The anticholinergic drugs competitively block the acetylcholine receptors at the muscarinic cholinergic receptor sites that are responsible for mediating the effects of parasympathetic postganglionic impulses. Some are more specific to particular receptors in the respiratory, genitourinary (GU), or GI tracts, making them preferred for treating specific conditions, and others more generally depress the parasympathetic system. When the parasympathetic system is blocked the effects of the sympathetic system are more prominently seen. These drugs can be used to decrease secretions before anesthesia, to treat parkinsonism (by blocking the stimulating effects of acetylcholine), to restore cardiac rate and blood pressure after vagal stimulation during surgery, to relieve bradycardia caused by a hyperactive carotid sinus reflex, to relieve pylorospasm and hyperactive bowel, to prevent the signs and symptoms of motion sickness and vomiting, to relax biliary and ureteral colic, to relax bladder detrusor muscles and tighten sphincters, to help to control crying or laughing episodes in patients with brain injuries, to relax uterine hypertonicity, to help in the management of peptic ulcer, to control rhinorrhea associated with hay fever, as an antidote for cholinergic drugs and for poisoning by certain mushrooms, and as an ophthalmic agent to cause mydriasis or cycloplegia in acute inflammatory conditions. Anticholinergic drugs also are thought to block the effects of acetylcholine in the central nervous system (CNS), which may account for their effectiveness in treating motion sickness and preventing nausea and vomiting.
Atropine, the prototype drug, has been used for many years and is derived from the plant belladonna. (Belladonna was once used by fashionable ladies of the European courts to dilate their pupils in an effort to make them more innocent looking and alluring.) Atropine is used to depress salivation and bronchial secretions and to dilate the bronchi, but it can thicken respiratory secretions (causing obstruction of airways). Atropine also is used to inhibit vagal responses in the heart, to relax the GI and GU tracts, to inhibit GI secretions, to cause mydriasis or relaxation of the pupil of the eye (also called a mydriatic effect), and to cause cycloplegia, or inhibition of the ability of the lens in the eye to accommodate to near vision (also called a cycloplegic effect).
Both atropine and scopolamine work by blocking only the muscarinic effectors in the parasympathetic nervous system and the few cholinergic receptors in the sympathetic nervous system (SNS), such as those that control sweating. They act by competing with acetylcholine for the muscarinic acetylcholine receptor sites. They do not block the nicotinic receptors and therefore have little or no effect at the neuromuscular junction.
Flavoxate and trospium act more specifically on the smooth muscle of the urinary tract to relax the bladder and ureter and are used to treat overactive bladder and bladder spasms.
黄酮哌酯和曲司氯铵对泌尿道平滑肌更具特异性，可松弛膀胱和输尿管，用于治疗膀胱活动过度和膀胱痉挛。
Aclidinium, ipratropium, tiotropium, and umeclidinium act more specifically to decrease respiratory secretions and cause bronchodilation and are used as bronchodilators and to decrease symptoms of upper respiratory irritation.
阿地溴铵、异丙托铵、噻托溴和芜地溴铵对减少呼吸系统分泌和引起支气管扩张更有特异性，用作支气管扩张剂，减少上呼吸道刺激症状。
Meclizine reduces the sensitivity of the labyrinthine apparatus and partially blocks the cholinergic receptors in the chemoreceptor trigger zone, helping to decrease the effects of motion sickness and preventing nausea and vomiting. Hyoscyamine and methscopolamine act more specifically on the receptors in the GI tract and are used as adjuncts in the treatment of peptic ulcers, irritable bowel syndrome, and GI disorders.
Darifenacin, fesoterodine, solifenacin, and toliterodine are used to treat overactive bladder with symptoms of urinary incontinence, urgency, and urinary frequency.
达非那新、非索罗定、索利那辛和托特罗定用于治疗有尿失禁、尿急、尿频症状的膀胱活动过度症。
anticholinergic – a. n. 抗胆碱能的（药）
aclidinium – n. 阿地溴铵
Tudorza Pressair – n. 图多尔扎（阿地溴铵吸收性粉剂）
atropine – n. 阿托品
darifenacin – n. 达非那新
Enablex – n. 替尼达普
dicyclomine – n. 双环维林
fesoterodine – n. 非索罗定
Toviaz – n. 托维亚兹
flavoxate – n. 黄酮哌酯
glycopyrrolate – n. 格隆溴铵
Robinul – n. 甘罗溴
hyoscyamine – n. 茛菪碱
Symax – n. 【奥】西麦克斯
ipratropium – n. 异丙托铵
Atrovent – n. 爱喘乐
meclizine – n. 美克洛嗪
Bonine – n. 【奥】博宁（盐酸美克洛嗪）
methscopolamine – n. 甲东茛菪碱
Pamine – n. 【奥】哌明
propantheline – n. 丙胺太林
scopolamine – n. 东茛菪碱
Transderm Scop – n. 东茛菪碱皮贴
solifenacin – n. 索利那新
VESIcare – n. 卫喜康
tiotropium – n. 噻托溴
Spiriva – n. 思力华
toliterodine – n. 托特罗定
Detrol – n. 【奥】底特罗尔
trospium – n. 曲司氯铵 注：标记【奥】者为本站临时用名，只为方便会员学习记忆，不得作为临床用药依据。
1. Which of the following would the nurse be least likely to include when developing a teaching plan for a patient who is receiving an anticholinergic agent?
A. Encouraging the patient to void before dosing
B. Setting up a bowel program to deal with constipation
C. Encouraging the patient to use sugarless lozenges to combat dry mouth
D. Performing exercises to increase the heart rate
2. Remembering that anticholinergics block the effects of PNS, the nurse would question an order for an anticholinergic drug for patients with which of the following conditions?
A. Biliary spasms
B. Bradycardia
C. Glaucoma
D. Asthma
答案 Answers 1. D. Performing exercises to increase the heart ate Rationale: Exercises should be avoided because this drug blocks sweating. This placed the patient at increased risk for heat stroke. 2. C. Glaucoma Explanation: All other options are indications for atropine
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