Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology Exam 2 > Cholinergic Agonists 1 > Flashcards

Cholinergic Agonists 1 Flashcards

1
Q

What nervous system is the PNS/Parasympathetic nervous system under?

A

Autonomic which is under the Peripheral Nervous system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some things that the Parasympathetic Nervous system do in the body?

A

Constrict pupils
Increase Salivation
Vasodilate
Decrease heartrate
Decrease blood pressure
Bronchoconstriction
Increase respiratory secretions
Increase peristalsis
Release Bile (digest)
Urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some things that the Sympathetic nervous system do to the body?

A

Pupil dilation
Dry Mouth
Vasoconstriction
Increase heartrate
Increase BP
Bronchodilation
Decrease Respiratory secretions
Decrease peristalsis
Glucose release
Urination block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the definition of Cholinergic Drugs?

A

They are chemicals that act at the same site as the neurotransmitter acetylcholine (ACh)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the action of Cholinergic drugs?

A

○Often called parasympathomimetic drugs because their action mimics the
action of the parasympathetic nervous system.
○Not limited to a specific site; therefore, associated with many undesirable
systemic effects.
○Work either directly or indirectly on ACh receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should we keep in mind when giving children Cholinergic agents?

A

Children have an increased risk of adverse effects.
Their dosage should be based on weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should we keep in mind when giving adults Cholinergic agents?

A

Adults should be careful when driving while taking Cholinergic agents.
No adequate study on pregnancy/lactation.
Use alternative method to breastfeed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What should we keep in mind when giving older adults Cholinergic agents?

A

More likely to have adverse reactions.
More likely to experience toxicity.
Start low go slow.
Institute safety precautions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are direct-acting cholinergic agonists?

A

Agent that act directly on the cell membrane at the ACh receptor sites of the postganglionic cholinergic nerves.

They cause increased stimulation of the cholinergic receptor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are indirect-acting cholinergic agonists?

A

Doesn’t work directly on the cell but on the neurotransmitter itself. It react with the enzyme acetylcholinesterase and prevent it from breaking down the ACh released from the nerve.

Produce effects indirectly by producing increase in level of ACh in the synaptic cleft, leading to increased stimulation
of cholinergic receptor site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What suffix(es)/drug classes/outliers do we need to know for Direct-Acting Cholinergic Agonists (Muscarinic) Agents?

A

Bethanechol
Carbachol
Cevemeline
Pilocarpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does Pilocarpine do ?

A

Act at cholinergic receptors in the peripheral nervous system to mimic the
effects of ACh and parasympathetic stimulation,

Pilocarpine is a Direct-acting Muscarinic cholinergic agonist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why would you give a patient Direct-acting Cholinergic Agonists?

A

If they suffer from Urinary retention - Bethanechol

To induce miosis (pupil constriction) - Carbachol

To trat dry mouth - Cevimeline & pilocarpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would be some reasons / Contraindications to not give Direct-acting Muscarinic cholinergic agonists to a patient?

A

Hypersensitivity/allergy - Absolute
○Any condition that would be exacerbated by parasympathetic effects
bradycardia, hypotension
○Peptic ulcer disease, intestinal obstruction or recent GI surgery
○Asthma
○Bladder obstruction
○Epilepsy and parkinsonism - increase in symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should we be cautious to giving direct-acting Muscarinic cholinergic agonists to a patient?

A

If they are pregnant or breastfeeding as safety has not been established.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would be some adverse reactions to taking Cevimeline?

A

Drug acts systemically and have many adverse reactions.

Nausea, vomiting, cramps, diarrhea, increase salivation, and involuntary
defecation.
Bradycardia, heart block, hypotension
Urinary urgency
Flushing or increased sweating

Cevimeline is a Direct-acting Muscarinic cholinergic agonists.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what drug-drug interaction should we be mindful/cautious of when giving a patient Bethanechol?

A

Acetylcholinesterase inhibitors - double dose may lead to cholinergic crisis.

Bethanechol is a Direct-acting Muscarinic cholinergic agonist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What assessments should we make prior to giving a patient Carbachol?

A

Assess for contraindications and cautions.

