Chapter 46 - Myasthenia Gravis and Alzheimer's Disease

Question 1

neostigmine (Prostigmin)

Answer 1

Class: Cholinergics

Question 2

neostigmine (Prostigmin) 
MOA:
Uses:
AE:
Contra:
Antidote:

Answer 2

MOA: Allows Ach to accumulate in the synapse; improves skeletal muscle tone and strength
Uses: MG, antidote for tubocurarine and nondepolarizing skeletal muscle relaxants in surgery
AE: Cardiac dysrhythmias, hypotension, syncope, cardiac arrest, cholinergic crisis, increased oral secretions, SOB, respiratory paralysis
Contra: Persons with lung disease, heart disease, CAUTION in those with BPH (benign prostatic hypertrophy –> prostate gland becomes enlarged & causes urinary obstruction)
Antidote: Atropine

Question 3

donepezil (Aricept)

Answer 3

Class: Cholinergics (Reversible Indirect-Acting)

Question 4

donepezil (Aricept)
MOA:
Uses:
AE:
Contra:
Admin:

Answer 4

MOA: Increases Ach in the brain by inhibiting its metabolism (taking away of Ach in synapse) –> slows the neuronal degradation
Uses: AD, enhance memory in MS, MG
AE: Headaches, dizziness, depression, vertigo, insomnia, GI upset; breathing problems, fainting, heart disease, seizures, trouble urinating
Contra: Lung or heart disease
Admin: At bedtime

Question 5

Memantine hydrochloride (Namenda)
MOA:
Use:
Admin:

Answer 5

MOA: Blocks N-methyl-D-aspartate receptor sites and slow Ca accumulation without interfering with glutamate that is required for memory
Use: Alzheimer’s
Admin: Monitor diabetics for hyperglycemia; cannot take with Na Bicarb (increases serum memantine level) –> Too much..SLUD

Question 6

bethanechol chloride (Urecholine)

Answer 6

Class: Cholinergics (Direct-acting)

Question 7

bethanechol chloride (Urecholine)
MOA:
Use:
AE:

Answer 7

MOA: Acts at the cholinergic receptors in urinary and GI tracts to increase muscle tone (detrusor muscle)
Use: Post-op/postpartum treatment of nonobstructed urinary retention and neurogenic atony of bladder muscle
AE: Transient heart block, orthostatic hypotension, cardiac arrest, abdominal discomfort, increased salivation, N/V, fecal incontinence