Chapter 21

Question 1

Cholinergic-Blocking Drugs

Answer 1

Drugs that block or inhibit the actions of acetylcholine (ACh) in the parasympathetic nervous system (PSNS)

Question 2

What are cholinergic-blocking drugs also known as?

Answer 2

-anticholinergics, parasympathetics, and antimuscarinic drugs

Question 3

Drugs to know

Answer 3

1. atropine
2. oxybutynin (Ditropan)
3. scopolamine (Transderm-Scōp)

Question 4

Page 334 and page 335

Answer 4

have good information on important drugs

Question 5

Effect on eye

Answer 5

Dilated pupils (mydriasis)
Decreased accommodation caused by paralysis of ciliary muscles (cycloplegia)

Question 6

Effect on Gastrointestinal

Answer 6

• Relax smooth muscle tone of GI tract (i.e. used for IBS)
• Decrease intestinal and gastric secretions
• Decrease motility and peristalsis

Question 7

Effect on Genitourinary (GU)

Answer 7

Relaxed detrusor muscle
Increased constriction of internal sphincter
Result: urinary retention (use these for overactive bladder treatment)

Question 8

Effect on Glandular

Answer 8

Decreased bronchial secretions, salivation, sweating

Question 9

Effect on respiratory

Answer 9

Decreased bronchial secretions

Dilated bronchial airways

Question 10

Benztropine (Cogentin)

Answer 10

used in the treatment of parkinson’s

-decreases muscle rigidity and muscle tremors

Question 11

Atropine

Answer 11

only give IV push 1 mg for symptomatic bradycardia

other uses: bradycardia, ventricular asystole, antidote for anticholinesterase inhibitor toxicity or poisoning, and preoperatively to reduce salivation and GI secretions

Question 12

Contraindications

Answer 12

1. Known drug allergy
2. Angle-closure glaucoma
3. Acute asthma or other respiratory distress
4. Myasthenia gravis
5. Acute cardiovascular instability
6. GI or GU tract obstruction (e.g., benign prostatic hyperplasia [BPH])

Question 13

Antidote for overdose anticholinergic

Answer 13

Physostigmine (can give this via IV)

Question 14

Oxybutynin (Ditropan) uses

Answer 14

overactive bladder and antispasmodic for neurogenic bladder associated with spinal cord injuries and congenital conditions such as spina bifida

Question 15

Scopolamine

Answer 15

treats motion sickness; prevention of motion sickness and to help prevent postoperative, postanesthesia nausea and vomiting
-given as a round bandaid/patch, don’t need prescription

Question 16

What do patient complain about when on anticholinergics?

Answer 16

dry mouth; can be handled with chewing gum, frequent mouth care, and hard candy

Question 17

Anticholinergics taken by older adult patients may lead to higher risk for _____ because of the effects on heat-regulating mechanisms.

Answer 17

heatstroke