Cholinergic Flashcards
What do cholinergic agents mimic?
The action of acetylcholine and stimulate the parasympathetic nervous system
List the three primary uses of cholinergic drugs.
- Relieve urinary retention
- Improve muscle strength and increase tolerance of activity in myasthenia gravis
- Improve memory and cognitive function in Alzheimer’s Disease
What is the mechanism of action for direct-acting cholinergic drugs?
Drug binds to the receptor sites and produces effects similar to acetylcholine (Ach)
What do indirect-acting cholinergic drugs inhibit?
The enzyme acetylcholinesterase, which inactivates ACh
What is the role of Donepezil in Alzheimer’s Disease?
To inhibit acetylcholinesterase, allowing for more ACh for greater effect
What is the primary action of bethanechol (Urecholine)?
Relieve urinary retention by producing smooth muscle contraction
Why is bethanechol only given orally?
Due to the risk of adverse effects with other routes
What is neostigmine (Prostigmin) used for?
Long-term treatment of myasthenia gravis
What is donepezil (Aricept) used for?
Treatment of mild to moderate Alzheimer’s Disease
What are contraindications for cholinergic agents?
- Urinary or GI tract obstruction
- Asthma
- Peptic ulcer disease
- Coronary artery disease
- Hyperthyroidism
- Pregnancy
- Inflammatory abdominal conditions
What should clients on long-term cholinergic therapy wear?
Medic-alert bracelets with the name of the medication
What is the antidote for an overdose of cholinergic drugs?
Atropine
List common adverse effects of cholinergic drugs.
- Nausea
- Vomiting
- Diarrhea
- Increased secretions
- Arrhythmias
- Bradycardia
- Hypotension
What can excessive cholinergic drugs cause?
- Bradycardia
- Decrease in BP
- Bronchial constriction
- Excessive mucus and saliva
- Nausea, vomiting, diarrhea, and cramping
What is the nursing process for direct-acting cholinergics?
- Obtain baseline VS
- Assess UO and report decrease
- Obtain health/med history
- Monitor liver enzymes
- Give 1 hour before or 2 hours after meals
- Report side effects
- Rise slowly from sitting/supine position
How do anticholinergic drugs work?
Block the action of acetylcholine at the cholinergic receptor sites
List the indications for anticholinergic use.
- GI disorders
- Genitourinary disorders
- Respiratory conditions
- Cardiology
What are contraindications for anticholinergics?
- Prostatic hypertrophy
- Glaucoma
- Tachyarrhythmias
- Myocardial infarction
- Congestive Heart Failure
What are common side effects of anticholinergics?
- Urinary retention
- Constipation
- Dry mouth
- Blurred vision
- Tachycardia
What are geriatric considerations for cholinergics?
- More sensitive to effects
- Side effects include diarrhea, increased secretions, and bronchoconstriction
What is the antidote for an overdose of anticholinergics?
Physostigmine
Fill in the blank: Antispasmodics suppress _______ muscle spasms.
smooth
What was atropine sulfate derived from?
The belladonna plant
What is tolterodine tartrate (Detrol) used for?
Overactive bladder
