Anti Muscarinic Drugs

Anti muscarinic drugs

Mrs.B.Kiran, Asst. Professor Department of Pharmacology Also called as

Atropinics or anti cholinergics or parasympatholytic drugs Definition

• Blocks actions of ACh on autonomic effectors and CNS mediated through M receptors Classification

• Natural- Atropine, Hyoscine • Semisynthetic- Homatropine, Ipratropium bromide, Tiotropium bromide • Synthetic- • Mydriatics- Cyclopentolate,Tropicamide • Antipeptic ulcer(Anti secretory)- Pirenzepine, Telenzepine • Anti spasmodic- Dicyclomine, Valethamate • In urinary incontinence (Vasicoselective)- Oxybutynin, Flavoxate, Tolterodine • Antiparkinsonian- Benzhexol, Benztropine, Procyclidine,Biperidin Atropine- Prototype

Pharmacological actions • CNS

Receptor???

•Stimulation As mad as hen Anti Motion sickness Effect •

• M1 blockade Anti parkinsonian effect

• Cholinergic •Reduces overactivity in cholinergic Parkinson’s overactivity disease CVS • Low dose- Bradycardia????

• Therapeutic doses- Tachycardia???? •Improves AV conduction

• High Dose- “Atropine Flush” As red as BEET ????? EYE • Receptor??? • Before After • Passive Mydriasis??? • Cycloplegia • Loss of Light reflex • Blurring of vision •Photophobia • Dryness of eye As blind as bat Smooth muscle • Receptor??????? •GIT-?? • Bronchi-?? • Urinary Tract?? GIT GIT • Motility ↓ •Secretions ↓ • Sphicters - constricted • Constipation • Smooth muscles- relaxed Bronchi • Bronchodilatation • Interferes with mucociliary clearance Glands • Receptor???? •

• Dryness of all secretions Dry mouth Dry skin As dry as bone Body temparature

• Increases ??? As hot as hare Adverse effects As mad as hen As red as BEET ????? As blind as bat As dry as bone As hot as hare Atropine poisoning( Belladonna poisoning) • Management •Physostigmine 1-3 mg IV Contra indications

• Elderly men with BPH • Narrow irido corneal angle Therapeutic Uses • CNS USE- Parkinson’s disease

Effective

Effective Drugs useful •Benztropine • Benzhexol • Biperidin • Procyclidine Anti motion sickness Drugs useful • Dicyclomine- Oral, IM • Hyoscine ( Scopolamine)- Oral, IM, Transdermal

“PROPHYLACTICALLY” Ophthalmic Use • Refractive errors- Mydriasis,cycloplegia both

Drugs used • Atropine- 7 days •Homatropine-3 days • Cyclopentolate- 24 hrs. • Tropicamide- 3-6 hrs. (QUICK n BRIEF) Preanaesthetic medication • Reason???? • Atropine, Hyoscine, Glycopyrrolate Respiratory Use • • • COPD •& • Asthma Drugs used

• Ipratropium bromide • Tiotropium bromide CVS USE

• Sinus bradycardia GI USE

• Peptic ulcer-M1 selective blockers • Drugs used- • Pirenzepine ,telenzepine GI Use • Intestinal colic, Abdominal cramps- Dicyclomine, Clidinium…………

• Non infective , nervous, drug induced diarrhoea-Atropine Urinary incontinence • Drugs used- •Tolterodine •Flavoxate • Oxybutynine Uterine use

• Dysmenorrhoea- Dicyclomine OP POISONING •Atropine 2 mg IV Curare poisoning

• Atropine with neostigmine Drotaverine

•Novel drug • Non anticholinergic • Anti spasmodic M.O.A: Use: Advantage: Side effects: R.O.A: