Chapter 16: Cholinergic Agonists and Antagonists Flashcards
Neurotransmitter that innervates the muscle in Parasympathetic NS is?
Acetylcholine
Drugs that stimulate the Parasympathetic NS
Cholinergic agonists
Parasympathomimetics
What enzyme inactivates acetylcholine?
Acetylcholinesterase
Two types of cholinergic receptors
Muscarinic - stimulates smooth muscle and slow heart rate
Nicotinic - affects skeletal muscles
Bethanechol chloride
Direct-acting cholinergic agonist
For urinary retention and neurogenic bladder
What are the major responses of cholinergic agonists?
Drug class Bethanechol chloride
Cholinergic Parasympathomimetic
ROA and Contraindications of Bethanechol chloride
PO and SUBQ
Intestinal or urinary tract obstruction
IBS
Bradycardia
Hypotension
Asthma
Peptic Ulcer
Hyperthyroidism
Seizures
Parkinsonism
Caution:
COPD in Older Adults
Drug and Lab interaction of Bethanechol chlorid
Drug:
Decreased effect with antidysrhythmic (procainamide)
Atropine, flavoxate and opiates counteract bethanechol action
Increased AST, bilirubin, amylase and lipase
Bethanechol chloride side effects and adverse reactions
SE:
Nausea, vomiting, headache, dizziness
Abdominal cramps and diarrhea
hypersalivation and diaphoresis, flushing
urinary urgency and frequency
Miosis (small pupil) and lacrimation
AE:
Tachycardia
Hypotension
When is the best time to take Bethanechol to minimize nausea and vomiting?
1-2 hrs before meals on an empty stomach
Pilocarpine
Direct acting cholinergic agonist
Constricts pupils of the eyes
Used to treat glaucoma
Primary use of reversible cholinesterase inhibitors
Treatment for Myasthenia Gravis and Alzheimer Disease
Primary use of irreversible cholinesterase inhibitors
Treat Glaucoma
Drugs to increase muscular strength in myasthenia gravis (short, moderate and long acting)
Neostigmine - short
Pyridostigmine bromide - moderate
Ambenonium - long
