OzEMedicine - Wiki for Australian Emergency Medicine Doctors

see also pharmacology main index, anti-muscarinic anticholinergic agents

• CNS:
  • ? motion sickness; Parkinsonian tremor & extrapyr.;
  • ? memory function; EEG inc. voltage & freq. alpha-rhythm;
    • ⇒ cortical arousal;
  • produce slow excitatory post-syn. potentials → modulatory effect:
  • symp.ganglia;
  • post-gang. neurons of myenteric plexus;
  • postganglionic intramural neurons → inc. gastric secret.
  • presynaptic nerve terminals of autonomic neurons (some are M2):
    • ⇒ decr. transmitter release incl. NA & ACh;
    • ⇒ decr. symp. stimulation of heart, etc;

• heart:
  • hyperpol. & decr. rate spontaneous depol. at SA node
    • ⇒ delay attainment of threshold level → decr.HR;
  • decr. AV conduction → may cause CHB in XS;
  • inc. funct. refract. period AV node → decr. vent.resp. to AF
  • decr. contract.(esp. atrial); decr. duration of AP;
  • decr. effective refractory period;
  • if disease or arrhythmia → partial depol. then ⇒ inc. cond. velocity in atrial muscle
    • ⇒ exac. AF/flutter from ectopic focus;
  • decr. automaticity of Purkinje fibres;
  • inc. threshold for VF;
  • decr. myocardial response to catecholamines;
• vascular:
  • vasodilatation;

• secretion
  • inc.: nose/mouth/pharynx/bronchi (incl. salivary & lacrimal), gastric; exocrine sweat glands;
• sm.muscle:
  • pupil constriction; accomodation; bronchoconstriction;
  • inc. GIT tone, motility; relax GIT sphincters;
    • ⇒ N, belching, vomit, cramps, defecation;
  • inc. urinary & biliary systems tone & contractions;
    • ⇒ inc. detrussor tone but decr. trigone tone;