ch 13 Flashcards
name the 6 categories of cholinergic drugs
- muscarinic agonists
- muscarinic antagonists
- cholinesterase inhibitors
- ganglionic stimulating agents
- ganglionic blocking agents
- neuromuscular blocking agents
what do muscarinic agonists do
mimic the effects of acetylcholine at muscarinic receptors (bind to muscarinic receptors thereby causing receptor activation)
what do cholinesterase inhibitors doe
prevent the breakdown of acetylcholine by acetylcholinesterase
This results in more acetylcholine AV to activate cholinergic receptors
what do ganglionic stimulating agents do
selectively mimic the effects of acetylcholine at nicotinicN receptors of autonomic ganglia
what do ganglionic blocking agents do
selectively block ganglionic nicotinicN (neuronal) receptors
what do neuromuscular blocking agents due
selectively block the effects of acetylcholine at nicotinicM (muscle) receptors at the neuromuscular junction (NMJ)
What other term are muscarinic agonists known by
parasympathomimetic agents
What type of agent is Bethanechol
muscarinic agonists
What drug treats nonobstructive urinary retention
Bethanechol
What data and monitoring should be done with Bethanechol
Gather vitals and urination trends
- Monitor I/O, signs of excessive muscarinic response (abnormal salivation, sweating , urinary urgency, bradycardia and hypotension)
Who is bethanechol contraindicated for
Patients with : Peptic Ulcer Disease Urinary tract obstruction intestinal obstruction coronary insufficiency hypotension asthma hyperthyroidism
What are the therapeutic goals of Bethanechol
absence of bladder distention or suprpubic discomfort
adequate urinary output
Education for pt taking bethanechol
take on empty stomach to reduce n/v
MD may need to treat excessive muscarinic stimulation with atropine/supportive measures
What effect does activation of muscarinic receptors in the eye have
- miosis (pupillary constriction)
2. contraction the ciliary muscle resulting in accommodation for near vision
How long for effect of bethanechol
30-60 minutes and persist for 1 hour
What is off label use of bethanechol
GERD
Ileus
Examples of what can be treated by muscarinic agonists
Dry mouth
glaucoma
What do reversible cholinesterase inhibitors treat
MG alzheimer disease Parkinson disease dementia poisoning by muscarinic antagonists reversal of NMB
Why is the use of cholinesterase inhibitors limited
because they lack selectivity
What do irreversible cholinesterase inhibitors treat
glaucoma
what are the two types of cholinesterase inhibitors
reversible
irreversible
