Parkinsonism
Uses of Anticholinergics
• I. As antisecretory
• II. As antispasmodic
• III. Bronchial asthma, COPD
• IV. As mydriatic and cycloplegic
• V. As cardiac vagolytic
• VI. For central action
• VII. To antagonise muscarinic effects of drugs and poisons
I. As antisecretory
• 1. Preanaesthetic medication
• Atropinic drugs prevent laryngospasm by reducing respiratory
secretions that reflexly predispose to laryngospasm.
• Vasovagal attack during anaesthesia can also be prevented.
• 2. Pulmonary embolism
• These drugs benefit by reducing pulmonary secretions evoked reflexly
by embolism.
II. As antispasmodic
• 1. Intestinal and renal colic, abdominal cramps:
• 2. Motion sickness
• Hyoscine is the most effective drug for motion sickness.
• The drug should be given prophylactically (0.2 mg oral), because
administration after symptoms have setin is less effective; action lasts
4–6 hours.
VII. To antagonise muscarinic effects of
drugs and poisons
• Atropine is the specific antidote
for anti ChE and early
mushroom poisoning.
Anticholinestrase Insecticide
Side effects and toxicity
• Datura Poisoning
Side effects and toxicity
• Belladonna poisoning
• May occur due to drug overdose or consumption of seeds and berries
of belladonna/datura plant.
• Manifestations are due to exaggerated pharmacological actions.
• Dry mouth,
• Difficulty in swallowing and talking.
• Dry, flushed and hot skin (especially over face and neck), fever,
• Difficulty in micturition, decreased bowel sounds.
• Dilated pupil, photophobia, blurring of near vision, palpitation.
Treatment of Belladona poisoning
• If poison has been ingested, gastric lavage should be done with tannic
acid.
• The patient should be kept in a dark quiet room.
• Cold sponging or ice bags are applied to reduce body temperature.
• Physostigmine 1–3 mg s.c. or i.v. antagonises both central and
peripheral effects.
• Other general measures (maintenance of blood volume, assisted
respiration, diazepam to control convulsions) should be taken as
appropriate.
Contraindications
• In individuals with a narrow iridocorneal angle—may precipitate acute
congestive glaucoma.
• Caution is advocated in elderly males with prostatic hypertrophy—
urinary retention can occur.
Thank You