Physical assessment:
VS, Lung sound, cardiac status, bowel sounds, bladder distention and I&O.

Carbachol is a Direct-acting Muscarinic cholinergic agonist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What nursing diagnosis could we expect to make when giving a patient Pilocarpine?

A

Impaired comfort related to GI effects
○Altered cardiac output related to CV effects.

○Impaired urinary elimination related to GU effects.

○Injury risk related to blurred vision and changes in visual acuity - due to pupil constricting effect of the drug.

○Diarrhea related to GI effects

○Knowledge deficit regarding drug therapy.

Pilocarpine is a Direct-acting Muscarinic cholinergic agonist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What nursing implementations would we expect to make when giving a patient Bethanechol?

A

○Ensure proper administration of ophthalmic preparations

○Administer oral drug on an empty stomach

○Monitor patient response closely

○Provide safety precautions if the patient reports poor visual acuity

○Monitor urinary output - making sure they have proper hydration.

○Provide thorough patient teaching

Bethanechol is a Direct-acting Muscarinic cholinergic agonist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What suffix(es)/drug classes/outliers do we need to know for Direct-acting Cholinergic Agonists Nicotinic agents?

A

●Bupropion
●Nicotine
●Varenicline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hoe does nicotinic agents work in the body?

A

○Bupropion: may act by weakly inhibiting neuronal reuptake of norepinephrine
and dopamine
○Nicotine: replacement therapy
○Varenicline: acts as nicotine receptor partial agonis

23
Q

Why would we give nicotinic agents to a patient?

A

For Smoking cessation.

24
Q

What are some conditions/ contraindications that would prevent us from wanting to give nicotinic agents to a patient?

A

○Hypersensitivity/allergy
○Seizure disorder (bupropion) - may reduce the seizure threshold.

25
Q

What are some conditions where we should be cautious of giving nicotinic agents to a patient?

A

Pregnancy/lactation

26
Q

What are some adverse effects of Bupropium?

A

○Tachycardia, hypertension
○Seizures, neuropsychiatric adverse effects, dizziness, strange dreams
○Nausea, dry mouth
○Skin rash - cholinergic reaction to ACh

Bupropion is a nicotinic agent

27
Q

What are some drug-drug interactions to be mindful of when it comes to Nicotinic agents?

A

Numerous - workplace should provide.

28
Q

What assessments should be done on a patient prior to giving them Varenicline?

A

○Assess for contraindications and cautions
○Perform a physical assessment
○Assess amount of tobacco use
○Assess VS, heart & lung sounds, ECG
○Assess mood, sleep, suicidal thoughts and behaviors

Varenicline is a nicotinic agent

29
Q

What nursing diagnosis would you expect to make prior to administering nicotine to a patient?

A

○Impaired comfort related to GI effects
○Altered cardiac output related to cardiovascular effects
○Injury risk related to seizures or neuropsychiatric side effects
○Knowledge deficit regarding drug therapy

Nicotine is a nicotinic agent

30
Q

What nursing implementations would you anticipate to make prior to administering Bupropion to a patient?

A

○Ensure proper administration of nicotine replacement preparations
○Check for medication interactions
○May be taken with or without food.
○Monitor patient response closely
○Arrange to adjust dose accordingly
○Provide safety precautions if the patient reports neuropsychiatric events or
seizure activity
○Provide thorough patient teaching

Bupropion is a Nicotinic agent.

31
Q

What is Myasthenia Gravis?

A

○Chronic muscular disease caused by
a defect in neuromuscular
transmission

○Autoimmune disease; patients make
antibodies to ACh receptors, causing
gradual destruction of them

32
Q

What are the symptoms of Myasthenia Gravis?

A

Progressive weakness and lack of
muscle control with periodic acute
episodes.

33
Q

Which Indirect-Acting Cholinergic Agonists are used to Treat Myasthenia Gravis?

A

Neostigmine: Has a strong influence at the neuromuscular junction

Pyridostigmine: Has a longer duration of action than neostigmine

Edrophonium: Diagnostic agent for myasthenia gravis - short acting. Evaluated if muscle strength improved. not used as a diagnostic anymore.

34
Q

What is Alzheimer’s Disease?

