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anti dirrhoeal and purgative laxatives.pptx

This document discusses cholinergic and anticholinergic drugs. Cholinergic drugs act as agonists of acetylcholine to increase parasympathetic nervous system activity, which can relieve diarrhea. Examples include direct acting drugs like bethanechol and indirect acting reversible inhibitors of cholinesterase enzymes. Anticholinergic drugs block the action of acetylcholine and are used to treat conditions like glaucoma, asthma, Parkinson's disease. They work by competitively inhibiting muscarinic acetylcholine receptors. Side effects include dry mouth, blurred vision, constipation, urinary retention and tachycardia. People with certain medical conditions should avoid anticholinergic drugs due to risk of worsening their conditions

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M-SC-NURSING•Psychiatric Nursing• B.Sc. Nursing•
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ANTI DIRRHOEAL PURGATIVE / LAXATIVES By:- Ravikant Sir
 Dirhoea is defined as frequent passage of stool .  Acetylcholine is primary neurotransmitter within the parasympathetic nervous system
 Cholinergic drugs stimulate the activation of the parasympathetic nervous system by activating receptors for acetylcholine.  These drugs inhibit cholinesterase enzyme that rapidly destroy acetylcholine and so prevent the destruction of acetylcholine.  Cholinergic drugs are Agonist of acetylcholine.
1. Direct acting 2. Indirect acting Synthetic esters of choline eg. bethonechol, carbacol, methacholine, urecholine) Cholinomimetic alkaloids eg. Pilocarpine, muscarine, Arecholine Reversible cholinesterase inhibitors e.g Physostigmine, Neostigmine, pyridostigmine Irreversible cholinesterase Inhibitors eg :- Malathione, parathione.
Physostigmine  0.5-2 mg IM or IV given slowly (not to exceed mg/minute IV) Neostigmine  Adults: 0.5-25 mg slow IV.
Topical (eye)  Treatment of open angle glaucoma.  Reverse cycloplegia and mydriasis due to atropine like agents. Systemic  Diagnosis and treatment of myasthenia gravis.  Relief of postoperative abdominal distension and urinary distention  Neostigmine is antidote to muscle relaxant.
Acetylcholine Accumulation at cholinergic synapses Competitively blocks acetylcholine Hydrolysis by cholinesterase + mimics acetylcholine Increase Cholinergic stimulation Eg.- Miosis and Ciliary muscle contraction increase aqueous humor outflow and decrease intraocular pressure
 Bronchial asthma  Deceased visual acuity, eyelid twitching, increased tearing, mild headache.  Sweating  Urinary urgency  Excessive salivation.  Nausea, diarrheas.  Cramping, Muscle twitching.
 Inflammation of the iris or ciliary body, Narrow/Close angle glaucoma.  Asthma  cardiovascular disease.  Intestinal or urinary obstruction  Mega colon.  Acute peptic ulcer.  Hyperthyroidism.
 Explain about salivations, vomiting, urination and other side effects.  Reduce dosage if excessive nausea or sweating occurs.  Have atropine sulfate (Ant cholinergic) injection ready, in case of allergic action or accidental overdose.  Have emergency measures readily available (e.g. atropine oxygen with respiratory suction apparatus) in case if a breathing crisis.
 Anticholinergic drugs Also called cholinergic blocking agents or parasympatholytics.  They inhibit the parasympathetic nervous system by blocking the action of acetylcholine. OR  Anticholinergics are substances that block the action of the neurotransmitter acetylcholine at synapses in the central and peripheral nervous system
1. Natural alkaloids 2. Semisynthetic 3. Synthetic Atropine Scopolamine Homatropine, Ipratropium bromide a) Mydriatics: Cyclopentonate. b) Antisecretory / Antispasmodics: Dicyclomine, oxybutynin. c) Antiparkinsonian: Benztropine, Trihexyphenidyl (pacitan)
Anticholinergic inhibit the muscarinic actions of acetylcholine by blocking parasympathetic impulses. It competing with acetylcholine for sites on muscarinic receptors
 Mydriatics and cycloplegia for ophthalmic examinations.  Close Angle Glaucoma  Preoperative medication to reduce excess salivation and prevent bradycardia  Decrease Gl motility and secretion.  GI spasms  Treatment enuresis in children.  Treatment of sinus bradycardia and conduction (due to excessive vagal tone)  Antidote to overdose with cholinergic agents.  Relief of symptoms of parkinsonism and control of extra pyramidal disorders resulting antipsychotic treatment.  Treatment of motion sickness – hyoscine (scopolamine)
1. Cardiovascular • Decreased heart rate in small doses. • Increased heart rate in large doses. • Vasodilatation. 2. Gastrointestinal Tract • Decreased motility. • Decreased muscle tones. • Decreased secretions. 3. Urinary Tract • Relaxation of detrusor muscles. • Contraction of sphincter muscles. 4. Eye • Mydriatics. • Cycloplegia.(paralysis of muscle that adjust shape of eye lens ) 5. Smooth Muscles • Slight relaxation of non-vascular smooth muscles. 6. Exocrine Glands • Decreased sweat glands secretions. • Decreased salivation. • Decreased mucous gland secretions 7. Central Nervous System • Drowsiness, disorientation, hallucinations. • Decreased tremors and rigidity of parkinsonism.
o Decreased mucus production. o Xerostomia (Dry mouth) o Pupil dilation. o Urinary retention. o Tachycardia. o Disorientation & Agitation. o Confusion. o Diminished bowel movements. o Respiratory depression. o Increased intraocular pressure.
o Glaucoma. o Chronic renal, lung or hepatic disease. o Myasthenia gravis. o Heart disease & Tachycardia. o Paralytic ileus. o Ulcerative colitis. o Genitourinary (GU) obstruction. o Severe hemorrhage.
This is not the END…….  • Write Nursing responsibility as I discussed in class………