Question Answer
An agent that blocks parasympathetic nervous fibers is called anticholinergic bronchodilator
An agent that produces the effect of acetylcholine is called cholinergic
An agent that blocks parasympathetic nervous fibers,which allow relaxation of the smooth muscle in the airway,is called a(n) parasympatholytic
____________ is the same as cholnergic,producing the effect of acetylcholine or an agent that mimics acetylcholine. muscarinic
The word____________ has the same meaning as anticholinergic:blocking the effect of acetylcholine at the cholinergic site antimuscarinic bronchodilator
A __________ agent produces effects similar to those of parasympathetic nervous fiber parasympathomimetic
Two anticholinergic bronchodilators that are indicated for maintenance and treatment of COPD,Chronic Bronchitis,and Emphysema ipatropium bromide(Atrovent) and albuterol. “Combivent”
The drug used in severe asthma,especially bronchoconstriction that doesn’t respond well to B-agonist therapy ipatropium
Brand name for: tiotropium bromide Onset:? Peak:? Duration:? Dosage:(or puffs)? Administration(s): spiriva Onset:30min. Peak:3hrs. Duration:24hrs. Dosage:1 inhalation (one capsule) Administration(s): DPI
Brand name for: ipatropium bromide Onset:? Peak:? Duration:? Dosage:(or puffs)? Administration(s): atrovent Onset:15min. Peak:1-2hrs. Duration:4-6hrs. Dosage:(puffs)2 qid Administration(s):MDI Atrovent HFA Administrations: HFA MDI SVN NASAL SPRAY (2 sprays per nostril 2 to 4 times daily)
Brand name for: ipatropium bromide and albuterol Onset:? Peak:? Duration:? Dosage:(or puffs)? Administration(s): combivent & duoneb Onset:15min. Peak:1-2hrs. Duration:4-6hrs. Dosage:(puffs)2 qid Administration(s): MDI(Combivent) SVN(Duoneb)
Ipatropium is a derivative of atropine
Atropine is a _____________ ____________ and fully ionized,and is therefore readily absorbed into the bloodstream,is distributed through out the body,crosses the blood-brain barrier,and causes changes in CNS quaternary ammonium
Cholinergic effects: decreased heart rate miosis( eye dilation) thickening of the lens SLUD secretion of mucus bronchoconstriction
Anticholinergic effects: increased heart rate mydriasis(pupil dilation) cycloplegia (lens flattened) drying upper airway no tear formation urinary retention constipation mucociliary slowing inhubition of constriction
The most common side effects seen with anticholinergic aerosol ipatropium are ___________ and_____________. dry mouth and blurred vision
Currently the major use for Atropine sulfate is for bradycardia
Two terms synonymous “parasympatholytic” are antimuscarinic and anticholinergic
In COPD,what two conditions restrict airflow? bronchoconstriction and increased mucus production
Bradycardia is often caused by stimulation of the __________ nerve. vagas
Why wouldn’t Atropine work for someone with a heart transplant? because they must have a vagal connection,this which is lost during transplantation, in return will leave no stimulation to the heart of the new owner.
What is rhinitis? inflammation of the nasal passage
Why is atrovent used to treat rhinitis? is reduces nasal activity (constricts mucus glands)
What are two desirable pulmonary effects of delivery of parasympatholytic agents? decreased bronchoconstriction and bronchodilation
The main desired effect of antimuscarinic drugs are bronchodilation
ipatropium bromide(atrovent) has what two general indications? COPD with airway obstruction and rhinorrhea
_____________ is a drug often given to help diagnose asthma methacholine
During a “certain drug” challenge(to diagnose asthma), a physician need to be available in short notice. Why? Patient could go into severe bronchospasm
When giving anticholinergics SVN, the patient must be sure to not get it in the eye,ESPECIALLY if the have glaucoma. Why? Glaucoma is a condition that causes pressure and fluid in the eye. An anticholinergic will increase the pressure already existing in the eye.
What maneuver should be tested before and after administration of a rapid action albuterol? peak flow
How do you assess effectiveness in therapy given to a patient? 1.)peak flow 2.)auscultations 3.)patient response

Question Answer
substance that blocks neurotransmitter acetylcholine in central/peripheral nervous system anticholinergic agent
anticholinergic inhibit _ nerve impulses by selectively binding the acetycholine to its receptor in nerve cells parasympathetic
nerve fibers of the parasympathetic system R responsible 4 _ movement of _ muscles present in GI tract & urinary tract & lungs involuntary smooth muscle
stimulation of the parasympathetic nerve causes _ bronchoconstriction
so agents that block parasympathetic receptors will cause airway _ relaxtation
paragents R used to Tx chronic bronchitis COPD Asthma where cough is present
parasympathetic agents like atropine R _-_ anti-muscarinic
anti-muscarinic block the action of _ on receptor sites by competitively occupying the receptor site & result in smooth muscle relaxation acetylcholine
w/anticholinergics if atropine blocks the action of acetylcholine this = bronchoconstriction & histamine is not released from mast cells
this drug is M! M2 M3 block receptors that cause bronchospasm onset 15min/ duration 4-6 hrs/ nebulizer or MDI QID don’t cross BBB=<SE ipratropium bromide (atrovent)
This drug is used in moderate to large airway Pt who smoke or have a smoking HX COPD from smoking Atrovent {Ipratropium bromide}
Atrovent will not help allergic asthma but _-_ agents + anticholinergic agents have an additive effect  Beta-adrenergic agents
same drug as Atrovent but w/longer duration (24hrs) & is a DPI SE= dose&med related dryness of mouth &skin tachycardia/blurred vision/dilation of pupils/ difficulty w/speech&swallowing/ mental confusion spiriva Tiotropium bromide