Chap 20 Cholinergic Drugs

Question 1

Cholinergic Drugs: 
Mechanism of Action and Drug Effects

Answer 1

Mechanism
Mimic the effects of acetylcholine*

Drug Effects
Increased gastric secretions*
Increased gastrointestinal motility*
Increased urinary frequency*

Constriction (miosis)
Reduced intraocular pressure*

Increased salivation and sweating*

Question 2

Cholinergic Drugs: Indications

Answer 2

Reduce intraocular pressure

Useful for glaucoma* and intraocular surgery*

Increases* tone* and motility* of bladder and gastrointestinal (GI) tract

Relaxes sphincters* in bladder* and GI tract, allowing them to empty

Helpful for postsurgical* atony of the bladder and GI tract

Used to treat excessively dry mouth (xerostomia) resulting from a disorder known as Sjögren’s syndrome

Used as a neuromuscular* blocker* in general anesthesia *

Indirect-acting anticholinesterase drugs
Used for treatment of mild to *moderate Alzheimer’s *disease

Question 3

Cholinergic Crisis Toxicity and Management

Answer 3

SLUDGE, which stands for
Salivation,
Lacrimation,
Urinary incontinence,
Diarrhea,
GI cramps, and
Emesis

Question 4

Bethanechol (Urecholine)

Answer 4

Uses: treatment of acute postoperative* and postpartum* nonobstructive urinary* retention*

Question 5

Donepezil (Aricept)

Answer 5

works centrally in the brain to increase* levels of ACh* by inhibiting acetylcholinesterase

Used in the treatment* of mild to moderate Alzheimer’s* disease*

Question 6

Memantine (Namenda)

Answer 6

NMDA receptor agonist

Used for treatment of Alzheimer’s disease

Question 7

Pyridostigmine (Mestinon)

Answer 7

Pyridostigmine (Mestinon)

Question 8

Neostigmine, Pyridostigmine, and Physostigmine

Answer 8

treating* severe* overdoses* of tricyclic* antidepressants;* and antidote* after toxic exposure to nondrug anticholinergic* agents*,

Question 9

Cholinergic Drugs:
Nursing Implications/ Antidote

Answer 9

with myasthenia gravis to take* medication 30* minutes* before* eating* to help* improve* chewing* and swallowing.*

patients* urinary retention* or hypotonic bladder, urination* should occur within 60* minutes of bethanechol administration.

patients* with Alzheimer’s* disease:
Improvement* in symptoms*
Improvement* in mood* and
decrease* in confusion*

for Alzheimer’s disease, be honest* with caregivers and patients that the drugs* are for management* of symptoms (not a cure).

Atropine* is the antidote* for cholinergics*