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But, due to feedback regulation of the vasomotor center, there is a fall in blood pressure due to vasodilation. Important [ 5 ] muscarinic antagonists include atropine , hyoscyamine , hyoscine butylbromide and hydrobromide , ipratropium , tropicamide , cyclopentolate , pirenzepine and scopalamine .
Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
For symptomatic bradycardia, the usual dosage is 0.5 to 1 mg IV push; this may be repeated every 3 to 5 minutes, up to a total dose of 3 mg (maximum 0.04 mg/kg). [23] Atropine is also useful in treating second-degree heart block Mobitz type 1 (Wenckebach block), and also third-degree heart block with a high Purkinje or AV-nodal escape rhythm.
Actions of atenolol include the reduction in myocardial contractility and heart rate, hence producing the effect of lowering blood pressure and cardiac output. [14] Side effects of atenolol include cold extremities and exacerbation of cardiac failure, hence this drug is not suitable for patients with heart failure. [14]
The main contraindication for ipratropium in any form is hypersensitivity to atropine and related substances. [20] [21]Conditions such as narrow-angle glaucoma, prostatic hyperplasia, or bladder neck obstruction are not necessarily contraindicators, but should be taken into account, particularly if the patient is receiving an anticholinergic by another route.
An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) between different analgesics. [1]
Examples of sympathomimetic effects include increases in heart rate, force of cardiac contraction, and blood pressure. [1] The primary endogenous agonists of the sympathetic nervous system are the catecholamines (i.e., epinephrine [adrenaline], norepinephrine [noradrenaline], and dopamine), which function as both neurotransmitters and hormones.
Class IV agents affect calcium channels and the AV node. Class V agents work by other or unknown mechanisms. With regard to management of atrial fibrillation, classes I and III are used in rhythm control as medical cardioversion agents, while classes II and IV are used as rate-control agents.