Anticholinergics

Question 1

List the Anticholinergics - Short acting (SAMA) & Long acting (LAMA

Answer 1

“ ium”
SAMA- ipratoprium
LAMA- tiopropium( ONCE DAILY) ,umeclidinium (ONCE daily), aclidinium ( TWICE daily)

Question 2

What is the Indication,MOA of LAMA

Answer 2

Indication-Commonly used in COPD
MOA- bind to the cholinergic receptors and inhibit them, blocking acetylcholine

Question 3

What are the precautions , A/E, Pregnancy and breastfeeding Information

Answer 3

Adverse effects-
-C/ dry mouth( can’t SPIT) INFREQUENT- blurred vision( can’t SEE), urinary retention(cant PEE), dizziness( ipratropium esp) Rare/ constipation( can’t SHIT)

Precautions.
- cardiovascular- may increase risk of cardio vascular effects
- Acute angle glaucoma crisis may be precipitated - symptoms may be worsened.
Pregnancy/Breastfeeding- safe

Question 4

What are the practice points and Counselling with anticholinergics

Answer 4

• Notify your doctor if you have any pain in eye ( hint- can’t make acute Angle glaucoma worse )
• Can cause dizziness/ can affect your mental alertness and hence don’t drive - esp with ipratropium
• Can’t use SAMA and LAMA together - stop ipratropium if tiopromium is required