Cholinergic and Anti-Cholinergic

Question 1

cholinergic receptors

Answer 1

• nicotinic: motor nerves/skeletal muscles (muscle contraction)
• muscarinic: internal organs; increase secretions

Question 2

cholinergic meds

Answer 2

(neostigmine - prostigmine)
- mimic action of acetylcholine to simulate PSNS

• will inhibit acetylcholine destruction; anticholinesterase - to destroy cholinesterase

Question 3

clinical uses: cholinergic

Answer 3

• bladder/GI atony (help release sphincter/urine/tract)
• dx & tx of myasthenia gravis (decrease # receptors.. need to destroy the cholinesterase)
• glaucoma (decrease IOP)
• early treatment alzheimer’s (loss of neurons producing aceylcholine - drugs will increase production/release more)

Question 4

contraindications: cholinergic

Answer 4

• urinary/GI obstruction
• asthma: bronchoconstriction
• peptic ulcer: increase HCL
• CAD: can drop HR, BP
• pregnancy

Question 5

ADE: cholinergic

Answer 5

• common: exacerbation of intended effects “wet” (salivation, diaphoreses, n/v, diarrhea)
• serious: bradycardia, hypotension, shock

Question 6

cholinergic vs myasthenia crisis

Answer 6

• chol: too much anticholinesterace leading to increased acetylcholine and secretions
• mya: decrease receptors, muscle weakness
• give dose
• if gets worse: cholinergic - increases acetylcholine
• if better: myast - increase acetyl to reach few receptors

Question 7

anti-cholinergic

Answer 7

(atropine) - used for cholinergic crisis
- block the action of acetylcholine
“dry”

Question 8

ADE: anti-cholinergic

Answer 8

• common: blurred vision, dry mouth, constipation, urinary retention
• serious: cardiac arrhythmias

Question 9

contraindications: anti-cholinergic

Answer 9

• BPH (already decrease urine)
• glaucoma
• tachy arrhythmias, acute MI
• congestive heart failure
• myastinia gravis: need acetylcholine

Question 10

clinical use: anti-cholinergic

Answer 10

• parkinson’s: decrease tremors, spasticity
• examine retina, pre-op
• tx bradycardia
• asthma
• tx obstructive gall bladder disease, ulcer disease, ileitis, colitis, GI spasms
• enuresis (pm bed wetting)

Question 11

patient teaching: anti-cholinegic

Answer 11

• protect eyes (photophobic) and skin
• avoid tooth decay
• prevent constipations
• avoid alcohol & overheating