Cholinergic Agonists

Question 0

Cholinergic agents cont…

Answer 0

●AKA. . . cholinergic agonists, parasympathomimetic
●Acetylcholine is neurotransmitter
●Direct action = stimulates muscarinic receptors sites (cholinergic agonist)
●Indirect action = prevents Ach degradation at synapses (cholinesterase inhibitor

Question 1

Cholinergic agents

Answer 1

●Parasympathetic response, which is. . .
●Agonists and cholinesterase inhibitors increase the parasympathetic response
●Receptor sites include
●Muscarinic
●CNS, heart, smooth muscle of organs (GI),glands
●Nicotinic
●Skeletal muscle, CNS

Question 2

Therapeutic

Answer 2

●Direct acting:
●Urinary retention
●GI tract symptoms
●Indirect acting:
●Restore skeletal muscle function:
●Treatment and diagnosis of myasthenia gravis
●Differentiates bt myasthenia and cholinergic crisis
●Slowing of alzheimer’s disease

Question 3

Special meds

Answer 3

●Bethanechol (urinary retention)
●Metoclopramide (Reglan) (GI motility)
●Edrophonium chloride (Tensilon) (diagnose myasthenia gravis)

Question 4

Contraindications

Answer 4

●Bradycardia
●Hypotension
●Urinary tract or intestinal obstruction
●Asthma

Question 5

Drug interactions

Answer 5

●Cholinesterase inhibitors and direct-acting cholinergic agonists can increase cholinergic effects
●Atropine is the antidote for cholinergic overdose
●Alcohol and CNS depressants enhance sedation

Question 6

Adverse effects

Answer 6

●Sedation and drowsiness
●Hypotension with tachycardia
●Excessive salivation
●GI symptoms, diarrhea, cramping, abdominal pain
●Life threatening pulmonary effects

Question 7

Nursing implications

Answer 7

●When treating GI symptoms, give 30 mins before meal
●Watch for cholinergic overdose
●Have atropine at bedside when doing a Tensilon test
●Watch for respiratory complications, report any to MD
●Tolerance to cholinesterase inhibitor can occur (ambenonium, treats myasthenia gravis)