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NURS 252 (Pharmacology 2) > Cholinergic Blocking Drugs > Flashcards

Cholinergic Blocking Drugs Flashcards

1
Q

What are cholinergic blocking drugs and what are they AKA?

A

Drugs that inhibit the action of ACh in the Parasympathetic NS
AKA: Anticholinergics, parasympatholytic drugs, antimuscarinic drugs

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2
Q

What is the MOA of cholinergic blocking drugs?

A

Competitive antagonist
They compete with ACh for binding at muscarinic receptors

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3
Q

Name 2 Natural plant alkaloids

A

Atropine sulphate
Scopolamine hydrobromide

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4
Q

Name 3 synthetic and semisynthetic anticholinergics

A

Glycopyrrolate
Oxybutynin
Tolterodine

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5
Q

What are CNS and Cardiovascular drug effects in small and large doses?

A

CV
Small doses: Decreased HR
Large doses: Increased HR
CNS
Small doses: Decreased muscle rigidity and tremors
Large doses: Drowsiness, disorientation, hallucinations

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6
Q

What are the eye and GI drug effects?

A

Eye: Dilated pupils, Decreased accomodation caused by paralysis of ciliary muscles
GI: Relaxed muscle tone, Decreased secretions, motility and peristalsis

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7
Q

What are the GU, Glandular and Respiratory drug effects?

A

GU: Relaxed detrusor, increased constriction of internal sphincter resulting in urinary retention
Glandular: Decreased sweating
Resp: Decreased bronchial secretions

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8
Q

What are the CNS indications of anticholinergics?

A

Decreasing muscle rigidity and muscle tremors
Parkinson’s
Drug-induced extrapyramidal reactions

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9
Q

What are the cardiovascular indications of anticholinergics?

A

Affect the hearts conduction system
Low doses: Decreased HR
High: Block inhibitory vagal effects on SA and AV node pacemaker cells resulting in increased HR

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10
Q

Atropine is used primarily for cardiovascular disorders such as:

A

Diagnosis of sinus node dysfunction
Symptomatic second-degree heart block
Severe sinus bradycardia with hemodynamic compromise

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11
Q

What are the respiratory indications of anticholinergics?

A

Exercise-induced bronchospasms
Asthma
COPD

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12
Q

What are the GI indications of anticholinergics?

A

IBD
GI hypersecretory states

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13
Q

What are the GU indications of anticholinergics?

A

Reflex neurogenic bladder
Incontinence

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14
Q

What are the contraindications of Anticholinergics?

A

Angle-closure glaucoma
Acute asthma or other resp distress
Myasthenia gravis
Acute cardiovascular instability
GI or GU tract obstruction

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15
Q

What are the cardiovascular and CNS adverse effects?

A

Cardio: Increased HR, Dysrhythmias
CNS: Excitation, restlessness, irritability, disorientation, hallucinations, delirium

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16
Q

What are the Eye and GI adverse effects?

A

Eye: Dilated pupils, increased intraocular pressure
GI: Decreased salivation, gastric secretions and motility resulting in constipation

17
Q

What are the GU, Glandular and resp adverse effects?

A

GU: Urinary retention
Glandular: decreased sweating
RESP: decreased secretions

18
Q

What are the treatments of anticholinergic toxicity/ OD?

A

Continuous ECG monitoring
Activated charcoal
Treatment of shock
Physostigmine (cholinergic)

19
Q

What are the possible interactions with anticholinergics?

A

Amantadine
Antihistamines
Phenothiazines
Digoxin

20
Q

What is atropine? (ID, CI)

A

ID: Brady, ventricular asystole, antidote for cholinergic toxicity, pre-op to decrease salivation and GI secretions
CI: Angle-closure glaucoma, renal and hepatic dysfunction, hiatal hernia, intestinal atony, GI or GU obstructions, ulcerative colitis

21
Q

What is Glycopyrrolate? (ID, MOA)

A

MOA: Blocks receptor sites in the autonomic nervous system that control prod of secretions
ID: Pre-op to reduce salivation and secretions in resp and GI

22
Q

What is oxybutynin? (ID, CI)

A

ID: Overactive bladder and antispasmodic for neurogenic bladder associated with spinal cord injuries
CI: Urinary or gastric retention, angle-closure glaucoma

23
Q

What is Scopolamine? (ID, AE, IE)

A

ID: Prevention of motion sickness, prevention of post-op N/V
AE: Drowiness, dry mouth, blurred vision
IE: CNS depressants or alcohol results in increased sedation

24
Q

What is Tolterodine? (ID)

A

ID: Urinary freq, urgency and urge incontinence caused by bladder over-activity

25
Q

Why are newer drugs preferred over tolterodine?

A

Newer drugs are associated with a much lower incidence of dry mouth

26
Q

What is a consideration when giving opthalmic solutions?

A

Apply pressure to inner canthus to prevent systemic absorption

27
Q

What is a consideration regarding administration of anticholinergics to older patients?

A

It may lead to a higher risk for heatstroke because of the effects on heat-regulating mechanisms

NURS 252 (Pharmacology 2) (23 decks)

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