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PNS
Anticholinergic agents
-Parasympatholytics,
cholinergic blockers, muscarinic antagonists
Pharmacologic effects
-CNS
-exocrine
glands
-respiratory
-GI smooth
muscle
-eye
-cardiovascular
Adverse
reactions
-blurred
vision
-confusion
-mydriasis
-constipation
-urinary
retention
-lower BP
-dry mouth
-inhibition of
sweating
Contraindications
-glaucoma
-intestinal
urinary obstruction
-prostrate
problems
-cardiovascular disease
Uses
-preoperative
medication – decrease secretions, block vagal slowing of heart that occurs
with general anesthesia.
-GI disorders
– increased motility (diarrhea), gastric ulcers
-Opthalmolgic
exams ~ myadriasis (opens pupils to see retina); cycloplegia
-Parkinson-like movements ~ reduce tremors & rigidity (minor use)
-motion
sickness and OTC sleep aids
-dentistry –
dry field before procedure (1 to 2 hr. prior to appt.)
Drug
interactions
-additive
anticholinergic effects – phenothiazines, antihistamines, tricyclic
antidepressants
-dry field (muscarinic
blockers) could interfere with patients using cholinergic agonists.
DRUGS
-Atropine
(dry field in dentistry)
-Glycoprrolate
-Scopolamine
-Methylatropine
-Dicyclomine (ulcers)
-methylscopolamine
-Cyclopentalate
-Propantheline
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Cholinergic Agents
-Parasympathomimetrics,
muscarinic agents
-direct
acting are choline derivatives; indirect acting inhibit AchE
Pharmacologic effects
-cardivascular
-gastrointestinal
-eye
-salivary
glands
-urinary
tract
-blood
vessels
Adverse reactions
-diarrhea
-diaphoresis
-miosis
-nasuea
-urinary
urgency
-broncho
Contraindications
-asthma
-GI
obstruction (mechanical)
-increase
motility
-peptic
ulcers
Uses
-Glaucoma
– direct acting; since reduces intraocular pressure
-Myasthenia gravis (muscle weakness)
-Urinary
retention
-Xerostomia
-Insecticides, chemical warfare – irreversible CE inhibitors muscarinic
agonists
DRUGS
**Direct
acting:
-Acetylcholine
-bethanechol
-pilocarpine
(glaucoma)
**Indirect acting
-Physostigmine
-Neostigmine
-malathion,
parathion – insecticides
-Sarin
MIMIC THE
EFFECTS OF THE PARASYMPATHETIC NERVOUS SYSTEM.
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