Cholinergic Antagonists

What is the overall MOA of cholinergic antagonists

Block acetylcholine at muscarinic or nicotinic receptors to reduce cholinergic signaling = decrease ACh levels

What is the MOA of atropine

Antagonist at muscarinic receptors in the heart → blocks parasympathetic effects

What is the primary indication of atropine

Bradycardia

What are the side effects of atropine?

Anticholinergic side effects (dry mouth, constipation, urinary retention, rapid heart rate, decrease secretions, decrease GI motility)

What is the MOA of hycosamine

Muscarinic antagonist at muscarinic receptors stomach & lungs

What’s the primary indication of hycosamine

1. Reduces bronchial & pharyngeal secretions

2. Reduces hydrochloride acid production to treat peptic ulcer disease

What are the side effects of hycosamine

Anticholinergic side effects (dry mouth, constipation, urinary retention, rapid heart rate, decrease mucus/ bronchial/ intestinal secretions, decrease GI motility, decrease sweating)

What is the MOA of scopolamine

Muscarinic antagonist at muscarinic receptors at bronchials & salivary glands

What are the primary indications of cholinergic antagonists?

They are all cholinergic = parasympathetic effects treated by cholinergic antagnists

What’s the primary indication for hycosamine

Drooling (treats excessive salivary gland secretion)

What are the side effects of scopolamine?

Anticholinergic side effects (dry mouth, constipation, urinary retention, rapid heart rate, decrease mucus/ bronchial/ intestinal secretions, decrease GI motility, decrease sweating)

• given as a patch formulation

What is the MOA of glycopyrrolate

Muscarinic antagonist at muscarinic receptors in salivary glands 

What is the primary indication of glycopyrrolate

Drooling (treats excessive salivary gland secretion)

What are the side effects of glycopyrrolate?

Anticholinergic side effects (dry mouth, constipation, urinary retention, rapid heart rate, decrease mucus/ bronchial/ intestinal secretions, decrease GI motility, decrease sweating

What’s the MOA of ipratropium

Muscarinic antagonist at muscarinic receptors in lungs

What is the primary indication for ipratropium

Asthama/COPD to treat wheezing

What are the side effects for ipratropium

Anticholinergic side effects (dry mouth, constipation, urinary retention, rapid heart rate, decrease mucus/ bronchial/ intestinal secretions, decrease GI motility, decrease sweating

What is the MOA of oxybutynin?

Muscarinic antagonist at muscarinic receptors in the bladder

What is the primary indication of oxybutynin?

Urinary incontinence/overreactive bladder

What’s the side effects of oxybutynin

Anticholinergic side effects (dry mouth, constipation, urinary retention, rapid heart rate, decrease mucus/ bronchial/ intestinal secretions, decrease GI motility, decrease sweating

What’s the MOA Pancuronium & cisatracurium

Non-depolarizing neuromuscular blocker (competitive antagonist at nicotinic receptors) —> no depolarization —> no muscle contraction

What’s the primary indication of pancuronium & cisatracurium

Skeletal muscle relaxes during surgery or mechanical ventilation

What is the notable aspect for pancuronium & cisatracurium

Effects can be reversed by acetylcholinesterase inhibitors 

What is the MOA of succinylcholine

Depolarizing neuromuscular blocker at nicotinic receptors working as an agonist to produce persistent depolarization —> paralysis from overworking the muscle

What’s the primary indication of succinylcholine

Skeletal muscle relaxation during surgery or mechanical ventilation

What’s the notable aspect of succinylcholine

Effects cannot be reversed by acetylcholinesterase inhibitors