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Atropine
- Antimuscarinic Drug
- Alkaloid of belladona plant
- Competitive antagonist of all muscarinic receptors
- Effects: Decreased parasympathetic tone effects, CNS drowsiness, CNS hallucinations, decreased sweating
- Acute Myocardial Infarction/Cardiopulmonary Resuscitation: reverses sustained bradycardia, reduces ventricular arrythmias, treats nausea induced by morphine (morphine being used to treat for pain)
- Pesticide Overdose: counteracts the effect of increased ACh at muscarinic receptors
- Preoperative: counteracts general anesthetic-induced bradycardia, salivation, and increased bronchial secreations
- Eye Exams: produces mydriasis (pupil dilation) and cycloplegia (inability to accommodate)
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Scopolamine
- Antimuscarinic Drug
- Alkaloid of belladona plant
- Competitive antagonist of all muscarinic receptors
- More fatigue and drowsiness than atropine (because it crosses blood-brain barrier easier), more mydriasis and cycloplegia (blurred vision) than atropine, less heart effects than atropine
- Motion Sickness: decreases salivary secretions and GI motility, decreases nausea in CNS.
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Ipratropium and Tiotropium
- Antimuscarinic Drug
- Competitive antagonist of all muscarinic receptors
- Inhaler (low systemic side effects)
- Asthma: topical bronchodilator with a dry mouth side effect
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Benztropine
- Antimuscarinic Drug
- Competitive antagonist of all muscarinic receptors
- Parkison's Disease: Parkinson's is caused by a decrease of dopamine in the brain. This drug decreases ACh which results in an increase of dopamine. Also reduces drooling with this disorder.
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Pirenzapine
- M1 selective antagonist
- Not available anymore
- Peptic Ulcer Disease: Decreases gastric acid secretion. Lower incidence of dry mouth and tachycardia side effects.
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Oxybutnin
- M1 and M3 selective antagonist
- Urinary Incontinence (frequent urination/urge to urinate): decreases frequency of bladder muscle contractions, decreases desire to void. High incidence of dry mouth, drowsiness, constipation and blurred vision.
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Tolterodine
- Not muscarinic selective
- Urinary Incontinence: this drug is more selective for the bladder over the salivary gland. Lower incidence of dry mouth than oxybutnin but it's less effective for incontinence.
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Solifenacin
- M3 receptor antagonist
- Urinary Incontinence: Less dry mouth than oxybutnin.
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