Chapter 19

Question 1

CARDIOVASCULAR effects of cholinergic agonists

Answer 1

decreases heart rate, lowers BP bc of vasodilation, slows conduction of AV node

Question 2

gastrointestinal effects of cholinergic agonists

Answer 2

increases tone and motility of smooth muscle of stomach and intestine. increases peristalsis and relaxes sphincter muscles

Question 3

genitourinary effects of cholinergic

Answer 3

contracts muscles of the urinary bladder, increases tone of ureters, relaxes bladder’s sphincter muscles

Question 4

ocular effects of cholinergic agonists

Answer 4

increases pupillary constriction, increases accomodation (flattening or thickening of eye lens for distant and near vision

Question 5

glandular effects of cholinergic agonists

Answer 5

increases salivation, perspiration and tears

Question 6

bronchial effects of cholinergic agonists

Answer 6

stimulates bronchial smooth muscle contractions and increases bronchial secretions

Question 7

striated muscle cholinergic agonists do what?

increases ___ ____ and maintains _____ _____ and _______

Answer 7

increases neuromuscular transmission and maintains muscle strength and tone

Question 8

muscarinic receptors sitmulate what?

Answer 8

stimulates smooth muscle and slows heart rate

Question 9

nicotinic receptors (neuromuscular) affect what?

Answer 9

affect skeletal muscles

Question 10

indirect acting cholinergic agonists inhibit what?

Answer 10

inhibit the action of the enzyme cholinesterase (acetylcholinesterase) by forming a chemical complex, thus permitting acetylcholine to persist and attach to the receptor

Question 11

BETHANECHOL CHLORIDE
DRUG CLASS:
THER. EFFECT:
MOA:
CONTRA:
SIDE EFFECTS

Answer 11

BETHANECHOL CHLORIDE
DRUG CLASS: muscarinic/cholinergic
THER. EFFECT: to treat urinary retention
MOA: stimulates the muscarinic receptors, promotes contraction of bladder, increases GI secretions and peristalsis, pupillary constriction and bronchoconstriction
CONTRA: intestinal or urinary tract obstruction, severe bradycardia, hypotension, COPD, asthma, peptic ulser, parkinosnism
SIDE EFFECTS: frequent urination , misosis, cramps, blurred vision, orthostatic hypotension, bradycardia

Question 12

Tolterodine Tartrate
DRUG CLASS:
THER. EFFECT:
MOA:
CONTRA:
SIDE EFFECTS

Answer 12

DRUG CLASS: antimuscarinic; anticholinergic
THER. EFFECT: to decrease urinary frequency, incontinence, urgency
MOA: blocks cholinergic (muscarinic) receptors selectively in urinary bladder
CONTRA: controlled narrow angle glaucoma, cardiovascular disease, urinary bladder outflow obstruction, pyloric stenosis, or other obstructive GI disorders, renal or hepatic dysfunction
ADVERSE reactions: bronchitis, visual abnormalities, chest pain, hypertension

Question 13

atropine
DRUG CLASS:
THER. EFFECT:
MOA:
CONTRA:
SIDE EFFECTS

Answer 13

DRUG CLASS
anticholinergic/antimuscarinic (bc it blocks the muscarinic effects of acetylcholine)
THER. EFFECT: preoperative medicine to reduce salivation, to increase heart rate for bradycardia, dilates pupiles for ocular diagnostic exam
MOA: inhibits acetylcholine by occupying the receptors
CONTRA: narrow angle glaucoma, obstrucitive GI disorders, paralytic ileus, ulcerative colitis, tachycardia, benign prostate hypertrophy, myasthenia gravis, myocardial ischemia, hypersensitivty
SIDE EFFECTS: tachycardia, hypotension are adverse reactions.

Question 14

cholinergic overdose is treated by

Answer 14

atropine sulfate is the antidote

Question 15

cholinesterase inhibitors binds with ??
allowing ______ to do what?
permitting?
which increases?

Answer 15

this type of drug binds with cholinesterase, allowing acetylcholine to activate the muscarinic and nicotinic cholinergic receptors, permitting skeletal muscle stimulation, which increases the force of musuclar contraction

Question 16

reversible cholinesterase inhibitors are useful to do what?

they are contraindicated by…

Answer 16

increase muscle tone for patients with myasthenia gravis (a neuromuscular disorder) 2 to produce pupillary constriction in the treatment of glaucoma

contraindicated by: patients with intestinal or urinary obstructions

Question 17

irreversible cholinesterase inhibitors
long lasting or short lasting?
used to produce what?

Answer 17

are potent agents bc of their long lasting effect. it is used to produce pupillary constriction

Question 18

AC cardio effects

Answer 18

increases heart rate with large doses, small doses can decrease heart rate

Question 19

AC gi effects

Answer 19

relaxes smooth muscles of GI tract, decreases GI motility and peristalsis

Question 20

urinary tract AC effects

Answer 20

relaxes bladder detrusor muscle and increases constriction of internal sphincter. urinary retention can result

Question 21

AC ocular effects

Answer 21

dilates pupils (mydriasis) and paralyzes ciliary muscle , causing a decrease in accomodation

Question 22

AC glandular effects

Answer 22

decreases salivation, perspiration, bronchial secretions

Question 23

AC bronchial effects

Answer 23

dilates bronchials, decreases bronchial secretions

Question 24

AC CNS effects

Answer 24

decreases tremors and rigidity of muscles. drowsiness, disorientation, and hallucinations can result from large doses

Question 25

benztropine
DRUG CLASS:
THER. EFFECT:
MOA:
CONTRA:
SIDE EFFECTS

Answer 25

Benztropine
DRUG CLASS: anticholinergic
THER. EFFECT: decreases involuntary symptoms of parkinsonism or drug induced parkinsonism
MOA: blocks cholinergic (muscarinic) receptors, thus decreasing acetylcholine to reduce excess cholinergic activity (involuntary movements). blocks dopamine reputake to prolong dopamine effects and decrease involuntary movement
CONTRA: closed-angle glaucoma, dementia, myasthenis gravis, tardive dyskinesia, psychosis
SIDE EFFECTS/ adverse effects: tachycardia, palpitations, urinary retention, anhidrosis (decreased sweating), hyperthermia

Question 26

epi overdose is treated by ____ which causes _____

Answer 26

phentolamine mesylate , causes vasodilation