Anticholinergics Video Pharmacology BUD the wide-eyed tachycardic CAT

In this episode, I go over how you can use BUD, the wide-eyed tachycardia CAT (BUDCAT), to remember the anticholinergics and what that means for pharmacology indications and adverse effects in that drug group.

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Welcome to the Memorizing Pharmacology podcast. I'm Tony Guerra, pharmacist and author of The Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.

Com forward slash P forward slash moving. Let's get started with the show. Okay, today we're going to do anticholinergics and our mnemonic will be Bud the wide-eyed tachycardic cat and I'll explain all of this to you as the issue with anticholinergic and cholinergic is not necessarily getting it, it's remembering all seven or more actually of the adverse effects that you have but if you can get those down then you are in good shape. So first let's talk a little bit about Bud the wide-eyed tachycardic cat so b u d and c-a-t are all going to

Stand for something so it's going to stand for blurry vision urinary retention dry mouth constipation and hydrosis which is no sweating and tachycardia. The problem is we have a b and a t in our mnemonic so we have to use tachycardic to remind us that the T is for tachycardia and the B is FLIR from blurry vision because of dry eyes and then we want to say wide-eyed because madriasis is just not going to work in the mnemonic and finally we're going to put this cat in the desert now he's just on some tan

Carpet so we'll say that that's the desert because anticholinergics are all about dry and when we get to cholinergics you're going to see it's all about wet okay to the mechanism of action anticholinergics inhibit acetylcholine capital a Capital C little h a neurotransmitter the issue we have is that it has two synonyms muscarinic antagonists which we sometimes call anti-muscarinics and parasympatholytics so we want to keep those three straight we want to keep those three together because we're going to have the opposite

Three when we get to cholinergics okay all right so what are the adverse effects what does bud cat stand for so again B for blurry vision that's dry eyes U for urinary retention again dry we're not urinating dry mouth you might sear it as xerostomia constipation if we pull water out of the bowel we're going to plug things up and hydrosis is a lack of sweat and again this is our tachycardic cat so tachycardia and finally madriasis m-y-d-r-a-s-i-s for wide-eyed and it's nice it has the word dry in the middle

To remind you that all of this is very dry so why are we starting with adverse effects instead of indications well you're going to hear all the time that oh that drug has anticholinergic properties watch out for that and what they're saying is that maybe in the elderly something like diphenhydramine or Benadryl you don't want to use because it causes sedation but it also has anticholinergic effects causing many of these problems so the reason we start with adverse effects is because we're now going to go to indications

So how do you take a quotation fingers bad thing and make it good well the blurry vision or dry eyes is one of the many things that happens when somebody has cholinergic crisis from an organophosphate so the pesticides and things like that atropine is the antidote we have urinary retention so if we retain urine that becomes an indication if we're trying to treat over active bladder with oxybutynin tolteridine solofenacine if we have dry mouth or xerostomia okay we might want to reduce salivary secretions and we might use

Glycopyrolate constipation is just a placeholder I don't know why you would want to use this exactly for constipation there are other things you can use anhidrosis okay so atropine okay can help with hyperhidrosis or profuse sweating and the big one because it causes tachycardia it can help someone who is very bradycardic so madriasis wide-eyed might want to dilate the pupils although we don't really use atropine we use something called homotropine we get that it's a Madrid edict which is basically "Something that's going to dilate and make those pupils wide just like our cat. So if you were using atropine IV, you know you would use it for that bradycardia, bronchial secretions or in that cholinergic crisis with the organophosphates. So atropine as the antidote okay, but let's look a little bit more at that OAB and some mnemonics that we can use with some of those drugs themselves.

So a normal bladder, the detruser muscle is contracting when the bladder is full. However, if an overactive bladder, we have the detruser muscle contracting before the bladder is full right. Well what could we do? We've got medications that have an indication for overactive bladder so oxybutynin is Ditropan or Oxytrol and oxybutynin kind of rhymes with keeping here and in tolteridine is detrol which takes the word letters from detruser and control solofenacin or Vesicare is fencing urine in if you're kind of looking at the stem and then physica is Latin for bladder so literally it is vesica care they kind of just squish that word together and then Darth venison is an ablex where you're again fencing the urine in with that stem but you're enabling an exit from the house because many people with overactive bladder really feel uncomfortable going out they are worried that they're going to have an accident and things like that so the nice thing is when we go back to our adverse effects for these four drugs we see that we have our cat back right you might have some blurry vision urinary retention dry mouth constipation and hydrosis tachycardia madriasis but these drugs are getting more specific for that urinary retention so the idea is that maybe some of these side effects would be quite minimized there are some other indications that we have with anticholinergics for example Scopolamine is called transderm scope and often it's used in motion sickness so you put it on for um maybe a cruise or something like that where maybe it's something that that really bothers you but what would we really expect with side effects we'll get to that in a second and then ifritropium bromide or atrovent this is something that uh bronchodilates but really relaxes the smooth muscle of the lungs and when we go back to adverse effects sure enough who's there well it's bud so we might get blurry vision urinary retention dry mouth constipation and hydrosis and tachycardia so again the thing with anticholinergics is you know getting down that okay here are the medications we've got atropine we've got these glycopyrolate we've got these drugs for overactive bladder Scopolamine for that motion sickness and we've also got the you know generic atrovent or which is a neb um which is ipritropium and the idea is that okay we've got all of those but we already know what they're going to do because we've got the adverse effects down for anticholinergic in the next section we'll go over cholinergics disclaimer as always the information is provided for you for informational purposes only it's not intended to provide should not be relied upon for medical or any other advice consult with a medical professional if you have a medical condition thanks for listening to the memorizing pharmacology podcast you can find episodes cheat sheets and more at memorizingfarm.com again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile thanks again for listening.

Like to learn more?

Find my book here: https://geni.us/iA22iZ

or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

and subscribe to YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

Here is the Link to my Pharmacy Residency Courses: residency.teachable.com