Ch 13 Chronic Neurological Disorders

Question 1

What are the 2 categories of cholinesterase inhibitors

Answer 1

1. ) reversible inhibitors - the effect is for a moderate duration used to treat myasthenia graves, AD, PD
2. ) irreversible inhibitors, echothiophate ( Phospholine Iodide)- the effect is for a long duration used to treat glaucoma.

Question 2

What is used to reverse the effect of echothiophate

Answer 2

Pralidoxime (2 Pam)

Question 3

What are adverse effects of cholinesterase inhibitors

Answer 3

Excessive muscarine stimulation as evidenced by increased GI motility, increased GI secretions, bradycardia, and urinary urgency. ( adverse effects may be treated with atropine)

Cholinergic crisis (excessive muscarinic stimulation and respiratory depression from neuromuscular blockade. Can be treated with atropine.

Question 4

What are contraindications and precautions of cholinesterase inhibitors

Answer 4

Pregnancy category C
Obstruction of GI and renal system use cautiously in pt.s with seizure disorders, hyperthyroidism, peptic ulcer disease. Asthma, bradycardia, and hypotension.

Question 5

What are medication/ food interactions of cholinesterase inhibitors

Answer 5

Atropine ( Atropair) counteracts the effects of neostigmine.

Neostigmine reverses neuromuscular blockade caused by neuromuscular blocking agents after surgical procedures and overdose.

Succinylcholine, a depolarizing short acting neuromuscular blockade for surgical procedures.

Question 6

What is atropine used for?

Answer 6

Atropine is used to treat neostigmine toxicity( ^ muscarinic stimulation and respiratory depression.
Monitor the client closely and provide mechanical ventilation until the client has regained full muscle function.

Question 7

Nursing considerations of cholinesterase inhibitors

Answer 7

Neostigmine may be given PO, IM,IV or SC
educate clients who have myasthenia gravis to take oral meds at the same time everyday to prevent weakness of respiratory and swallowing muscles.

Question 8

Name cholinesterase inhibitors

Answer 8

Prototype: neostigmine ( Prostigmin)
ambenonium( Mytelase)
pyridostigmine ( Mestinon)
edrophonium ( Tensilon)

Question 9

Cholinesterase inhibitors

Answer 9

Cholinesterase inhibitors are known as anticholinesterase agents and have 2 categories.