Term
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Definition
also known as cholinergic agonists or parasypathomimetics
Mimic effects of PSNS neurotransmitter acetylcholine (ACh) |
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Term
| Direct-acting cholinergic agonists - moa |
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Definition
| bind to cholinergic receptors, activating them |
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Term
| Indirect-acting cholinergic agonists -moa |
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Definition
| inhibit the enzyme acetylcholinesterase, which breaks down ACh and results in more ACh available at the receptors |
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Term
| Drug effects: SLUDGE acronym |
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Definition
Salivation
Lacrimation
Urinary incontinence
Diarrhea
Gastrointestinal cramps
Emesis |
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Term
| Drug Effects - Stimulation |
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Definition
Stimulate intestine and bladder
1. increased gastric secretions
2. increased gastrointestinal motility
3. increased urinary frequency
Stimulate pupils
1. constriction (miosis)
2. reduced intraocular pressure
Increased salivation and sweating |
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Term
| Drug effects - cardiovascular and respiratory |
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Definition
Cardiovascular effects
1. decreased heart rate
2. vasodilation
Respiratory effects
1. Bronchial constriction, narrowed airways |
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Term
| Drug effects muscarinic vs nicotinic |
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Definition
1. at recommended doses affect muscarinic receptors - desired effects
2. at high doses stimulate nicotinic receptors - many undesired effects |
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Term
| Direct Acting Drugs - indications |
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Definition
1. reduce intraocular pressure
2. useful for glaucoma and intraocular surgery
a. acetylcholine
b. carbachol
c. pilocarpine
3. topical application b/c of poor oral absorption |
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Term
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Definition
1. direct-acting drug
2. increases tone and motility of bladder and GI tract
3. relaxes sphincters in bladder and GI tract, allowing them to empty
4. helpful for postsurgical atony of the bladder and GI tract; used for trreatment of acute postoperative and post partum nonobstructive urinary retention and for management of urinary retention assoc w/ neurogenic atony of the bladder; also prevent and treat bladder dysfunction induced by phenothiazine and tricyclic antidepressants
5. oral dose or SC injection
6. also used for postoperative GI atony and gastric retention, chronic refractory heartburn, diagnostic testing for infantile cystic fibrosis
7.Contraindicated in hyperthyroidism, peptic ulcer, active bronchial asthma, cardiac disease or coronary artery disease, epilepsy, and Parkinsonism.
8. Adverse effects include syncope, hypotension with reflex tachycardia, headache, seizure, GI upset, and asthmatic attacks
9. Interacts with indirect acting cholinergics |
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Term
| Indirect Acting Drugs - Indications |
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Definition
1. cause muscle contractions
2. used for diagnosis and treatment of myasthenia gravis
3. used to reverse neuromuscular blocking drugs
4. used to reverse anticholinergic poisoning (antidote)
5. Examples of drugs: phyosostigmine, pyridostigmine
6. used to treat alzheimers |
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Term
| A pt with myashenia gravis calls the office to say that her new medication does not help as promised when she eats. She says she takes it with meals but it does not help. How should the nurse advise this pt? |
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Definition
| The pt should take the med. 30 minutes before meals so that the drug begins to work before the pt chews and swallows. This will help strengthen the muscles for chewing and eating |
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Term
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Definition
1. works centrally in brain to increase levels of acetycholine by inhibiting acetycholineterase
2. treats mild to moderate alzheimers
3. adverse effects mild and resolve on their own: GI distress, drowsiness, dizziness, insomnia, muscle cramps
4. effects on cardiovascular system: bradycardia, syncope,hypotension with reflex tachycardia, hypertension
5. interacting drugs: anticholinergics (counteract donepezil), nonsteroidal antiinflammatory drugs |
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Term
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Definition
1. NOT a cholinergic drug, but included here in discussion of drugs for Alzheimers dementia
2. Classified as an NMDA receptor agonist
3.stimulation of these receptors believed to be part of Alzheimer's process
4. effects temporary but may add to quality of life
5. adverse effects uncommon, may include hypotension, headache, GI upset, musculoskeletal pain, dyspnea, ataxia, and fatigue |
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Term
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Definition
1. synthetic quaternary ammonium compound similar to drugs in this class
2. indirect-acting
3. improves muscle strength
4. used to relieve myasthenia gravis
5.treatment of severe overdoses of tricyclic antidepressants
6. contraindicated in gangrene, asthma, hyperthyroidism, cardiovascular disease, mechanical obstruction of the GI or GU tracts |
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Term
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Definition
1. indirect acting drug
2. used to treat xerostomia (dry mouth) resulting from Sjorgren's syndrome |
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Term
| Indirect acting drug list used for treatment of mild to moderate Alzheimer's |
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Definition
1. donepezil
2. tacrine
3. galantamine
4. rivastigmine |
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Term
| A pt has been taking an anti-Alzheimer's drug for 3 weeks. He seems to be walking with a more unsteady gait and almost falls when he stands up. When asks if he feels okay he says he's fine. What should the nurse assess? |
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Definition
| The pt may be experiencing adverse effects such as hypotension, bradycardia, and dizziness. Assess blood pressure and pulse for orthostatic changes |
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Term
| A pt is experiencing urinary retention after abdominal surgery, and Dr. has prescribed bethanechol. Pt has long history of smoking (1 pack/day) and has a nonproductive cough. Are there any concerns about this new medication? |
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Definition
| Bethanechol is contraindicated in active bronchial asthma, which may be present due to the pt's long history of smoking. The nurse should thoroughly assess his respiratory status |
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Term
| Antidote for cholinergics |
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Definition
| Atropine - should be available in pt's room for immediate use if needed |
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Term
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Definition
| they experience muscle weakness, abdominal cramps, diarrhea, or difficulty breathing |
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Term
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Definition
1. alleviated signs and symptoms of myasthenia gravis
2. in postoperative pts with decreased GI peristalis monitor for:
a. increased bowel sounds
b. passage of flatus
c. occurrence of BMs
3. in pts with urinary retention/hypotonic bladder, urination should occur within 60 minutes of bethanechol administration |
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Term
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Definition
| Using an antihistamine with a cholinergic drug may reduce effectiveness of the drug. do not use NSAIDs because both increase risk of gastric ulcers |
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Term
| I am an indirect-acting cholinergic drug used to diagnose, but not treat, myasthenia gravis. What drug am I? |
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Definition
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Term
| I am used to treat acute postoperative and postpartum nonobstructive urinary retention. What drug am I? |
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Definition
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Term
| I am used to treat the symptoms of myasthenia gravis. I can also be used to treat severe tricyclic antidepressant overdose and to reverse the effects of nondepolarizing neuromuscular blocking drugs. What drug am I? |
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Definition
| Physostigmine (Antilirium) |
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Term
| I am not a cholinergic drug, but I also help to reduce the degenerative cognitive symptoms of Alzheimer's disease. My effects are likely to be temporary. What drug am I? |
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Definition
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Term
| I am given once a day and I work as an indirect-acting anticholinesterase drug to increase the levels of ACh in the brain by blocking the breakdown of ACh. I am used in the treatment of mild to moderate Alzheimer's disease. What drug am I? |
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Definition
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