Antimuscarinics, Bronchodilators

Question	Answer
Give eg's of & indications for antimuscarinic bronchodilators.	eg's: ipratropium, tiotropium, glycopyrronium Indications: • In COPD short-acting antimuscarinics are used to relieve breathlessness & long-acting antimuscarinics are used to prevent breathlessness and exacerbations. • In asthma, short-acting antimuscarinics are used as adjuvant Rx for relief of breathlessness during acute exacerbations. Long-acting antimuscarinics are added to high-dose inhaled corticosteroids & long-acting β2 agonists at ‘step 4’ in the treatment of chronic asthma.
MOA of antimuscarinic bronchodilators.	Antimuscarinics act as competitive inhibitors of acetylcholine thereby opposing parasympathetic effects & ^HR & conduction, reduce smooth muscle tone & secretions from glands in the respiratory & GI tracts. In the eye they cause pupil dilation.
SE's of antimuscarinic bronchodilators.	SE's: Few from inhalation as little systemic absorption. Dry mouth.
CI's, cautions, & important interactions of antimuscarinic bronchodilators.	CI's: • None Cautions: • Angle-closure glaucoma • Pt's at risk of arrhythmias Important interactions: Interactions are not generally a problem due to low systemic absorption.

Resource summary

	Created by Andrew Street about 8 years ago