Cholinergic Flashcards
Direct acting cholinergic agonists initiate a ______ kind of response.
tissue
for example: used to treat urinary retention, glaucoma, gastroparesis.
indirect acting is a _______esterase inhibitor
and acts on an ______ level.
cholinesterase, enzyme.
cholinesterase inhibitors cause more ____ to be available at the receptors.
Ach
cholinergic drugs will stimulate intestine and bladder in:
_____ gastric secretions
_____ gastric motility
_____ urinary frequency
increasing, increasing, increasing.
cardiovascular effects of cholinergic drugs are seen in:
_______ HR
vaso______
increased, vasodilation (this is a PNS response)
pupils will be stimulated to do what in cholinergic drugs?
_____ intraocular pressure
constrict (miosis)
decreased
_________salivation and sweating.
increased
bronchial ________ and what kind of effect on the airways?
constriction, narrowed airways.
pilocarpine is indicated for which condition? For which surgery (hint: both involve the same structure)?
_____mouth or (_____) is treated with pilocarpine.
- this state of mouth is caused by S____’s syndrome
glaucoma, intraocular (decreases pressure) surgery, dry mouth or xerostomia. Sjogren’s syndrome.
cholinergic drugs can be used for which three indications that are not related to our drug in question?
as a neuromuscular blocker in general anesthesia, increasing muscle strength in myasthenia gravis, and also in Alzheimer’s/
Cholinergics are contraindicated in which conditions?
a. GI obstructions
b. GU obstructions
c. bradycardia
d. tachycardia
e. hyperthyroidism
f. hypothyroidism
g. strokes
h. seizures
i. hypotension
j. orthostatic hypotension
k. COPD
l. asthma
m. Tuberculosis
n. Parkinson’s
a, b, c, e, h, I, k, n
Adverse effects of cholinergics stem from:
overstimulation of the PNS
cardiac adverse effects (of cholinergics)
bradycardia
hypotension
syncope
conduction abnormalities (AV block or cardiac arrest)
CNS adverse effects (of cholinergics)
convulsions, ataxia, HA, dizziness.
GI adverse effects (of cholinergics)
abdominal cramping, increased secretions, n/v.
- mainly because of the increased GI secretions and peristalsis in PNS stimulation.
respiratory adverse effects (of cholinergics)
bronchial spasms, increased bronchial secretions.
other symptoms (for cholinergics)
meiosis, sweating, lacrimation
early signs of a cholinergic crisis
abdominal cramps, salivation, flushing of the skin, n/v, transient syncope, transient complete heart block.
Early signs of a cholinergic crisis
transient syncope/complete heart block, orthostatic hypotension, salivation, dyspnea, abdominal cramps.
Late symptoms of a cholinergic crisis
bloody diarrhea, circulatory collapse, hypotension, shock, cardiac arrest.
What is the unusual symptom of late cholinergic crisis?
bloody diarrhea
What are the three transient symptoms for early crisis?
transient syncope, complete heart block, (orthostatic) hypotension.
for an early crisis, give what?
atropine
for a later crisis, give what?
epinephrine, an adrenergic agonist.
Gingko is indicated to prevent what?
memory loss, vertigo, tinnitus.
“huh? whoah…the world is spinning! what is that sound?”
gingko may cause what?
GI upset, bleeding, HA
Gingko has interactions with which drugs?
NSAIDs, ASA, anticonvulsants, anticoagulants.
(No AAA batteries)
Cholinergic blocking drugs compete with Ach at the _____ receptors.
muscarinic
- where the GI secretions and motility were increased in cholinergic, they are _____ now.
- where miosis and decreased intraocular pressure happens; there is now ______
- in terms of external secretions:
- Heart rate was once decreased but it is now ______
- respiratory was once constriction and increased secretions, there is now______ and _____ mucous membranes/secretions.
decreased GI secretions and motility.
dilated pupils and increased intraocular pressure.
reduced sweating
increased HR
bronchodilation and dry mucous membranes.
atropine is available in which forms?
IV, PO, eye drops
atropine is the antidote for what?
a cholinergic crisis.
atropine solves heart problems with that cholinergic crisis by:
increasing the heart rate.
atropine is used _____operatively to reduce which kind of secretions?
pre-op, GI and saliva secretions.
which condition is contraindicated in atropine?
closed angle glaucoma.
caution for pts with which conditions, when taking atropine?
renal and hepatic dysfunction.
