Cholinergic Drugs

Question 1

Neurotransmission substance that carries nerve impulses across the parasympathetic branch of the autonomic nervous system

Answer 1

Acetylcholine (ACh)

Question 2

Two types of receptors in the parasympathetic nervous branch

Answer 2

Muscarinic receptors
Nicotinic receptors

Question 3

Stimulate smooth muscle

Answer 3

Muscarinic receptors

Question 4

Stimulate skeletal muscle

Answer 4

Nicotinic receptors

Question 5

Mimic the activity of the parasympathetic nervous system

Answer 5

Cholinergic drugs (parasympathomimetic)

Question 6

What makes the parasympathetic system function differently

Answer 6

Acetylcholinesterase (AChE)

Question 7

Enzyme that can inactivate the neurotransmitter ACh, preventing the never synapse from continuing the nerve impulse

Answer 7

AChE (acetylcholinesterase)

Question 8

Major uses of cholinergic drugs
SATA (3)

Answer 8

Urinary retention(when drug therapy indicated)
Neurogenic bladder when retention is an issue
Myasthenia gravis (for symptom management)

Question 9

Adverse reactions
SATA (5)

Answer 9

Nausea, diarrhea, abdominal cramping
Salivation
Flushing of the skin

Question 10

Contraindications
SATA(4)

Answer 10

Asthma
Peptic ulcer disease (PID)
Hyperthyroidism
Anything with the eye (secondary glaucoma, iritis, corneal abrasion, acute inflammatory disease of eye)

Question 11

Precautions
SATA (3)

Answer 11

Hypertension
Bradycardia
Megacolon

Question 12

Interactions w aminoglycosides
(Mycin)

Answer 12

Increased neuromuscular blocking effect

Question 13

Interactions with corticosteroids (glucocorticoids)
-treatment of inflammation/respiratory problems

Answer 13

Decreased effect of the cholinergic

Question 14

Antidote for cholinergic

Answer 14

Atropine

Question 15

Symptoms of myasthenia gravis
SATA (6)

Answer 15

Muscle weakness
Drooling
Lack of ability to swallow
Inability to chew & swallow
Drooping of eyelids (ptosis)
Difficulty breathing

Question 16

Symptoms of cholinergic crisis
SATA(4)

Answer 16

Severe abdominal cramping
Excessive salivation
Rigidity & spasm
Clenching of the jaw

Question 17

Ongoing assessment for client with urinary retention
SATA(5)

Answer 17

Measuring and documenting I&O
Palpate the bladder
Use bladder scanner after attempt to void
Measure for urine residual
Check BP & pulse

Question 18

Direct acting cholinergic

Answer 18

bethanechol (Urecholine)

Question 19

Indirect-acting (Anticholinesterase) Muscle stimulants

Answer 19

Pyridostigmine

Question 20

Use of pyridostigmine

Answer 20

Myasthenia gravis

Question 21

Adverse reaction of pyridostigmine

Answer 21

Cardiac arrhythmias