1. muscarinic antagonist-Ipratropium Bromide
1.1. oral, inhalation
1.2. elimination through renal
1.3. half life 2 to 4 hours
2. muscarinic antagonist-scopolamine
2.1. elimination through renal
2.2. half life 4 and half hours
2.3. competitive surmountable (reversible) antagonism
3. injection of atropine
3.1. treat some poisonings
3.2. in surgery, lower secretion
3.3. treat muscle spasm of GI tract, gall bladder system, urinary system
3.4. use when heart is not beating
4. adverse effect
4.1. bladder pain, bloody/cloudy urine, cough producing mucus, difficult, burning and painful urination
4.2. difficulty in breathing, urge to urinate frequently, lower and side pain, shortness of breath, tightness in chest, wheezing
4.3. nausea, sweating, irregular hearbeat
5. muscarinic antagonist
5.1. common names : anticholinergics, antimuscarinic, cholinergic blockers, antipasmodics, parasympatholytics
5.2. atropine
5.2.1. naturally occuring
5.2.2. found in plant Artropa belladona and Datura stramonium
5.3. scopolamine
5.3.1. from plant Hyocyamus niger
6. muscarinic antagonist-Atropine
6.1. IV, Ocular
6.2. metabolism in liver
6.3. elimination through renal
6.4. half life - 3 hrs
6.5. competitive surmountable (reversible) antagonism
6.6. highy selective for muscarinic receptor
7. clinical indication
7.1. bronchiole smooth muscle relaxes
7.1.1. therapeutic indication for asthma and allergic rhinitis
7.2. smooth muscle relaxes
7.2.1. therapeutic indication for GI antipasmodic
7.3. bladder smooth muscle relaxes
7.3.1. therapeutic indication for overactive bladder
8. antimuscarini drugs in the treatment of bronchiol asthma
8.1. ipratropium bromide
8.2. tiotropium bromide
8.3. M3 receptor
8.3.1. bronchiole constriction
8.4. therapeutic use
8.4.1. block bronchiole constriction
8.4.2. allow bronchodilation
9. nicotinic antagonist
9.1. receptor at neuromuscular junction
9.1.1. stimulate skeletal muscle contraction
9.1.2. MOA : postsynaptic and excitatory
9.2. pancuronium bromide
9.2.1. non depolarizing
9.2.1.1. IV
9.2.1.2. metabolism in liver
9.2.1.3. half life - 1.5-2.7 hrs
9.2.2. used with general anaesthesia in surgery
9.2.2.1. for muscle relaxation
9.2.3. side effect
9.2.3.1. various degree of skeletal muscle weakness
9.3. suxamethonium chloride
9.3.1. depolarizing
9.3.1.1. IV, IM
9.3.1.2. Metabolism by psseudocholinestrase to succinylmonocholine and choline
9.3.1.3. elimination through renal
9.3.2. MOA
9.3.2.1. bind to post-synaptic nicotinic receptor
9.3.2.2. then activate by opening ion channels
9.3.2.3. cause depolarization and contraction
9.3.3. uses
9.3.3.1. short surgical procedures
9.3.3.2. bronchoscopy, laryngeoscopy
9.3.4. side effect
9.3.4.1. various degree of skeletal muscle weakness