Dr.

Bhagyashree A
Assistant Professor
Dept. of Pharmacology
 Block actions of Ach on autonomic effectors
 CNS
 Muscarinic receptor antagonist
 Parasympatholytics
 Atropinic drugs
 Nicotinic receptor antagonists-
ganglionblockers/ neuromuscular blockers
 Competitive antagonist at muscarinic
receptor
 Blocks the actions of acetylcholine on
muscarinic receptor
 CNS:
 Overall stimulant action (appreciable at higher doses)
 Stimulates vagal, respiratory and vasomotor centre.
 Depresses vestibular excitation, antimotion sickness
 Suppresses cholinergic over activity in basal ganglia,
suppresses tremor and rigidity of parkinsonism.
 Higher doses-restlessness, disorientation,
hallucinations,
 Respiratory depression and coma
 CVS:
 Most prominent action is Tachycardia
 (M2 receptor block on SA node)
 Initial transient bradycardia on im/s.c use – due to
blockade of muscarinic autoreceptors on the
vagal nerve endings which increases Ach release
 BP: No consistent effect on Blood pressure
 Smooth muscles:
 Relaxation of all smooth muscles (M3 blockade)
 GIT - Peristalsis is incompletely suppressed, but
constipation can occur
 Respiratory - Produces bronchodilatation and
reduces airway resistance
 Uterus and urinary bladder - Relaxant effect
 Beneficial for increasing bladder capacity and
controlling detrusor hyperreflexia.
 Eye:
 Topical instillation causes Mydriasis - by blocking
the M3 receptors on the iris
 Abolition of light reflex and cycloplegia for 7-10
days
 Blurring of vision and photophobia
 Due to mydriasis, i.o.t increases – due to narrow
anterior chamber and the iris obstructs the
outflow of aqueous humor into the trabeculae
 Eye:
 Glands
 Decreased secretion in salivary, lacrimal, sweat
and tracheobronchial glands
 Decreases the volume of gastric secretions

 Local anesthetic action:

 Mild anesthetic action on the cornea
 Body temperature:
 Increase in body temperature
 Due to inhibition of sweat secretion
 Due to stimulation of temperature centre in
hypothalamus
Atropa belladona Hyoscyamus niger
 Atropine sulfate : im/iv inj ,eye drop,
ointment
 Hyoscine hydrobromide: oral, im,
transdermal patch
 Semi synthetic derivatives of belladonna
alkaloids & synthetic compounds.
 Derivatives used on the eye- tropicamide
 Antispasmodics- dicyclomine
 Peptic ulcer- pirenzepine
 Bronchial asthma- ipratropium bromide,
tiotropium bromide
 Parkinsonism- trihexyphenidyl
 Preanaesthetic medication- glycopyrrolate
 Antisecretory
• Preanaesthetic medication

• Pulmonary embolism
• Decrease salivation
 Antispasmodic
• Intestinal, renal colic, abdominal cramps

• Non infective diarrhoea

• Spastic constipation
• Gastritis, gastric hypermotility
• Urinary frequency and urgency
• Dysmenorrhoea
Bronchial asthma, COPD- ipratropium
bromide, tiotropium bromide
(Bronchodilatation)
 As mydriatic and cycloplegic
• Testing errors of refraction- mydriasis and
cycloplegia
• Fundoscopy- mydriasis

• Therapeutic- reduces painful spasm of

intraocular muscles in iritis, keratitis etc.
 As cardiac vagolytic- sinus bradycardia,
partial heart block
 Central action
• Parkinsonism
• Motion sickness

 To antagonise muscarinic drugs

 CNS- restlessness, excitement, delirium and
hallucinations
Convulsions and coma- severe

 Eye- dilated pupil, photophobia, headache,

blurring of vision

 CVS- tachycardia, palpitation and

hypotension and cardiovascular collapse
 GIT- dry mouth, difficulty in swallowing,
constipation

 Urinary tract- urinary retention, difficulty in

micturition

 Acute belladona poisoning

 Children
 Exaggerated pharmacological actions
 Dry and flushed skin
 Photophobia, blurring of vision
 Dilated pupil
 Difficulty in micturition

 Restlessness, confusion, disorientation,

hallucination

 Severe- respiratory depression,

cardiovascular collapse, convulsions, coma
and death
 Hospitalization
 Gastric lavage

 Patient kept in dark and quiet room

 Assisted respiration
 Maintain blood volume
 Cold sponging- temperature
 Diazepam- convulsions
 Antidote- Physostigmine, 1-3mg s.c or i.v
 Persons with narrow iridocorneal angle- acute
congestive glaucoma
 BPH- urinary retention
 Anticholinergic drugs- antisecretory,
antispasmodic, asthma, mydriatic, cardiac
vagolytic, motion sickness.
 Anticholinergic drugs- dry mouth, maintain
good oral hygiene
 CI in glaucoma, shallow anterior chamber and
narrow iridocorneal angle
 CI in elderly males with BPH