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Drug
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Actions
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Therapeutic Uses
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Pharmacokinetics
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Adverse Effects
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Other
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Atropine (antimuscarinic)
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-bind competitively to muscarinic receptors, blocking the binding of
Ach
-eye: persistent mydriasis, unresponsiveness to light, cycloplegia
-blockage of M1 receptors on presynaptic neurons results in bradycardia (low dose)
-higher doses block M2 receptors on SA node, causing modest increase in cardiac rate
-blocks the salivary glands, causing xerostomia
-affects sweat and lacrimal glands
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-GIT: antispasmodic to reduce activity of GIT -used to reduce hypermotility states of bladder
-used for measurement of refractive errors without interference by the accommodative capacity of eye
-Antidote for
cholinesterase inhibitor insecticides and mushroom poisoning
-Used as an antisecretory agent prior to surgery
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-general actions last about 4 hours
-topical application in eye can last for days -Half-life for 4 hours -Readily absorbed, partially metabolized by
the liver
-Eliminated in urine
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-Results in mydriasis for
7-14 days
-Dry mouth
-Blurred vision
-“Sandy eyes”
-Tachycardia
-Constipation
-Restlessness
-Confusion
-Hallucinations
-Delirium
-Depression, collapse of circulatory and resp. system and death
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-tertiary amine belladonna
alkaloid
-ability to enter CNS -atropine toxicity may be
overcome with PHYSOSTIGMINE
-Toxic levels cause dilation of cutaneous vasculature -May induce acute attack of eye pain in narrow-angle glaucoma patients
-In children it may induce rapid increase in body temp.
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Scopolamine (antimuscarinic)
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-blocks short-term memory -produces sedation, but at higher doses it produces excitation -may produce euphoria
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-Most effective anti-motion sickness drug
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-Readily absorbed, partially metabolized by
the liver
-Eliminated in urine
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-similar to those of
ATROPINE
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-tertiary amine belladonna alkaloid
-peripheral effects similar to ATROPINE, but greater CNS effects
-longer duration of action than
ATROPINE
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Ipratropium (antimuscarinic)
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-doesn’t enter CNS or systemic
circulation, isolating its effects to
pulmonary system
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-Useful in treating asthma in patients who can’t take adrenergic agonists
-Management of COPD
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-Quaternary derivative of
ATROPINE
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Tropicamide
Cyclopentolate
(antimuscarinic)
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-opthalmic solutions for mydriasis and cyclyplegia
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-Tropicamide: 6 hours -Cyclopentolate: 24 hours
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Nicotine (ganglionic
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-nondepolarizing, competitive antagonist
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-nicotine patches are effective in reducing the
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-deleterious to health
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-component of cigarette smoke
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