Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHARM > Cholinergic drugs > Flashcards

Cholinergic drugs Flashcards

1
Q

Cholinergic Drugs what is it?

A

Drugs that stimulate the parasympathetic nervous system (the opposing system to the sympathetic nervous system), Also known as cholinergic agonists or parasympathomimetics
Mimic effects of the parasympathetic nervous system neurotransmitter acetylcholine (ACh)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the two types of cholinergic receptors?

A

Nicotine receptors and muscarinic receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the two types of cholinergic receptors determined by?

A
  • location
  • Action once stimulated.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nicotinic Receptors are?

A

Located in the ganglia of both systems
Named nicotinic because they can be stimulated by the alkaloid nicotine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cholinergic Drugs: Mechanism of Action, Direct-acting cholinergic agonists

A

Bind to cholinergic receptors, activating them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cholinergic Drugs: Mechanism of Action, Indirect-acting cholinergic agonists

A

Also known as cholinesterase inhibitors
Inhibit the enzyme acetylcholinesterase, which breaks down ACh
Results in more ACh available at the receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indirect-Acting (Cholinesterase Inhibitors) - reversible

A

Bind to cholinesterase for a short period of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indirect-Acting (Cholinesterase Inhibitors) - Irreversible

A

Bind to cholinesterase for a long period of time
Bind to cholinesterase and form a permanent covalent bond
The body must make new cholinesterase to break these bonds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drug Effects

A

Effects seen when parasympathetic system is stimulated
This system is the “rest and digest” system.
Sympathetic nervous system: “flight or fight”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Drug Effects - stimulates intestine and bladder

A

Increased gastric secretions
Increased gastrointestinal motility
Increased urinary frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drug effects - stimulates pupils

A

Constriction (miosis)
Reduced intraocular pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

whats another drug effects

A

Increased salivation and sweating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cholinergic Drug Effects - Cardiovascular effects

A

Decreased heart rate
Vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cholinergic Drug Effects - Respiratory effects

A

Bronchial constriction, narrowed airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cholinergic Drug Effects

A

At recommended doses, cholinergics primarily affect muscarinic receptors.
At high doses, cholinergics stimulate nicotinic receptors.
Desired effects are from muscarinic receptor stimulation.
Many undesirable effects are caused by stimulation of nicotinic receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications - Direct-acting drugs

A

Reduce intraocular pressure
Useful for glaucoma and intraocular surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indications - Direct-acting drugs

A

pilocarpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Indications

A

Topical application because of poor oral absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does direct acting bethanechol do?

A

Increases tone and motility of bladder and gastrointestinal (GI) tract
Relaxes sphincters in bladder and GI tract, allowing them to empty
Helpful for postsurgical atony of the bladder and GI tract
Oral dose or subcutaneous injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Indications - Direct-acting drug succinylcholine do?

A

Used as a neuromuscular blocker in general anaesthesia
Intravenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indications - Indirect-acting drugs

A

Increase ACh concentrations at the receptor sites, which leads to stimulation of the effector cells
Cause skeletal muscle contractions
Used for diagnosis and treatment of myasthenia gravis
Used to reverse neuromuscular blocking drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Used to reverse anticholinergic poisoning (antidote)
Example

A

physostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Indications - Indirect-acting anticholinesterase drugs, and what drug is it.

A

Used for treatment of mild to moderate Alzheimer’s disease. donepezil (Aricept®)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Indications - memantine (Ebixa®)

