Antikolinergik: Perbedaan antara revisi
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Baris 6:
Istilah "antikolinergik" biasanya digunakan untuk merujuk pada antimuskarinik yang secara kompetitif menghambat pengikatan ACh ke reseptor asetilkolin muskarinik; agen tersebut tidak memusuhi pengikatan reseptor asetilkolin nikotinat di [[sambungan neuromuskular]], meskipun istilah ini kadang-kadang digunakan untuk merujuk pada agen yang melakukan hal tersebut.<ref name="Migirov Datta 2020 p."/><ref name="UpToDate">{{cite web | title=Anticholinergic poisoning | website=UpToDate | url=https://www.uptodate.com/contents/anticholinergic-poisoning | access-date=2020-03-24 | last1=Su | first1=Mark | last2=Goldman | first2=Matthew | editor1-last=Traub | editor1-first=Stephen J. | editor2-last= Burns |editor2-first= Michele M. |editor3-last=Grayzel | editor3-first=Jonathan}}</ref>
==Kegunaan dalam medis==
Obat antikolinergik digunakan untuk mengobati berbagai kondisi seperti:
*[[Pusing]] (termasuk gejala yang berhubungan dengan [[vertigo]] dan [[mabuk gerak]])
*Gejala ekstrapiramidal, potensi efek samping obat antipsikotik
*Gangguan gastrointestinal (misalnya [[tukak lambung]], diare, pilorospasme, [[divertikulitis]], [[kolitis ulseratif]], mual, dan muntah)
*Gangguan genitourinari (misalnya sistitis, uretritis, dan [[prostatitis]])
*Insomnia, meski biasanya hanya dalam jangka pendek
*Gangguan pernapasan (misalnya asma, bronkitis kronis, dan [[penyakit paru obstruktif kronik]] [PPOK])
*Sinus bradikardia karena [[saraf vagus]] yang hipersensitif
*Keracunan zat saraf berbasis organofosfat, seperti [[VX (racun saraf)|VX]], [[sarin]], tabun, dan soman ([[atropin]] lebih disukai jika digabungkan dengan oksim, biasanya pralidoksim)<ref>{{Cite web|title=NERVE AGENTS|url=https://fas.org/nuke/guide/usa/doctrine/army/mmcch/NervAgnt.htm#MEDICAL%20MANAGEMENT|access-date=2020-07-27|website=fas.org}}</ref><ref>{{Cite journal|last1=Nair|first1=V. Priya|last2=Hunter|first2=Jennifer M.|date=2004-10-01|title=Anticholinesterases and anticholinergic drugs|url=https://academic.oup.com/bjaed/article/4/5/164/291028|journal=Continuing Education in Anaesthesia, Critical Care & Pain|language=en|volume=4|issue=5|pages=164–168|doi=10.1093/bjaceaccp/mkh045|issn=1743-1816|doi-access=free}}</ref>
Antikolinergik umumnya memiliki efek antisialagogue (menurunkan produksi air liur), dan sebagian besar menghasilkan efek sedasi pada tingkat tertentu, keduanya bermanfaat dalam prosedur pembedahan.<ref>Page 592 in: {{cite book |author1=Cahalan, Michael D. |author2=Barash, Paul G. |author3=Cullen, Bruce F. |author4=Stoelting, Robert K. |title=Clinical Anesthesia |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2009 |isbn=978-0-7817-8763-5 }}</ref><ref>{{cite book|url=https://books.google.com/books?id=-YI9P2DLe9UC|title=Clinical Anesthesia|access-date=8 December 2014|url-status=live|archive-url=https://web.archive.org/web/20170220091947/https://books.google.com/books?id=-YI9P2DLe9UC|archive-date=20 February 2017|isbn=9780781787635|last1=Barash|first1=Paul G.|year=2009|publisher=Lippincott Williams & Wilkins }}</ref>
