ANTICHOLINERGIC GROUP 7 Pharm

ANTICHOLINERGICS
GROUP 4
NAME OF GROUP MEMBE
RS
Kareem Abisola
Agboola Ayomide
Adeniyi Philip
Oyedotun Feranmi
Fawole Oyinlola
Adeoti Chrisianah
OLANGUNJU Omobolanle
Adesoye Opeyemi
Onyinye Obidiaso
Orei Elewechi
ANTICHOLINERGICS
Anticholinergics are drugs that are used to block the
effects of acetylcholine. Because this action lyses or
blocks the effect of the parasympathetic nervous
system, they are also called Parasympatholytic
agents.
Anticholinergics agents include;
• Atropine
• Cyclizine (Merazine)
• Dicyclomine (Generic)
• Flavoxate (Urispas)
ANTICHOLINERGIC AGENTS CONTD.
Glycopyrrolate ( Robinul)
Hyosoyamine (Symax and others)
Ipratripium (Atrovent)
Meclizine (Bonine, Antivert)
Methscopolamine (pamine)
Propantheline (Generic)
Scopolamine (Transderm Scop)
Tiotropium (Spiriva)
Trospium (Sanctura)
GENERAL INDICATIONS FOR ANTICHOLINERGIC
S
• They are used to decrease secretions before anaesth
esia
• To treat parkinsonism
• To restore cardiac rate and blood pressure after vag
al stimulation during surgery
• To relieve bradycardia caused by a hyperactive bow
el
• To prevent the signs and symptoms of motion sick
ness and vomiting
• To relax biliary and ureteral colic
• To relax uterine hypertonicity
INDICATION CONTD.
 To relax bladder detrusor muscles and tighten sp
hincters
To help controlling crying or laughing episodes in
patients with brain injuries
To help in the management of peptic ulcer
To control rhinorrhea associated with hay fever
It is used as an antidote for cholinergic drugs and
for poisoning by certain mushrooms
As an ophthalmic agent to cause mydriasis or cycl
opegia in acute inflammatory conditions.
THERAPEUTIC ACTION OF ANTICHOLINERG
IC DRUGS
The anticholinergic drug competitively block the ac
etylcholine receptors at the muscarinic cholinergic r
eceptor sites that are responsible for mediating the e
ffects of the parasympathetic post ganglionic impuls
es. Some are more specific to particular receptors in
the respiratory, genitourinary or gastrointestinal tra
cts, making them preferred for treating specific con
ditions and others more generally depress the paras
ympathetic system.
 When the parasympathetic system is blocked, the
effect of the sympathetic are more prominent.
ATROPINE
GENERIC NAME: Atropine
GROUP: Anticholinergic
INDICATION: It decreases secretions, bradycar
dia, pylorospasm, ureteral colic, relaxing of bladd
er, to treat emotional liability with head injuries,
used as an antidote for cholinergic drugs, pupil dil
ation.
 MECHANISM OF ACTION: They block only the musc
arinic effectors in the parasympathetic nervous system a
nd the few cholinergic receptors in the sympathetic nerv
ous system. They do this by competing with acetylcholin
e for the muscarinic acetylcholine receptor sites.
ATROPINE CONTD.
ADVERSE EFFECTS: Dry mouth, mydriasis, pho

tophobia, cyclopegia, altered taste perception, tac
hycardia, palpitations, urinary hesitancy, retentio
n, predisposition to heat prostration.
DOSAGE: Adult: 0.4 -0.6mg, Pediatric: 0.1-0.4m
g.
 ROUTE OF ADMINISTRATION: Intramuscula
r, Subcutaneous, Intravenous.
CYCLIZINE
GENERIC NAME: Cyclizine
BRAND NAME: Marezine
GROUP: Anticholinergic
INDICATION: Prevention and treatment of naus
ea, vomiting, dizziness associated with motion sick
ness.
MODE OF ACTION: It reduces the sensitivity of th
e labyrinthine apparatus and partially block the ch
olinergic receptors in the chemoreceptor trigger zo
ne helping to decrease the effects of motion sicknes
s.
CYCLIZINE CONTD.
ADVERSE EFFECTS: Insomnia,mental confusion, e
xcitement, decreased sweating, blurred vision, dry
mouth.
DOSAGE: 50mg, thirty minutes before exposure to
motion, may repeat every 4-6 hours. Pediatr
ic: 25mg tds.
ROUTE OF ADMINISTRATION: Oral.
CONTRAINDICATIONS: Overactive thyroid gland,
increased pressure in the eye, closed angle glaucoma
, high blood pressure, stenosing peptic ulcer, blocka
ge of the urinary bladder, enlarged prostate, urine re
tention, chronic idiopathic constipation
FLAVOXATE
BRAND NAME: Urispas

