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ANTICHOLINERGIC

ANTICHOLINERGIC

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pharmacology
pharmacology

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Published by: SUTHAN on May 28, 2009
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ANTICHOLINERGIC
An
anticholinergic
agent is a substance that blocks theneurotransmitter  acetylcholinein thecentraland the peripheral nervous system. An example of an anticholinergic isdicyclomine. Anticholinergics are administered to reduce theeffects mediated by acetylcholine on acetylcholinereceptorsinneuronsthrough competitive inhibition. Therefore, their effects are reversible.
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[edit] Pharmacology
Anticholinergics are classified according to the receptors that are affected:
agents operate on themuscarinic acetylcholine receptors.The majority of anticholinergic drugs are antimuscarinics.
agents operate on thenicotinic acetylcholine receptors. Themajority of these are non-depolarising skeletal muscle relaxants for surgicaluse, along with a few of the depolarising agents and drugs of other categories structurally related to curare.Examples of anticholinergics •ipratropium bromide(Atrovent) •oxitropium  bromide(Oxivent) •tiotropium(Spiriva) Physostigmine is one of a few drugs which are used as antidotes for anticholinergic poisoning, and nicotine also counteracts antichlolinergics.
[edit] Effects
Anticholinergic drugs are used in treating a variety of conditions:
Gastrointestinal disorders (e.g.,gastritis, pylorospasm,diverticulitis, ulcerative colitis)
Genitourinary disorders (e.g.,cystitis,urethritis, prostatitis)
Respiratory disorders (e.g.,asthma,chronic bronchitis)
Parkinson’s diseaseand Parkinson-like adverse medication effects
 
Sinus bradycardia- Hypersensitivevagus nerveWhen a significant amount of an anticholinergic is taken into the body, atoxicreactionknown as
acute anticholinergic syndrome
may result. This may happenaccidentally or intentionally as a consequence of recreational drug use.Anticholinergic drugs are usually considered the least enjoyable by experiencedrecreational drug users, possibly due to the lack of euphoria caused by them. (For some of the recreational effects, see the article ondeliriants.) Because most usersdo not enjoy the experience, they do not use it again, or do so very rarely. The risk of addiction is low in the anticholinergic class. The effects are usually more pronounced in the elderly, due to natural reduction of acetylcholine productionassociated with age.Exceptions to the above include scopolamine, orphenadrine,dicycloverine/dicyclomine and first-generation antihistamines with central nervoussystem penetration.Possible effects of anticholinergics include:
Ataxia; loss of coordination
Decreased mucus production in the nose andthroat; consequent dry, sorethroat
Xerostomiaor dry-mouth with possible acceleration of caries
Cessation of  perspiration; consequent decreased epidermal thermaldissipation leading to warm, blotchy, or red skin
Increased body temperature 
Pupil dilation (mydriasis); consequent sensitivity to bright light( photophobia)
Loss of accommodation (loss of focusing ability, blurred vision — cycloplegia)
Double-vision (diplopia)
Increased heart rate (tachycardia)
Tendency to be easily startled
Diminished bowel movement, sometimesileus- (decreases motility via thevagus nerve)
Increasedintraocular pressure; dangerous for people with narrow-angleglaucoma 
Shaking
 
Possible effects in thecentral nervous systemresemble those associated withdelirium, and may include:
Confusion
Disorientation
Agitation
Respiratory depression
Memory problems
 
Inability to concentrate
Wandering thoughts; inability to sustain atrain of thought 
Incoherent speech
Unusual sensitivity to sudden sounds
Illogical thinking
Photophobia
Visual disturbances
Periodic flashes of light
Periodic changes in visual field
Restricted or "tunnel vision"
Visual, auditory, or other sensoryhallucinations
Warping or waving of surfaces and edges
Textured surfaces
"Dancing" lines; "spiders", insects
Lifelike objects indistinguishable from reality
Hallucinated presence of people not actually there
Rarely: seizures, coma, and deathAcute anticholinergic syndrome is completely reversible and subsides once all of the toxin has been excreted. In ordinary circumstances, no specific treatment isindicated. However, in extreme cases, especially those that involve severe

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