Hingga awal abad ke-20, obat antikolinergik banyak digunakan untuk mengobati gangguan kejiwaan.<ref>Bangen, Hans: ''Geschichte der medikamentösen Therapie der Schizophrenie''. Berlin 1992, {{ISBN|3-927408-82-4}}</ref>
==Contoh==
{{div col|colwidth=20em}}
* '''Agen Antimuskarinik'''
** [[Antidepresan trisiklik]]
** [[Antipsikotik]] ([[klozapin]], [[kuetiapin]])<ref name=TI113>{{cite web |title=[113] How well do you know your anticholinergic (antimuscarinic) drugs? {{!}} Therapeutics Initiative |url=https://www.ti.ubc.ca/2018/09/10/113-anticholinergic-antimuscarinic-drugs/ |website=Therapeutics Initiative |access-date=20 September 2018 |date=10 September 2018}}</ref>
** [[Atropin]]
** [[Benztropin]]
** [[Biperiden]]
** [[Klorfenamin]]
** [[Difenhidramin]]<ref name=TI113/>
** [[Dimenhidrinat]]<ref name=TI113/>
** Disiklomin ([[Disikloverin]])
** [[Doksepin]]
** [[Doksilamin]]
** [[Flavoksat]]
** [[Glikopironium|Glikopironium/-late]]
** [[Hiosiamin]]
** [[Ipratropium bromida]]
** [[Oksibutinin]]<ref name=TI113/>
** [[Oksitropium bromida|Oksitropium]]
** [[Orfenadrin]]
** [[Prometazin]]
** [[Propantelin bromida]]
** [[Hiosin hidrobromida|Skopolamin]]
** [[Solifenasin]]
** SSRI tertentu ([[Paroksetin]])<ref name=TI113/>
** [[Tolterodin]]
** [[Tiotropium]]
** [[Triheksifenidil]]
** [[Tropikamida]]<ref name="autogenerated1">{{Cite journal | doi = 10.1016/j.genhosppsych.2013.04.013| pmid = 23706777| title = Drops of madness? Recreational misuse of tropicamide collyrium; early warning alerts from Russia and Italy| journal = General Hospital Psychiatry| volume = 35| issue = 5| pages = 571–3| year = 2013| last1 = Bersani | first1 = F. S. | last2 = Corazza | first2 = O. | last3 = Simonato | first3 = P. | last4 = Mylokosta | first4 = A. | last5 = Levari | first5 = E. | last6 = Lovaste | first6 = R. | last7 = Schifano | first7 = F. }}</ref>
** [[Umeklidinium]]
* '''Agen Antinikotinat'''
** [[Bupropion]] – Penghambat ganglion<ref name="pmid24484978">{{cite book |vauthors=Carroll FI, Blough BE, Mascarella SW, Navarro HA, Lukas RJ, Damaj MI |chapter=Bupropion and Bupropion Analogs as Treatments for CNS Disorders |title=Emerging Targets & Therapeutics in the Treatment of Psychostimulant Abuse |volume=69 |pages=177–216 |year=2014 |pmid=24484978 |doi=10.1016/B978-0-12-420118-7.00005-6 |series=Advances in Pharmacology |isbn=9780124201187 }}</ref><ref name="Dwoskin2014">{{cite book | author = Dwoskin, Linda P. | title = Emerging Targets & Therapeutics in the Treatment of Psychostimulant Abuse | url = https://books.google.com/books?id=b3UpAgAAQBAJ&pg=PA177 | date = 29 January 2014 | publisher = Elsevier Science | isbn = 978-0-12-420177-4 | pages = 177–216 | url-status = live | archive-url = https://web.archive.org/web/20170320155042/https://books.google.com/books?id=b3UpAgAAQBAJ&pg=PA177 | archive-date = 20 March 2017 }}</ref><ref name="TasmanKay2011">{{cite book | author1 = Tasman, Allan | author2 = Kay, Jerald | author3 = Lieberman, Jeffrey A. | author4 = First, Michael B. | author5 = Maj, Mario | title = Psychiatry | url = https://books.google.com/books?id=vVG7zz7eaxcC&pg=RA9-PT2900 | date = 11 October 2011 | publisher = John Wiley & Sons | isbn = 978-1-119-96540-4 | url-status = live | archive-url = https://web.archive.org/web/20170320140656/https://books.google.com/books?id=vVG7zz7eaxcC&pg=RA9-PT2900 | archive-date = 20 March 2017 }}</ref>
** [[Dekstrometorfan]] - Penekan batuk dan penghambat ganglion<ref name="pmid15356218">{{cite journal |doi=10.1124/jpet.104.075093 |pmid=15356218 |title=Effect of Dextrometorphan and Dextrorphan on Nicotine and Neuronal Nicotinic Receptors: In Vitro and in Vivo Selectivity |journal=Journal of Pharmacology and Experimental Therapeutics |volume=312 |issue=2 |pages=780–5 |year=2004 |last1=Damaj |first1=M. I. |last2=Flood |first2=P |last3=Ho |first3=K. K. |last4=May |first4=E. L. |last5=Martin |first5=B. R. |s2cid=149958 }}</ref><ref name="pmid16563374">{{cite journal |doi=10.1016/j.ejphar.2006.02.034 |pmid=16563374 |title=Effects of dextrorotatory morphinans on α3β4 nicotinic acetylcholine receptors expressed in Xenopus oocytes |journal=European Journal of Pharmacology |volume=536 |issue=1–2 |pages=85–92 |year=2006 |last1=Lee |first1=Jun-Ho |last2=Shin |first2=Eun-Joo |last3=Jeong |first3=Sang Min |last4=Kim |first4=Jong-Hoon |last5=Lee |first5=Byung-Hwan |last6=Yoon |first6=In-Soo |last7=Lee |first7=Joon-Hee |last8=Choi |first8=Sun-Hye |last9=Lee |first9=Sang-Mok |last10=Lee |first10=Phil Ho |last11=Kim |first11=Hyoung-Chun |last12=Nah |first12=Seung-Yeol }}</ref><ref name="pmid10869398">{{cite journal |pmid=10869398 |url=http://jpet.aspetjournals.org/cgi/pmidlookup?view=long&pmid=10869398 |year=2000 |last1=Hernandez |first1=S. C. |title=Dextromethorphan and Its Metabolite Dextrorphan Block α3β4 Neuronal Nicotinic Receptors |journal=The Journal of Pharmacology and Experimental Therapeutics |volume=293 |issue=3 |pages=962–7 |last2=Bertolino |first2=M |last3=Xiao |first3=Y |last4=Pringle |first4=K. E. |last5=Caruso |first5=F. S. |last6=Kellar |first6=K. J. }}</ref>
** [[Doksakurium]] – Relaksan otot rangka nondepolarisasi
** [[Heksametonium]] – Penghambat ganglion
** [[Mekamilamin]] – Penghambat ganglion dan bantuan [[penghentian merokok]] sesekali<ref>{{cite journal|last=Shytle|first=RD|author2=Penny, E |author3=Silver, AA |author4=Goldman, J |author5= Sanberg, PR |title=Mecamylamine (Inversine): an old antihypertensive with new research directions |journal=Journal of Human Hypertension|date=Jul 2002|volume=16|issue=7|pages=453–7|pmid=12080428 |doi=10.1038/sj.jhh.1001416|doi-access=free}}</ref>
** [[Tubokurarin]] - Relaksan otot rangka nondepolarisasi
{{div col end}}
===Antidot===
Fisostigmin adalah salah satu dari sedikit obat yang dapat digunakan sebagai penangkal keracunan antikolinergik. [[Nikotin]] juga melawan antikolinergik dengan mengaktifkan reseptor asetilkolin nikotinat. [[Kafeina]] (meskipun merupakan [[antagonis reseptor]] [[adenosina]]) dapat melawan gejala antikolinergik dengan mengurangi sedasi dan meningkatkan aktivitas asetilkolin, sehingga menyebabkan kewaspadaan dan gairah.
==Referensi==
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