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Exam 2 Pharmacology > Chapter 21 Cholinergic-blocking drugs > Flashcards

Chapter 21 Cholinergic-blocking drugs Flashcards

1
Q

By blocking the Cholinergic drugs, we are essentially having what type of effects

A 
sympathetic effects
(blocking ACh from binding and having it's cholinergic effects, allows the sympathetic NS to dominate)
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2
Q

Give two other names for Cholinergic blockers

A
  • anticholinergics

* parasympatholytics

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3
Q

What do cholinergic blockers do?

A

block the actions of acetylcholine at the muscarinic receptor in the PSNS

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4
Q

What happens to ACh when it is released from the stimulated site but then cannot attach to the muscarinic receptor site due to the cholinergic blocker drug?

A

it will not bind and therefore fails to have it’s cholinergic effect

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5
Q

Cholinergic blockers are competitive antagonists, what are they competing with?

A

ACh

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6
Q

Once chilinergic-blockers bind to receptors, what do they inhibit at these receptors?

A

nerve transmission

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7
Q

What do cholinergic blockers block, at which specific receptors, in which specific nervous system?
(answer all three questions)

A
  • block ACh
  • at muscarinic receptors
  • in PSNS
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8
Q

Is the preganglionic fiber short or long?

Is the postganglionic fiber short or long?

A
  • pre= long

* post= short

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9
Q

Where is the nicotinic receptor found?

A

Ganglion

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10
Q

At which type of receptor site do cholinergic-blockers have little effect on?
(only in high doses they have partial blocking effects)

A

Nicotinic receptors

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11
Q

Where does the cholinergic -blockers binding to receptors occur mainly?

A

neuroeffector junction, or where the nerve ending reaches effector organs such as smooth muscle, cardiac muscle and glands

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12
Q

What are the drug effects for cholinergic-blockers on the CNS?
small dose: ?
large dose: ?

A

small dose: decrease muscle rigidity and tremors

Large dose: drowsiness, disorientation, hallucinations

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13
Q

What are the drug effects for cholinergic-blockers on the Cardiovascular?
small dose: ?
large dose: ?

A

small dose: decrease heart rate

large dose: increase heart rate

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14
Q

What are the drug effects for cholinergic-blockers on the Respiratory?

A

decreased bronchial secretions

dilated bronchial airways

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15
Q

Since these drugs have little effect at nicotinic receptors, the majority of the site of action takes place at the

A 
heart
respiratory tract
GI tract
Bladder
eye 
exocrine glands
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16
Q

These drugs have the opposite effect of cholinergic drugs (ex: so there is blockade of ACh)
true or false?

A

true

17
Q

List this drugs effects on the eye

A
  • Dilated pupils (mydriasis)

* decreased accommodation caused by paralysis of ciliary muscles (cycloplegia)

18
Q

List the drug effects on the GI

A
  • relax smooth muscle tone of GI tract
  • decrease intestinal and gastric secretions
  • decrease motility and peristalsis
19
Q

List the drug effects on the genitourinary

bladder

A
  • relaxed detrusor muscle
  • increased constriction of internal sphincter
  • result: urinary retention
20
Q

drug effects on glandular?

A

decreased bronchial secretions, salivation, sweating

21
Q

What are the indications for the CNS?
(cholinergic blockers)
(on test)

A

decreased muscle rigidity and muscle tremors

  • Parkinson’s Disease
  • Drug-induced extrapyramidal reactions
22
Q

Why do we use these drugs for the cardiovascular system (indications) ?
low dose effect: ?
high dose effect: ?

A

they can effect the heart’s conduction system
lose dose: slow the HR
high dose: Block inhibitory vagal effects on SA and AV node pacemaker cells (because vagal effect normally reduces HR)
* results in increased (+) HR

23
Q

What is Atropine primarily used for?

A

CV disorders (normally used when patient is coding (Cardiac Arrest)

24
Q

What are the results to be expected from this drug when used for Respiratory?

A
  • decreased secretion from nose, mouth, pharynx, bronchi
  • relaxed smooth muscle in bronchi/bronchioles
  • decreased airway resistance
  • Bronchodilation
25
Q

Name for things that cholinergic blockers are used to treat

A
  • exercise induced bronchospasms
  • Chronic bronchitis
  • Asthma
  • COPD
26
Q

Blocking the Cholinergic stimulation of the PSNS allows for unopposed action of the ___

A

SNS (sympathetic NS)

27
Q

When Cholinergics are working on the GI system, rest and digest is happening so there are secretions, contractions in smooth muscle, GI motility and peristalsis. So when a cholinergic-blocker does its job and blocks cholinergic effect, what happens to the GI?

A

the opposite
decrease secretions
relaxation of smooth muscle
decreased GI motility and peristalsis

28
Q

Name two issues that cholinergic-blockers are used to treat

A
  • IBS (irritable bowel syndrome)

* GI hypersecretory states

29
Q

If cholinergic-blocker drugs interact with antihistamines, phenothiazines, tricyclic antidepressants, or MAOIs, what is the outcome?

A

it increases the cholinergic effect (does the opposite of what they are meant for)

30
Q

Nursing Implications for cholinergic-blockers. What do we need to know about patient

A

assess for

  • allergies
  • presence of BPH
  • glaucoma
  • tachycardia
  • MI, HF, Hiatal hernia
  • GI or GU obstruction
  • baseline assess/ Vital signs
31
Q

When giving opthalmic solutions, what should you do to prevent systemic absorption?

A

apply pressure to inner canthus

32
Q

What is the antidote from Atropine overdose?

A

physostigmine

33
Q

Anticholinergics taken by edlerly patients may increase risk for what?

A 
heat stroke
(emphasis importance of adequate fluid and salt intake)
34
Q

therapeutic effects for patients with Parkinson’s?

A
  • fewer tremors

* decreased salivation and drooling

35
Q

therapeutic effects for patients with urologic problems?

A
  • improved urinary patterns
  • less hypermotility
  • increased time between voiding

Exam 2 Pharmacology (5 decks)

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