Cholinergic Drugs Flashcards
Which is a cardiovascular effect of cholinergic drugs? a. Bradycardia
b. Tachycardia
c. Vasoconstriction
d. Palpitations
ANS: A
The cardiovascular effects of cholinergic drugs are decreased heart rate (bradycardia) and vasodilation.
How are most direct-acting cholinergic drugs mainly used?
a. As antidotes for anticholinergic poisoning
b. Topically to reduce intraocular pressure
c. Orally in preparation for ocular surgery
d. For the diagnosis and treatment of myasthenia gravis
ANS: B
Direct-acting cholinergic drugs (with the exception of bethanechol [Urecholine®]) are poorly absorbed orally and are used topically to reduce intraocular pressure in patients with glaucoma and in patients undergoing ocular surgery.
When an overdose of an intravenous cholinergic drug occurs, which drug, administered promptly, can reverse a cholinergic crisis?
a. atenolol (Tenormin)
b. bethanechol (Duvoid®)
c. dobutamine
d. atropine sulphate
ANS: D
Prompt administration of atropine sulphate can reverse a toxic dose of a cholinergic drug.
A patient has had abdominal surgery and is being discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. Which therapeutic effects should the nurse teach the patient to watch for?
a. Decreased pulse rate
b. Abdominal cramping
c. Passage of flatus
d. Decreased frequency and urgency of voiding patterns
ANS: C
Patients experiencing a postoperative decrease in gastrointestinal peristalsis should watch for an increase in bowel sounds, the passage of flatus, and the occurrence of bowel movements that indicate increased gastrointestinal peristalsis.
A patient has been newly diagnosed with myasthenia gravis. What important information should the nurse give this patient about the administration of cholinergic drugs?
a. The medication should be taken with meals to avoid gastrointestinal distress.
b. Daytime dosages should be given close together for maximal therapeutic effect.
c. The medication should be taken 30 minutes before eating, to improve swallowing and chewing.
d. Expected adverse effects are increased muscle weakness, abdominal cramping, and diarrhea, which should subside in a few days.
ANS: C
Taking the medication 30 minutes before meals allows for the onset of action and therapeutic effects during the meal. The doses should be spaced evenly apart to optimize the effects of the medication. Increased muscle weakness, abdominal cramping, and diarrhea should be reported to the physician.
Which drug is considered to be the antidote for anticholinergic poisoning and for poisoning by organophosphates and carbonates, such as those in common insecticides?
a. pilocarpine
b. bethanechol (Duvoid)
c. physostigmine
d. cholinesterase
ANS: C
Indirect-acting drugs such as physostigmine inhibit acetylcholinesterase, thus reversing the neuromuscular blockade produced by anticholinergic poisoning.
The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer’s disease. The patient was diagnosed 3 months ago and has mild memory loss. She will be receiving donepezil (Aricept®). Which statement accurately describes the drug’s actions?
a. It prevents memory loss in later stages.
b. It will reverse the course of Alzheimer’s disease.
c. It provides sedation to prevent agitation and restlessness.
d. It may help to improve the symptoms of Alzheimer’s disease.
ANS: D
Donepezil is used to treat the mild to moderate dementia of Alzheimer’s disease and may improve the symptoms of the disease.
A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer’s disease. The patient’s daughter calls the physician’s office, upset because her mother has not shown any improvement. What is the nurse’s best response to the patient’s daughter?
a. “Increase the dosage to twice daily.”
b. “It takes time for the cure to take effect.”
c. “It may take up to 6 weeks to see an improvement.”
d. “Have her take the medication on an empty stomach for improved absorption.”
ANS: C
Donepezil therapy is not a cure for Alzheimer’s disease but may help to improve symptoms in the early stages. It may take up to 6 weeks to see improvement. The family should be taught that the medication must be taken exactly as ordered and with meals. Also, the medication should not be abruptly stopped, and the dosage should not be increased without the physician’s approval because of the possibility of serious complications
The desired effects of cholinergic drugs come from stimulation of which receptors? a. Muscarinic
b. Nicotinic
c. Cholinergic
d. Ganglionic
ANS: A
The desired effects come from muscarinic receptor stimulation; many of the undesirable adverse effects are due to nicotinic receptor stimulation.
A patient wants to begin taking ginkgo for memory enhancement. The nurse should warn this patient about possible drug interactions with which substances?
a. Digoxin, diuretics, and steroids
b. Caffeine-containing products
c. Alcoholic beverages
d. Aspirin, any nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin
(Coumadin®), and heparin
ANS: D
Drug interactions with gingko may occur with the ingestion of Aspirin, NSAIDs, warfarin, heparin, anticonvulsants, ticlopidine, clopidogrel, dipyridamole, and tricyclic antidepressants.
For each effect in the lower list, indicate which stimulation in the upper list the effect is due to.
a. Muscarinic stimulation
b. Nicotinic stimulation
c. Both muscarinic stimulation and nicotinic stimulation
1. Pupil constriction
2. Increased heart rate
3. Decreased blood pressure
- ANS: C
- ANS: B
- ANS: A
