Cholinergic Drugs

Question 1

What are cholinergic drugs

Answer 1

drugs that stimulate the parasympathetic nervous system (rest and digest)
-mimics effects of acetylcholine
-binds to cholinergic receptors
-inhibits breakdown of ACh

Question 2

Types of cholinergic receptors

Answer 2

nicotinic receptors
-can be stimulated by nicotine

muscarinic receptors
-located in smooth muscle, cardiac muscle, and glands

Question 3

What does acetylcholine do?

Answer 3

neurotransmitter that is responsible for the transmission of nerve impulses to effector cells

Question 4

Cholinergic drugs mechanism of action

Answer 4

-increased gastric secretions/GI motility
-increased urinary frequency
-increased salivation and sweating
-reduced intraocular pressure
-constrict pupils (miosis)

-decreased HR
-narrowed airways (bronchoconstrict)

Question 4

What do direct-acting cholinergic drugs do?

Answer 4

-reduce intraocular pressure
-used for glaucoma and intraocular surgery
-increase tone and motility of GI tract
-relaxes sphincter
-helpful for postsurgical atony

EX:
-cevimeline
-echothipphate
-carbachol
-pilocarpine

Question 5

cevimeline indications

Answer 5

direct acting cholinergic drug
-treats dry mouth (xerostomia) resulting from sjogren’s syndrome

Question 6

succinylcholine indications

Answer 6

direct acting cholinergic drug
-used as a neuromuscular blocker in general anesthesia

Question 7

What is the antidote for cholinergic drugs

Answer 7

ATROPINE

Question 8

what are indirect-acting anticholinesterase drugs for?

Answer 8

used for treatment of mild to moderate alzheimers disease

EX: donepezil

Question 9

Toxicity s/s of cholinergic drugs

Answer 9

THINK SLUDGE
Salivation
Lacrimation
Urinary incontinence
Diarrhea
GI cramps
Emesis

SECRETIONS WILL BE INCREASED

Question 10

What is given in a cholinergic crisis?

Answer 10

in early phase, atropine will be given, atropine is a cholinergic antagonist

Question 11

Bethanechol (Urecholine) indications

Answer 11

direct acting cholinergic drug
-used in treatment for postop and postpartum non-obstructive urinary retention, this drug will INCREASE secretions

AE of bethanechol is: HYPOTENSION w/ reflex tachycardia

Question 12

Donzepil (Aricept) indications

Answer 12

indirect acting cholinesterase inhibitor
-increases ACh levels by inhibiting acetylcholinesterase
-used for treatment in mild to moderate alzheimers disease

Question 13

What is Memantine?

Answer 13

NOT a CHOLINERGIC drug, it is an NMDA receptor agonist
-it is used for treatment in alzheimer’s disease

Question 14

Pyridostigmine

Answer 14

indirect-acting
-used for patients w/ myasthenia gravis

Question 15

Neostigmine, Pyridostigmine, and Physostigmine

Answer 15

-treats severe overdoses of tricyclic antidepressants
-antidote after toxic exposure to nondrug anticholinergic agents

Question 16

Pyridostigmine nursing implication

Answer 16

encourage pt w/ myasthenia gravis to take medicine 30 mins before eating to help improve chewing and swallowing

for pt w/ AD tell them the drug is for management of symptoms, and is not a cure

Question 17

what is used to reverse anticholinergic poisoning? (antidote)

Answer 17

physostigmine, and pyridostigmine

Question 18

In postoperative patients w/ decreased GI peristalsis what do we monitor for?

Answer 18

passage of flatus