Which topical Cholinergic Antagonist is most likely to penetrate the blood-brain barrier?

Prepare for the NBEO Ocular Pharmacology Exam with our quiz. Test your knowledge and enhance your learning with multiple choice questions, flashcards, hints, and detailed explanations. Ensure your success!

Scopolamine is the most likely topical cholinergic antagonist to penetrate the blood-brain barrier due to its chemical structure and lipophilicity. Scopolamine is a tertiary amine, which allows it to readily cross lipid membranes, including the blood-brain barrier. This property gives scopolamine significant central nervous system (CNS) effects, such as sedation and the ability to alleviate motion sickness.

In contrast, the other options are quaternary amines or have less lipophilic properties, limiting their ability to cross the blood-brain barrier effectively. Atropine, while it can have some CNS effects, is less effective in penetrating the barrier compared to scopolamine. Cyclopentolate and homatropine are more clinically used for their local effects in ophthalmology and have minimal CNS penetration due to their structure, resulting in less impact on the central nervous system. Thus, scopolamine stands out as the most suitable choice for significant CNS involvement among the listed agents.

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