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UNIT 6 DRUGS INHIBITING CHOLINERGIC NEUROTRANSMISSION Muscarinic receptor antagonists. Ganglionic blockers. Neuromuscular blocking drugs

1. TOPICS TO DISCUSS

1. Classification of drugs inhibiting cholinergic neurotransmission.

2. Schematic diagram of efferent innervation. Localization of action of M-cholinoblockers, ganglion-blocking drugs, neuromuscular-blocking drugs.

3. Pharmacological effects of M-cholinoblockers. Main therapeutic uses. Adverse effects.

4. Mechanisms of mydriasis and cycloplegia caused by atropine. Effect on intraocular pressure. The main uses of atropine in ophthalmology. Comparison with cyclopentolate and tropicamide.

5. Main therapeutic use of atropine. Comparison of atropine with scopolamine. Main therapeutic use of scopolamine.

6. Toxic effects of atropine. Drugs used as antidotes for atropine overdose. Poisoning with at-ropineand scopolamine-containing plants (e.g. deadly nightshade and angel's trumpet). Treatment of such intoxications.

7. Comparison of pirenzepine, tolterodine, and ipratropium with atropine. Comparison of ip-ratropium and tiotropium.

8. Ganglion-blocking drugs. Characteristics of hexamethonium, trimethaphan, mecamyla-mine.

9. Pharmacological effects of ganglion-blocking drugs. Therapeutic uses and adverse effects.

10. Classification of neuromuscular-blocking drugs based on the mechanisms of action.

11. Pharmacological effects, therapeutic uses, and adverse effects of nondepolarizing neuromus-

cular blocking drugs. Characteristics of tubocu-rarine, atracurium, pancuronium, mivacurium. Antagonists of nondepolarising neuromuscular-blocking drugs. 12. Succinylcholine. Mechanism of action. Therapeutic uses and adverse effects. Comparison with nondepolarising neuromuscular blockers.

2. CLASSIFICATION OF DRUGS INHIBITING CHOLINERGIC

NEUROTRANSMISSION

A. Muscarinic receptor-blocking drugs

Tertiary amines:

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