A

A progressive disorder involving neural degeneration in the cortex

35
Q

What does Alzheimer’s Disease do to a person?

A

Leads to a marked loss of memory and the ability to carry on activities of daily living

36
Q

What is the cause of Alzheimer’s Disease?

A

Cause of the disease is not yet known
-There is a progressive loss of ACh-producing neurons and their target neurons.

37
Q

How are indirect-acting cholinergic agonists used to treat Alzheimer’s Disease?

A

They are used to slow down the progression of the disease.

38
Q

What does the Indirect-acting cholinergic agonists given for Alzheimer’s disease & Myasthenia gravis do?

A

Blocks AChE from breaking down ACh
released from the nerve endings which leads to increased and prolonged
stimulation of ACh

39
Q

What are the 3 drug classes we need to know that are used to treat Alzheimer’s disease?

A

Galantamine
○Available in solution for swallowing ease
Rivastigmine
○Available in solution for swallowing ease
Donepezil
○Has once-a-day dosing; available in rapidly dissolving tablet

40
Q

What client condition/s would indicate that you shouldn’t give the patient Indirect-acting cholinergic agents?

A

○Allergy
○Bradycardia
○Intestinal or urinary tract obstruction

41
Q

What patient condition would indicate increased caution when giving them Indirect-acting cholinergic agonists?

A

○Any condition that could be exacerbated by cholinergic stimulation
■Asthma, coronary disease, peptic ulcer, arrhythmias, epilepsy, or
parkinsonism
○Hepatic or renal dysfunction
○Pregnancy and lactation

42
Q

What are some adverse reactions that we should be prepared for when giving patient Indirect-acting Cholinergic agonists?

A

○Bradycardia, hypotension
○Increased GI secretions and activity
○Increased bladder tone
○Relaxation of GI and genitourinary sphincters
○Bronchoconstriction
○Pupil constriction

43
Q

What drug -drug interactions should we be knowledgeable about when giving patients Indirect-acting cholinergic agonists?

A

NSAIDs
cholinergic drugs

44
Q

What patient assessments should we do prior to administering indirect-acting cholinergic agonists to a patient?

A

○Assess for contraindications and cautions
○Perform a physical exam
○Assess orientation, affect, reflexes, ability to carry on activities of daily living
○Assess VS, ECG as appropriate, urinary output and renal/ liver function tests

45
Q

What nursing diagnosis would we anticipate to make prior to administering indirect-acting cholinergic agonists to a patient?

A

○Altered thought processes related to CNS effects
○Impaired comfort related to GI effects
○Decreased cardiac output related to blood pressure changes, arrhythmias, and
vasodilation
○Knowledge deficit regarding drug therapy
○Injury risk related to CNS effects
○Diarrhea related to GI stimulatory effects

46
Q

What nursing implementations would we anticipate to make when administering indirect-acting cholinergic agonists to a patient?

A

○If given intravenously, administer it slowly
○Maintain atropine sulfate on standby
○Discontinued the drug of excessive salivation, diarrhea, emesis, or frequent
urination
○Administer the oral drug with meals
○Mark the patient’s chart and notify the surgeon if the patient is to undergo
surgery
○Monitor the patient being treated for Alzheimer disease for any progress
○Arrange for supportive care and comfort measures
○Provide thorough patient teaching

47
Q

Why are cholinergic drugs also called parasympathomimetic drugs?

A

Because they action mimics the action of the parasympathetic nervous system.

48
Q

How come cholinergic are associated with many adverse reactions?

A

Due to acting systemically and not locally event though we might be seeking a local action.

49
Q

Do Cholinergic agents work directly or indirectly on ACh receptors?

A

They do both!

50
Q

Where does cholinergic agents act on the body?

A

They act at the same site as the neurotransmitter acetylcholine (ACh)

51
Q

What is Muscarinic?

A

It is a type of cholinergic receptor. therefore Direct-acting Cholinergic agonists act directly on these specific receptors. they are found in the central and peripheral nervous system.

52
Q

Where are most of the Nicotinic receptors found?

A

In the central nervous system.

53
Q

Which receptors respond faster. The Muscarinic or Nicotinic receptors?

A

The Nicotinic.

Pharmacology Exam 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions