It is also valuable in reducing involuntary voiding in
patients with neurologic disease, eg. children with
meningomyelocele.
Oxybutynin
(blank) oxybutynin or instillation of the drug by
(blank) into the bladder in such patients appears to
improve bladder capacity and continence and to
reduce infection and renal damage.
Oral, catheter
reduces the need for
multiple daily doses. of oxybutynin
Transdermally applied, oral
extended-release formulation
a nonselective antagonist, has been
approved and is comparable in efficacy and side
effects to oxybutynin.
Trospium,
are recently approved
antagonists that have greater selectivity for M 3
receptors than oxybutynin or trospium.
Darifenacin and solifenacin
have the advantage of
once-daily dosing because of their long half-lives.
Darifenacin and solifenacin
M 3-selective
antimuscarinics, are available for use in adults with
urinary incontinence. They have many of the
qualities of darifenacin and solifenacin and are
available in extended-release tablets.
Tolterodine and fesoterodine,
a newer antimuscarinic agent,
• An alternative treatment for urinary incontinence
Propiverine,
An alternative treatment for urinary incontinence
refractory to antimuscarinic drugs is intrabladder
injection of
botulinum toxin A.
a tricyclic antidepressant drug with
strong antimuscarinic actions
Imipramine,
is used for the treatment of overdoses of
cholinesterase inhibitor insecticides & some types
of mushroom poisoning.
Atropine
The potential use of cholinesterase inhibitors as
chemical warfare(blank) also requires an
awareness of the methods for treating acute
poisoning.
"nerve gases"
Both the nicotinic and the muscarinic effects of the
cholinesterase inhibitors can be
life-threatening.
To reverse the muscarinic effects, a (blank) (not
quaternary) drug must be used (preferably
atropine) to treat CNS effects as well as the
peripheral effects of the organophosphate
inhibitors.
tertiary amine
Large doses of atropine may be needed to oppose
the muscarinic effects of extremely potent agents
like
parathion
In this life-threatening situation, as much as (blank) may be required for as long as
➢ 1 month for full control of muscarinic excess
1 g of
atropine per day
A second class of compounds, composed of
substituted (blank) capable of regenerating active
enzyme from the organophosphorus-
cholinesterase complex, is also available to treat
organophosphorus poisoning.
oximes
These oxime agents include
pralidoxime (PAM),
diacetylmonoxime (DAM), Obidoxime, and
others.
is administered by intravenous
infusion, 1-2 z prven over 15-30 minutes.
Pralidoxime
Administration of multiple doses of pralidoxime
over several days may be useful in
severe poisoning.