cholinergic. blocking drugs

muscarinic receptors

stimulate smooth muscles

nicotinic receptors

stimulate skeletal muscle

cholinergic blocking drugs

actions: block muscarinic receptors in various locations throughout the body:

systemic: blocks ACH activation of muscarinic receptors throughout the body

urinary: prevents muscle contraction of the bladder, decreased the reflex to urinate

inhaled: blocks ACH in bronchial smooth muscle;e, reduces constriction and secretions

GI: blocks ACH impulses traveling from inner ear to vomiting center of brain

atropine

uses: cholinergic crisis, organophosphate (insecticide) poisioning, bradycardia, cardia arrest

complications: anticholinergic effects, tachycardia 

contraindications: glaucoma, urinary retention, MG

interactions: other drugs with anticholinergic effects

n/c: large doses require for cholinergic crisis, insecticide poisioning

must monitor BP, HR, mental status

oxybutynin

uses: overactive bladder

complications: anticholinergic effects

contrsindications: glaucome, urinary retention, MG

interactions: other drugs with anticholinergic effects

n/c: ER tablets available for extended release- do not crush, chew

monitor for effectiveness of drug

decreased urinary urgency

take steps to prevent/ address anticholinergic effects

ipatropium

uses: bronchospasm cause by copd

adr: dry mouth, blurred vision, urinary retention, bronchospasm (anticholinergic effects)

contraindications: acute asthma attack, glaucome, pt allergic to peanuts/ soy (when this drug is combines with albuterol)

n/c: educate this drug cannot be used alone for an asthma attack! just be combined with a SABA

wait 5 minutes before using inhaled corticosteroid

tiotropium

uses: bronchospams, long term asthma control

adr: increased stroke risk, dry mouth, anticholinergic effects

contraindtications:acute asthma attack, glaucome

n/c: this drug does not treat an asthma attack- it is for long term control only

do not swallow capsules (drug will not work)

scopolamine

uses: prevent, treat n/v, motion sickness

adr: anticholinergic effects, mydriasis

contraindications: glaucoma, bladder or bowel obstruction

n/c: motion sickness: transdermal patch placed behind the ear 3 hrs BEFORE travel. oral tablet 1 hr before travel