Cholinergic Drugs

Question 1

Cholingeric Agents are AKA…?

Answer 1

• Parasympatholytics
• Cholinergic Agonists

stimulate/mimic PANS

Question 2

Be able to write out the chart regarding cholinergic agonists

Answer 2

notes

Question 3

What are the Trade names (2) for bethanechol?

Answer 3

• Duvoid
• Urecholine

Question 4

Describe: 💊bethanechol

Type, Direct/Indirect, MOA, Route, Indications,Therapeutic Effects, Side Effects, