ch 13 Flashcards

1
Q

name the 6 categories of cholinergic drugs

A
  1. muscarinic agonists
  2. muscarinic antagonists
  3. cholinesterase inhibitors
  4. ganglionic stimulating agents
  5. ganglionic blocking agents
  6. neuromuscular blocking agents
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2
Q

what do muscarinic agonists do

A

mimic the effects of acetylcholine at muscarinic receptors (bind to muscarinic receptors thereby causing receptor activation)

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3
Q

what do cholinesterase inhibitors doe

A

prevent the breakdown of acetylcholine by acetylcholinesterase
This results in more acetylcholine AV to activate cholinergic receptors

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4
Q

what do ganglionic stimulating agents do

A

selectively mimic the effects of acetylcholine at nicotinicN receptors of autonomic ganglia

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5
Q

what do ganglionic blocking agents do

A

selectively block ganglionic nicotinicN (neuronal) receptors

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6
Q

what do neuromuscular blocking agents due

A

selectively block the effects of acetylcholine at nicotinicM (muscle) receptors at the neuromuscular junction (NMJ)

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7
Q

What other term are muscarinic agonists known by

A

parasympathomimetic agents

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8
Q

What type of agent is Bethanechol

A

muscarinic agonists

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9
Q

What drug treats nonobstructive urinary retention

A

Bethanechol

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10
Q

What data and monitoring should be done with Bethanechol

A

Gather vitals and urination trends
- Monitor I/O, signs of excessive muscarinic response (abnormal salivation, sweating , urinary urgency, bradycardia and hypotension)

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11
Q

Who is bethanechol contraindicated for

A
Patients with :
Peptic Ulcer Disease
Urinary tract obstruction
intestinal obstruction
coronary insufficiency 
hypotension
asthma 
hyperthyroidism
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12
Q

What are the therapeutic goals of Bethanechol

A

absence of bladder distention or suprpubic discomfort

adequate urinary output

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13
Q

Education for pt taking bethanechol

A

take on empty stomach to reduce n/v

MD may need to treat excessive muscarinic stimulation with atropine/supportive measures

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14
Q

What effect does activation of muscarinic receptors in the eye have

A
  1. miosis (pupillary constriction)

2. contraction the ciliary muscle resulting in accommodation for near vision

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15
Q

How long for effect of bethanechol

A

30-60 minutes and persist for 1 hour

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16
Q

What is off label use of bethanechol

A

GERD

Ileus

17
Q

Examples of what can be treated by muscarinic agonists

A

Dry mouth

glaucoma

18
Q

What do reversible cholinesterase inhibitors treat

A
MG
alzheimer disease
Parkinson disease dementia
poisoning by muscarinic antagonists 
reversal of NMB
19
Q

Why is the use of cholinesterase inhibitors limited

A

because they lack selectivity

20
Q

What do irreversible cholinesterase inhibitors treat

A

glaucoma

21
Q

what are the two types of cholinesterase inhibitors

A

reversible

irreversible