Anticholinergics (Parasympatholytics)
Anticholinergics are drugs that oppose the effects of acetylcholine. In essence, they also lyse
and block the effects of parasympathetic nervous system (PNS) so they are also called as
parasympatholytics. Atropine is currently the only widely used anticholinergic drug. Other
common examples include meclizine, scopolamine and ipratropium.
Anticholinergics: Generic and Brand Names
Here is a table of commonly encountered anticholinergic agents, their generic names, and brand
names:
Classification Generic Name Brand Name
Anticholinergics atropine (generic)
ipratropium Atrovent
meclizine Bonine, Antivert
methscopolamine Pamine
scopolamine Transderm Scop
tiotropium Spiriva
Disease Spotlight: Gastrointestinal Ulcers
● Anticholinergics were once very widely used to decrease GI activity and secretions.
However, more specific and less toxic drugs are available now and the utilization of
this drug class is now limited.
, ● GI ulcers are basically erosions in the lining of the GIT caused by increased HCl
production most commonly from H. pylori infection. Patients with GI ulcers suffer from
burning abdominal pain, nausea, and acid reflux.
Therapeutic Action
The desired and beneficial actions of anticholinergics are as follows:
● Competitively blocking the ACh receptors at muscarinic cholinergic receptor sites
that are responsible for mediating the effects of the parasympathetic postganglionic
impulses.
● Atropine, the prototype drug, is derived from the plant belladonna. It is used to
depress salivation and bronchial secretions and to dilate the bronchi, but it can
thicken respiratory secretions (causing obstruction of airways).
● Atropine and scopolamine work by blocking only the muscarinic effectors in the
parasympathetic nervous system and the few cholinergic receptors in the SNS.
Indications
Anticholinergics are indicated for the following medical conditions:
● Prevention of nausea, vomiting, and dizziness associated with motion sickness.
● Adjunctive therapy for treatment of GI ulcers
● Decrease secretions before anesthesia or intubation
● Maintenance treatment of bronchospasm associated with COPD.
● Treatment of irritable or hyperactive bowel in adults.
Here are some important aspects to remember for indication of anticholinergics in different age
groups:
Children
● More sensitive to the adverse effects of the drug (e.g. constipation, urinary retention,
heat intolerance, confusion).
● Dicyclomine is not recommended for use in children.
Adults
Anticholinergics are drugs that oppose the effects of acetylcholine. In essence, they also lyse
and block the effects of parasympathetic nervous system (PNS) so they are also called as
parasympatholytics. Atropine is currently the only widely used anticholinergic drug. Other
common examples include meclizine, scopolamine and ipratropium.
Anticholinergics: Generic and Brand Names
Here is a table of commonly encountered anticholinergic agents, their generic names, and brand
names:
Classification Generic Name Brand Name
Anticholinergics atropine (generic)
ipratropium Atrovent
meclizine Bonine, Antivert
methscopolamine Pamine
scopolamine Transderm Scop
tiotropium Spiriva
Disease Spotlight: Gastrointestinal Ulcers
● Anticholinergics were once very widely used to decrease GI activity and secretions.
However, more specific and less toxic drugs are available now and the utilization of
this drug class is now limited.
, ● GI ulcers are basically erosions in the lining of the GIT caused by increased HCl
production most commonly from H. pylori infection. Patients with GI ulcers suffer from
burning abdominal pain, nausea, and acid reflux.
Therapeutic Action
The desired and beneficial actions of anticholinergics are as follows:
● Competitively blocking the ACh receptors at muscarinic cholinergic receptor sites
that are responsible for mediating the effects of the parasympathetic postganglionic
impulses.
● Atropine, the prototype drug, is derived from the plant belladonna. It is used to
depress salivation and bronchial secretions and to dilate the bronchi, but it can
thicken respiratory secretions (causing obstruction of airways).
● Atropine and scopolamine work by blocking only the muscarinic effectors in the
parasympathetic nervous system and the few cholinergic receptors in the SNS.
Indications
Anticholinergics are indicated for the following medical conditions:
● Prevention of nausea, vomiting, and dizziness associated with motion sickness.
● Adjunctive therapy for treatment of GI ulcers
● Decrease secretions before anesthesia or intubation
● Maintenance treatment of bronchospasm associated with COPD.
● Treatment of irritable or hyperactive bowel in adults.
Here are some important aspects to remember for indication of anticholinergics in different age
groups:
Children
● More sensitive to the adverse effects of the drug (e.g. constipation, urinary retention,
heat intolerance, confusion).
● Dicyclomine is not recommended for use in children.
Adults
