Anticholinergics inhibits parasympathetics, by blocking the neurotransmitter acetylcholine [specifically, its binding to its receptor in neurons]. Parasympathetics are responsible for involuntary movement of smooth muscle present in the GI, urinary tract, lungs, etc.
Patient information
What are anticholinergics?
It's drugs that inhibit the parasympathetics, which is the rest and digest response, by blocking acetylcholine. So rest and digest includes digestion, urination, and constriction of the breathing tubes.
Indications
GI disorders, including:
Gastritis
Diarrhea
Pylorospasm
Diverticulitis
UC
Nausea
Vomiting
Genitourinary disorders, including:
Cystitis
Urethritis
Prostatitis
Respiratory disorders, including:
Asthma
Chronic bronchitis
COPD
Sinus bradycardia, due to a hypersensitive vagus nerve
Insomnia, although usually only on a short term basis
Dizziness, including vertigo, and motion sickness-related Sx
Patient information
When do you want to give a drug to inhibit the rest and digest response?
If there's a GI problem, like diarrhea, diverticulitis, ulcerative colitis, vomiting. If there's a urinary problem, like inflammation of the bladder, urethra, or prostate. If there's a breathing problem, like asthma, or COPD.
Categories
Anticholinergics can be divided into their specific targets:
Antimuscarinics, which block activity of the muscarinic ACh receptor. These include:
Ipratropium [bromide] (Atrovent), which relieves bronchspasms. It is used to Tx COPD and acute asthma
Mebeverine
Orphenadrine
Oxitropium
Oxybutynin
Pirenzepine
Procyclidine
Scopolamine (Hyoscine)
Solifenacin
Tolterodine
Tiotropium [bromide](Spiriva), used to Mx COPD
Trihexyphenidyl +/- Benzhexol
Tropicamide
Antinicotincs, including:
Bupropion
Dextromethorphan
Doxacurium
Hexamethonium
Mecamylamine
Tubocurarine
[Post-]ganglionic blockers, by acting as a nicotinic antagonist
Neuromuscular blockers, which act presynaptically via inhibition of acetylcholine ACh, or postsnaptically at the ACh receptors of the motor nerve end-plate. This causes paralysis of the affected skeletal muscles
Patient information
What are the different types of drugs that inhibit the rest and digest response?
The biggies are the antimuscarinics and antinicotinics. As it's mentioned, it acts against the muscarinic and nicotinic receptors. They're both receptors that bind acetylcholine.
Side effects
Decreased mucus production in the nose and throat, causing dry, sore throat
Dry mouth w/ possible acceleration of dental caries
Pupil dilation, causing photophobia (sensitivity to bright light)
Tachycardia (increased HR)
Diminished bowel movement, sometimes ileus (decreased motility via the vagus nerve)
Urinary retention
Ataxia (poor coordination)
Dementia
Stopping of sweating, causing decreased epidermal thermal dissipation causing warm, blotchy, or red skin
Increased body temperature
Loss of accommodation, loss of focusing ability, blurred vision
Double vision
Tendency to be easily startled
Increased IOP (intraocular pressure), dangerous for Pt's w/ narrow-angle glaucoma
Patient information
What are the side effects of the drugs that inhibit the rest and digest response?
Because you're inhibiting the rest and digest response, you'd be worried about promoting things associated with the fight and flight response. So things like decreased mucus production, dry mouth, pupil dilation, increased heart rate, slower bowel movement, urinary retention.
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