AnticholinergicsBy: Angela

Tipton

How do you define Anticholinergic ( an-ti-koh-luh-

nur-jik):1. Of or pertaining to a substance that

opposes the effects of acetylcholine; interfering

with the passage of parasympathetic nerve

impulses. 2. A drug or agent that blocks these

nerve impulses, used to control intestinal spasm,

increase the heart rate, dilate the pupils for

examination of the eyes, dry secretions in

anesthesia, and in some forms to treat

Alzheimer’s disease.

Anticholinergics originated between the 1940’s

and the 1945’s.

Anticholinergics are

a type of

bronchodilators

they affect the

muscles around the

bronchi.

Anticholinergics

work by stopping

the muscles from

tightening.

There are different types of Anticholinergic’s there are short acting and long acting some of the short acting anticholinergics are: GENERIC NAME TRADE NAME

Ipratropium bromide AtroventOxitropium bromide Oxiven

These types tend to work within 15 minutes and last for about 6-8 hours. There is currently only one long lasting anticholinergic drug called: tiotropium (Spiriva) which takes about 20 minutes to work and will usually last for 24 hours.

Possible Side Effects of Anticholinergic’s

Some possible side effects that you many experience from using anticholinergic drugs can be: Dry mouth, Blurred Vision (if eyes come in contact with spray.), worsening glaucoma and dry cough. Men who have prostate problems may have more difficulty urinating.

Anticholinergics are associated with Beta-

agonists which affect the bronchioles. There are

also two types of beta-agonists which are short

acting and long acting. Some short acting beta-

agonists last for about 4-5 hours some examples

of these are :Airolin, Inspiryl, Salbulin, albuterol,

bambuterol, bambes, alupent, metaprel, prometa,

brethine, bitolerol just to name a few.

Long lasting beta-agonists last for about 12

hours. Some examples of these types are:

Foradil, Oxis, Serevent.

Foradil - is a long-acting bronchodilator that

relaxes muscles in the airways to improve

breathing. It is used to prevent bronchospasm

in people with reversible obstructive airways

disease, including symptoms of night-time

asthma.

Side effects of Beta-Agonists

Some side effects that you may

experience from using beta-agonists

drugs can be: a fast heart beat, shakiness

and cramping of hands, legs and feet.

Anticholinergic Drugs and Drugs with Anticholinergic side effects used in the Elderly

Anticholinergics

Antiemetics/antivertigo

Anti-Parkinson’s

Antispasmodics(GI)

Antispasmodics(URO)

Antimigraine

Bronchodilators

Preanesthetics

Mydriatcs

Drugs with anticholinergic side

effects

Antiarrythmics

Antidiarrheals

Antihistamines

Skeletal muscle relaxants

Antiulcer drugs

Antidepressants

Antipsychotics

Herbals

Anticholinergic drugs are used to treat a variety of

disorders like gastrointestinal cramps, Urinary

bladder spasms, motion sickness, muscular

spasms. It can also be used as an aid to

anesthesia.

Anticholinergic drugs help to balance out the

production of Dopamine and Acetylcholine. They

can cause drowsiness and are also well known for

causing acute cognitive impairment in individuals

with dementia.

Just some more definitionsCholinergic – an agent that stimulates sites where acetylcholine is the neurotransmitter. Anticholinergic – an agent which blocks sites where acetylcholine is the neurotransmitter. Adrenergic- Stimulates sites where norepinephrine or epinephrine is the neurotransmitter. Antiadrengeric- Blocks sites where norepinephrine or epinephrine is the neurotransmitter. Beta-agonists – mainly affect the muscles around the airways.

Autonomic Nervous SystemThere are two

divisions to the ANS

there is the

sympathetic division

and the

parasympathetic

division. There is also

autonomic

neurotransmitters.

Sympathetic DivisionA. Location of Preganglionic neurons: T1 - L2 in the lateral horns of the gray matter of the spinal cord.

B. Preganglionic neurons send fibers out the ventral root. They leave the spinal nerves through the white rami (myelin) and enter the sympathetic trunk.

C. Ganglionic neurons are located within the sympathetic chain ganglia or in collateral ganglia outside of the sympathetic trunk.

D. Postganglionic fibers leave the sympathetic trunk through the gray rami and pass through the spinal nerve again before terminating on the effector organ.

E. Preganglionic fibers are short and myelinated.

F. Postganglionic fibers are long and unmyelinated.

H. Preganglionic fibers may:

Continued….1. Synapse with one or more neurons in the sympathetic trunk directly across from them;

2. Ascend or descend in the trunk before synapsing;

3. Pass through the sympathetic trunk and synapse with a collateral ganglion outside the sympathetic trunk; or

4. Directly stimulate the release of epinephrine and norepinephrine from the adrenal medulla.

I. The sympathetic division is responsible for vasomotor (sympathetic) tone:

Parasympathetic DivisionA. Location of preganglionic neurons: Brain stem and S2, S3, and S4.

B. Preganglionic fibers travel through cranial nerves III, VII, IX, and X, and spinal nerves S2-S4, and synapse with peripheral ganglia located very near or directly on the effector organ.

C. Ganglionic neurons are located within peripheral ganglia.

D. Preganglionic fibers are long and myelinated.

E. Postganglionic fibers are short and not myelinated.

F. Parasympathetic fibers do not control the diameter of the systemic arterioles but ARE responsible for peristalsis.

Autonomic NeurotransmittersA. Cholinergic fibers - release ACh

All preganglionic fibers release ACh (both parasympathetic & sympathetic)

Parasympathetic postganglionic fibers also release ACh

B. Adrenergic fibers - release NE

Sympathetic postganglionic fibers release NE except those that innervate sweat glands and some blood vessels in the skin and skeletal muscles (which cause vasodilation rather than vasoconstriction)

C. Actions of Autonomic NT's

D. Receptors of Effectors

Continued….1. Types of Cholinergic Receptors (bind Ach):

2. Types of Adrenergic Receptors (bind NE):

a. Alpha

B. Beta

Beta-blockers for heart patients

Adrenergic Drugs

Adrenergic drugs -are drugs that stimulate the sympathetic

nervous system. They are used to increase the output of the

heart, to raise blood pressure, and to increase urine flow as

part of the treatment of shock. Adrenergic’s are also used as

heart stimulants. They may be given to a patient to reverse

the drop in blood pressure that is sometimes caused by

general anesthesia.