clinical pharm #1

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  1. bethanecol (urecholine) 
    • muscarinic agonist 
    • stimulates detrusor muscle of bladder to contract, and relaxation of bladder sphincter.
    • stimulates urination after abd surgery
  2. Cholinesterase Inhibitors
    • increases ACh activity by blocking inactivation of ACh (insecticides and nerve gas)
    • If ACh is continually stimulated it can cause profuse salivation, pooping, peeing, bronchoconstriction 
    • ACh is the transmitter at the neuromuscular junction and if continually stimulated can cause respiratory paralysis, can be fatal
  3. Atrophine
    • cholinergic (muscarinic) antagonists
    • Pre-op to decrease GI motility and secretion
    • increases heart rate treats bradycardia
    • antidote for poisoning ( insectic, ner gas, shrooms)  that inhibit acetylcholinesterase.
    • it was used by ophthmologists to causemydriasis (dial pupils) low half life had to replace
    • tropicamide (mydriacyl) 3-4 hour half life causes pupil to dialate also acts as a anticholinergic
    • Bella donna plant enlarges pupils
  4. Ipratropium bromide (atrovent)
    • cholinergic (muscarinic) antagonist
    • anticholinergic drug used by inhaler treats emphysema and chronic bronchitis
    • starts working in 15 min lasts 3-4 hours
    • usually used with albuterol it reduces symptoms, does not slow progress of disease
  5. what are the 5 cholinergic (muscarinic) antagonists?
    • atropine
    • ipratropium bromide (atrovent)
    • tiotropium bromide (spiriva)
    • oxybutynin (ditropan and ditropan XL)
    • tolterodine (detrol detrol LA)
  6. Tiotropium bromide (spiriva)
    • cholinergic (muscarinic) antagonists
    • new anticholinergic
    • dry powder inhaler 
    • onset 15 min lasts 5-6 days
    • major advantage over ipratropium it has a longer half life
    • major disadvantage it is under patent and $$$
  7. Oxybutynin (ditropan and ditropan XL)
    • cholinergic (muscarinic) antagonist
    • antispasmodic 
    • treats nocturia,incontinence,and frequent peei
    • given bid or tid
    • available as ditropan XL, taken qd, and as a biweekly patch
  8. tolterodine (detrol and detrol LA)
    • cholinergic (muscarinic) antagonists
    • new bladder antispasmodic to compete with ditropan
    • given qd and as biweekly patch 
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clinical pharm #1
2013-01-18 01:41:29
clinical pharm

begginingof the drugs
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