GENERIC NAME: Flavoxate
GROUP: Anticholinergic, antispasmodic
INDICATION: For symptomatic relief of dysuria, urgen
cy, nocturia, suprapubic pain, frequency and incontinen
ce associated with cystitis, prostatis, urethritis, urethroc
ystitis, urethrogonitis.
MECHANISM OF ACTION: They relieve spasm of the
smooth muscle of the urinary tract by blocking parasym
pathetic activity, thus suppressing overactivity which lea
ds to relaxation of the detrusor and other urinary tract.
FLAVOXATE CONTD.
ADVERSE EFFECTS: Nausea, vomiting, dry mouth,
nervousness, tachycardia, blurred vision,dizziness, c
onfusion, urinary hesitancy and retention.
DOSAGE: 100- 200mg three to four times daily
ROUTE OF ADMINISTRATION: Oral.
CONTRAINDICATIONS: Known hypersensitivity t
o drug, pyloric or duodenal obstruction or recent su
rgery, obstructive urinary tract problems, glaucoma,
myasthenia gravis or acute hemorrhage, renal or hep
atic dysfunction, in pregnant and lactating patients.
IPRATROPIUM
BRAND NAME: Atrovent
GENERIC NAME: Ipratropium
GROUP: Anticholinergic, bronchodilator
INDICATION: For maintenance treatment of bro
nchospasm associated with chronic obstructive pu
lmonary disease (COPD). I
t is also used in Nasal spray for symptomatic relief
of perennial and seasonal rhinitis.
IPRATROPIUM CONTD.
MECHANISM OF ACTION: They are used as bron
chodilators because of their effect on the vagus nerv
e which is to block the action of the neurotransmitt
er acetylcholine at vagal- mediated receptor sites. N
ormally vagal stimulation results in a stimulating e
ffect on smooth muscle causing contraction. By blo
cking the vagal affection, relaxation of smooth mus
cle in the bronchii occurs, leading to bronchodilati
on.
DOSAGE: 500mcg tid to qid by inhalation; 2 inhal
ations by aerosol ( Do not exceed 12 inhalations per
day)
IPRATROPIUM CONTD.
ROUTE OF ADMINISTRATION: Inhalation
ADVERSE EFFECTS: Dizziness, headache, fatig
ue, nervousness, dry mouth, sore throat, palpitat
ion and urinary retention.
CONTRAINDICATIONS: Narrow-angle glauco
ma ( drainage of the vitreous humor can be block
ed by smooth muscle relaxation), bladder neck o
bstruction or prostatic hypertrophy, presence of
known allergy to the drug or to soy products, cau
tion should be used in pregnancy and lactation.
HYOSCYAMINE
BRAND NAME: Synax, Anaspaz, Levsin, Levbid
GENERIC NAME: Hyocyamine
GROUP: Anticholinergic,
INDICATIONS: Hyoscyamine is used to provide sympt
omatic relief of spasms caused by various lower abdomina
l and bladder disorders including peptic ulcers , irritable b
owel syndrome , diverticulitis , pancreatitis , colic , and int
erstitial cystitis . It has also been used to relieve some hear
t problems, control some of the symptoms of Parkinson's
disease , as well as for control of abnormal respiratory sym
ptoms and "hyper-mucus secretions" in patients with lung
disease.
HYOSCYAMINE CONTD.
MECHANISM OF ACTION: It blocks the action o
f acetylcholine at parasympathetic sites in sweat gl
ands, salivary glands, stomach secretions, heart mu
scle, sinoatrial node , smooth muscle in the gastroi
ntestinal tract , and the central nervous system .
ADVERSE EFFECTS: dry mouth and throat, incre
ased appetite leading to weight gain, eye pain, blur
red vision, restlessness, dizziness, arrhythmia , flus
hing, and faintness.
DOSAGE: 0.125-0.25mg tid to qid per oral or subli
ngually. 0.
25-0.5mg bid to qid for IM, IV or Subcutaneous
HYOSCYAMINE CONTD.
ROUTE OF ADMINISTRATION: Oral, sublingu
al, Intramuscular, Intravenous and Subcutaneous.
CONTRAINDICATIONS: Hypersensitivity, Clos
ed-angle glaucoma, Myasthenia gravis, Hemorrha
ge with cardiovascular instability, Paralytic ileus, I
ntestinal atony of elderly/debilitated patient, Obs
tructive uropathy, Toxic megacolon, GI obstructio
n, Tachycardia secondary to cardiac insufficiency
or thyrotoxicosis, Breastfeeding.
NURSING RESPONSIBILITIES
Assess for any known allergies to these drugs to a
void hypersensitivity reactions.
Assess neurological status including level of orie
ntation, affect, reflexes and papillary response to
evaluate any CNS effects.
Monitor vital signs before and after administrati
on of drugs.
NURSING RESPONSIBILITIES CONT..
Ensure proper administration of the drug to ensur
e effective use and decrease the risk of adverse effe
cts.
Provide thorough patient teaching about drug na
me, dosage and schedule for administration.

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ANTICHOLINERGICS

ADVERSE EFFECTS: Dry mouth, mydriasis, pho

BRAND NAME: Urispas

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