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Related Concept Videos

Cholinergic Antagonists: Pharmacological Actions01:28

Cholinergic Antagonists: Pharmacological Actions

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Antimuscarinic drugs block muscarinic receptors in multiple systems, including the gut, eye, smooth muscles, respiratory tract, cardiovascular, and central nervous systems. They produce similar effects with varying selectivity depending on the specific agent and tissue. Here are the key pharmacological actions of antimuscarinics:
Gastrointestinal Effects: Antimuscarinics reduce gut contractions, increase gastric emptying, and slow intestinal transit. They partly inhibit gastric acid secretion...
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Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

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Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
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Cholinergic Antagonists: Therapeutic Uses01:26

Cholinergic Antagonists: Therapeutic Uses

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Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:    
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
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Cholinergic Antagonists: Pharmacokinetics01:24

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Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations,  while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and...
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Direct-Acting Cholinergic Agonists: Pharmacological Actions00:59

Direct-Acting Cholinergic Agonists: Pharmacological Actions

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Direct-acting cholinergic agonists exert their pharmacological actions by mimicking the effects of acetylcholine on postsynaptic muscarinic receptors to generate parasympathetic responses. These agents elicit a range of physiological responses, including cardiovascular effects. For example, activation of muscarinic receptors induces bradycardia, decreased cardiac output, reduced peripheral resistance, and consequent hypotension. In the eye, stimulation of M3 receptors leads to smooth muscle...
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Antiasthma Drugs: Muscarinic Receptor Antagonists01:20

Antiasthma Drugs: Muscarinic Receptor Antagonists

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Muscarinic receptor antagonists, also known as antimuscarinic agents, are a class of bronchodilators used to treat asthma, although they are more commonly used to treat COPD. They work by inhibiting the action of acetylcholine (ACh), a neurotransmitter, on muscarinic receptors found in the airways.
Antimuscarinic agents compete with ACh for the same binding site on the muscarinic receptors. By binding to these receptors, they inhibit the downstream effects of ACh and block the parasympathetic...
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Bladder Smooth Muscle Strip Contractility as a Method to Evaluate Lower Urinary Tract Pharmacology
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Impact of anticholinergic load on bladder function.

Jacquia F De La Cruz1, Cassandra Kisby, Jennifer M Wu

  • 1Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina, Cb 7570, 3032 Old Clinic Building, Chapel Hill, NC, USA, jfenders@med.unc.edu.

International Urogynecology Journal
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PubMed
Summary

High anticholinergic load did not significantly impact postvoid residual (PVR) in most women. However, very high anticholinergic risk scores (≥5) were linked to increased PVR and reduced bladder capacity.

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Area of Science:

  • Urology
  • Pharmacology
  • Geriatrics

Background:

  • Anticholinergic medications are widely prescribed and associated with various side effects.
  • The cumulative effect of anticholinergic burden on bladder function, particularly urinary retention, requires further investigation.

Purpose of the Study:

  • To evaluate the impact of anticholinergic load on postvoid residual (PVR) and other urodynamic parameters.
  • To assess the relationship between anticholinergic risk scores and bladder function in women undergoing urodynamics.

Main Methods:

  • Retrospective cohort study of 599 women undergoing urodynamics (UDS).
  • Medications were scored using the Anticholinergic Risk Scale (ARS).
  • Women were divided into low (ARS 0-1) and high (ARS ≥2) anticholinergic load groups.

Main Results:

  • No significant difference in micturition PVR between low and high ARS groups.
  • Sensitivity analysis revealed increased PVR (p<0.01) and reduced maximum cystometric capacity (MCC, p=0.02) in women with ARS ≥5.
  • No differences observed in other voiding function parameters between groups.

Conclusions:

  • Anticholinergic load generally does not affect bladder function as measured by PVR.
  • A significant negative impact on bladder function, including PVR and MCC, is observed only with very high anticholinergic risk scores (≥5).