Anticholinergics are a broad class of medications that are involved in many disease and condition states.
There are two broad classifications
1.) Antimuscarinic
2.) Antinicotinic
Antimuscaranic medications or method of action affects the “muscarinic acetylcholine receptors”
- there is a reduction of action on these receptors
Medications/Agents
Antimuscaranic medications
. Atropine
Uses: anaesthesia, bradycardia, anticholinesterase overdose or poisoning
Adverse effects: blurred vision, urinary retention
. Scopolamine
Uses: motion sickness, nausea, cramping
. Ipratropium brominde [Atrovent HFA]
Uses: Asthma, Bronchitis, COPD
. Tropicamide [Mydriacyl]
Uses: Dilation of pupil
Adverse effects: Ocular Hypertension
. Pirenzepine [Gastrozepin]
Uses: Peptic Ulcers
. Diphenhydramine [Benadryl]
Uses: Antihistamine, sedative, hypnotic
. Dimenhydrinate [Dramamine]
Uses: Nausea, motion sickness
. Dicycloverine
Uses: Irritable Bowel Syndrome
. Flavoxate
Uses: Urinary Bladder Spasm
. Oxybutynin [Ditropan]
Uses: Urinary frequency, loss of bladder control
. Tiotropium [Spiriva]
Uses: COPD
. Cyclopentolate – Eye drops
Uses: Pediatric Eye Examinations
. Trihexyphenidyl [Artane]
Uses: Parkinson’s disease, Extrapyramidal side effects
. Tolterodine [Detrol]
Uses: Urinary Incontinence
. Solifenacin [Vesicare]
Uses: Overactive Bladder
. Darifenacin [Enablex]
Uses: Urinary Incontinence, Overactive Bladder
. Benzatropine [Cogentin]
Uses: Parkinson’s Disease, Extrapyramidal side effects, Dystonia
. Mebeverine [Colofac]
Uses: Irritable Bowel Syndrome, GI spasms
Antinicotinic medications
Antinicotinic medications or method of action affects the “nicotinic acetylcholine recptors
These compounds are often used during surgery for paralysis while others can be used for drug addiction.
They can be divided into a few catagories
1.) Ganglionic Blocking Agents
2.) Neuromuscular Blocking Agents [Non-depolarizing]
3.) Neuromuscular Blocking Agents [Depolarizing]
4.) Centrally Acting Nicotinic Antagonists
Ganglionic Blocking Agents
. Mecamylamine
Uses: Previously used in Hypertension now primarily used as a research tool
. Trimethaphan [Arfonad]
Method of Action: Binds and blocks the sympathetic nervous system and parasympathetic nervous system
Uses: Hypertensive Crisis, Dissecting Aortic Aneurysm, Pulmonary Edema, Bleeding during neurosurgery
Neuromuscular Blocking Agents [Non-depolarizing]
. Atracurium
Uses: Anesthesia, Skeletal muscle relation
. Doxacurium
Uses: Muscle relaxer
. Mivacuriuim
Uses: Neuromuscular blocker or Muscle relaxant
. Pancuronium
Uses: Muscle relaxant, General Anaesthesia – one of the drugs given during the “legal injection” in the United States
In some European countries such as Belgium and Netherlands is used in the protocol for euthanasia
. Tubocurarine
Uses: Anaesthesia
Used rarely
. Vecuronium [Norcuron]
Uses: Muscle Relaxant
Neuromuscular Blocking Agents [Depolarizing]
. Succinylcholine
Uses: Anesthesia, Emergency Medicine, Malignant Hypertension
Centrally Acting Nicotinic Antagonists
. 18-Methoxycoronaridine
Uses: Is still in the phase or research and hasn’t been tested on humans