4. pupillary mydriasis.
    1. anticholinergic toxicity; he was probably exposed to toxic levels of a chemical on the farm. The antidote is physostygmine.
    2. anticholinergic toxicity; he was probably exposed to toxic levels of a chemical on the farm. The antidote is benztropine.
    3. adrenergic toxicity; he was probably exposed to toxic levels of a chemical on the farm. The antidote is benztropine.
    4. neurotoxicity; he was probably exposed to toxic levels of a chemical on the farm. The antidote is bisoprolol.

    Author of lecture Anticholinergic Drugs

     Pravin Shukle, MD

    Pravin Shukle, MD


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