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Anti-Cholinergic Drugs download, in case of low pseudocholinestrase,…

- - - - Uses 💊👨‍🔬👩‍🔬
        
        Pre-anesthetic medication. salivary and bronchial secretions
        protects heart from (bradycardia) during anesthesia. :tired_face: 😷👨‍⚕️👩‍⚕️
        
        Antispasmodic. renal, intestinal and biliary colic. :recycle: ✅
        
        Antidote for anticholineesterases and organophosphorus poisoning⚖️ :!: :point_up::skin-tone-2:
        
        Atropine + Anti-cholinesterase treat competitive NMB toxicity 🤺⚔️🤼‍♂️🥊 :!!: :hand_with_index_and_middle_fingers_crossed::skin-tone-2:
        
        Passive mydriatic (7-14 days) :eyes:
      - Side effects :warning:
        
        Peripherally "FACT BUD-E"
        
        F: face flushing (hyperthermia)☺️😊
        
        C: constipation :confounded:🥴 🚽
        
        T: tachycardia :broken_heart: 🏃🏻‍♂️
        
        B: Blurred vision (mydriatic) :eyeglasses: 😳🥺
        
        U: urine retention 😬
        
        D: Dry mouth 👅🌞
        
        E: Elevated hyperthermia. :fire: 🥵
        
        A: acute eye pressure :eye: 😱😵
        
        Centrally
        
        Hallucination & delirium
        
        Cardiovascular collapse
        
        Death⚰️
      - Pharmacokinetics (ADME) :dart:
        
        A: well absorbed P.O
        
        M: 70% metabolite, 30% excreted unchanged
        
        D: 3ry amine, BBB
        
        E: lasts 4 hours P.O, but days if topically in eye
      - Contraindications :forbidden:
        
        Glucoma :eye: 😱
        
        Prostatic hypertrophy.
    - - Pharmacokinetics
        
        3ry amine
        
        Longer duration than atropine
      - Pharmacological actions
        
        More Potent than Atropine
        
        In anti-emetic activety
        
        in sedation (at small doses)
        
        On CNS
        
        Amnesia
        
        excitement (at
        high doses)
      - Uses
        
        treatment of motions sickness
        
        Pre-anesthetic medication
  - - - Ipratropium,
        tiotropium
        
        Bronchial
        asthma🫁❌
        
        COPD🫀‼️
        
        Inhaled🤥🙄
        
        4ry , not pass BBB
      - Pirenzepine
        
        Peptic Ulcer⭕️👉🏻
        
        Selective M1
        blocker,❌
      - Hyoscine-N-butylbromide
        Dicyclomine
        
        Intestinal colics😫😖
      - Tropicamide, homatropine, cyclopentolate
        
        fundus
        examination🔍👀
        
        mydriasis👁
        
        cycloplegia😳🥺
      - Darifenacin, solifenacin, fesoterodine, tolterodine, oxybutynin
        and trospium chloride
        
        Overactive urinary bladder disease😵🙈🚫
        
        low bladder capacity⬇️🚽
        
        frequent bladder contractions.🥴😷
      - Benztropine , trihexyphenidyl
        
        Adjuncts in Parkinson’s disease🧠‼️
- - - - Nicotine (large dose)
      - Produce initial stimulation followed by
        blocking
    - - Compete with Ach for Nn receptors on autonomic ganglia
      - Prevents depolarization
      - Mecamylamine
      - Trimethaphan
      - Hexamethonium
  - - - Decreased GIT motility
      - Constipation
      - Increased heart rate
      - Anhidrosis
      - Decreased all secretions
      - Urine retention
      - Passive mydriasis
    - - Decrease Peripheral resistance
      - Decrease Blood Pressure
      - Vasodilatation to blood vessels
- - - - suxamethonium (succinylcholine)
        
        last for (5-10) min⏱️
    - - blocking Nm receptors by
        
        Phase II
        
        Act as ANTAGONIST
        
        Sustained depolarization
        
        Phase I
        
        Act as AGONIST
        
        Initial depolarization
    - - Malignant hyperthermia 🤒
      - Apnea 😰
      - Postoperative myalgia 💪🏻
      - Hyperkalemia ⬆k+
  - - - d-tubocurarine, atracurim, mivacurium, pancuronium
    - - Hypotension
      - Tachycardia
      - Respiratory failure
      - Bronchoconstriction
    - - compete with Ach for Nm receptors
  - - - ⬇ Dose of GA
      - ⬇ Risk of anesthesia
    - - endotracheal intubation
      - laryngoscopy
      - bronchoscopy