A

Not a cholinergic drug
Also used in the treatment of Alzheimer’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Contraindications
Known drug allergy GI or genitourinary (GU) tract obstruction Bradycardia Defects in cardiac impulse conduction Hyperthyroidism Epilepsy Hypotension Chronic obstructive pulmonary disease Parkinson’s disease
26
Adverse Effects
Adverse effects are a result of overstimulation of the parasympathetic system.
27
Adverse Effects - Cardiovascular
Bradycardia, hypotension, syncope, conduction abnormalities (atrioventricular block and cardiac arrest)
28
adverse fx - CNS system
Headache, dizziness, convulsions, ataxia
29
adverse fx - GI
Abdominal cramps, increased secretions, nausea, vomiting, diarrhea, weight loss
30
adverse fx - respiratory
Increased bronchial secretions, bronchospasms
31
other adverse fx
Lacrimation, sweating, salivation, miosis
32
Cholinergic Crisis
Circulatory collapse, hypotension, bloody diarrhea, shock, and cardiac arrest. SLUDGE (salivation, lacrimation, urinary incontinence, diarrhea, gastrointestinal cramps, and emesis)
33
Cholinergic Crisis - Early signs
Abdominal cramps, salivation, flushing of the skin, nausea and vomiting, transient syncope, transient complete heart block, dyspnea, and orthostatic hypotension
34
Cholinergic Crisis - treatments in early phase
atropine sulphate, a cholinergic antagonist
35
Cholinergic crisis - Treatment of severe cardiovascular reactions or bronchoconstriction:
epinephirine
36
Interactions
Anticholinergics, antihistamines, sympathomimetics Antagonize cholinergic drugs, resulting in decreased responses Other cholinergic drugs Additive effects
37
bethanechol (Duvoid®) is a what?
Direct-acting cholinergic agonist
38
bethanechol (Duvoid®) uses?
Treatment of acute postoperative and postpartum nonobstructive urinary retention Management of urinary retention associated with neurogenic atony of the bladder
39
bethanechol (Duvoid®) contraindications?
Known drug allergy, hyperthyroidism, peptic ulcer, active bronchial asthma, cardiac disease or coronary artery disease, epilepsy, and parkinsonism
40
bethanechol (Duvoid®) adverse fx
syncope, hypotension with reflex tachycardia, headache, seizure, GI upset, and asthmatic attacks
41
bethanechol (Duvoid®) - interactions
acetylcholinesterase inhibitors (i.e., indirect-acting cholinergics)
42
donepezil (Aricept) does what?
Cholinesterase inhibitor that works centrally in the brain to increase levels of ACh by inhibiting acetylcholinesterase. Similar cholinesterase inhibitors include galantamine and rivastigmine.
43
donepezil (Aricept) uses?
Used in the treatment of mild to moderate Alzheimer’s disease
44
donepezil (Aricept) contraindications
known drug allergy
45
donepezil (Aricept) adverse fx
GI upset (including ulcer risk caused by increased gastric secretions), drowsiness, dizziness, insomnia, and muscle cramps. The effects on the cardiovascular system are complex and may include bradycardia, syncope, hypotension with reflex tachycardia, or hypertension.
46
donepezil (Aricept) - Interacting drugs
anticholinergics (counteract donepezil effects) and nonsteroidal anti-inflammatory drugs (NSAIDs)
47
pyridostigmine (Mestinon®) is what?
Indirect-acting cholinergic drugs that work to increase ACh by inhibiting acetylcholinesterase
48
pyridostigmine (Mestinon®) use
myasthenia gravis
49
Edrophonium (Tensilon)
indirect-acting cholinergic drug that is used to diagnose myasthenia gravis. It can also be used to differentiate between myasthenia gravis and cholinergic crisis.
50
pyridostigmine, and physostigmine uses.
reversing the effects of nondepolarizing neuromuscular blocking drugs; treating severe overdoses of tricyclic antidepressants; and antidote after toxic exposure to nondrug anticholinergic agents, including those used in chemical warfare
51
Ginkgo uses
Common uses Prevent memory loss Vertigo Tinnitus
52
Gingko adverse fx
May cause GI upset, headache, bleeding
53
Gingko potential interactions
Potential interactions Aspirin NSAIDs Anticoagulants Anticonvulsants
54
Nursing Implications (Assessment)
Assess for allergies, presence of GI or GU obstructions, asthma, peptic ulcer disease, and coronary artery disease. Perform baseline assessment of vital signs and systems overview.
55
Medications should be>
Medications should be taken as ordered and not abruptly stopped. Doses should be spread evenly apart to optimize the effects of the medication.
56
Therapeutic effects of anti-Alzheimer’s drugs may not occur for up to?
6 weeks
57
______is the antidote for cholinergics, and it should be available in the patient’s room for immediate use if needed.
Atropine
58
Monitor for therapeutic effects
Alleviated signs and symptoms of myasthenia gravis
59
Monitor for therapeutic effects - In postoperative patients with decreased GI
In postoperative patients with decreased GI peristalsis, monitor for: Increased bowel sounds Passage of flatus Occurrence of bowel movements
60
Monitor for therapeutic effects. In patients with urinary retention or hypotonic bladder how?
In patients with urinary retention or hypotonic bladder, urination should occur within 60 minutes of bethanechol administration.
61
Monitor for therapeutic effects - In patients with Alzheimer’s disease how?
Improvement in symptoms Improvement in mood and decrease in confusion

PHARM (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions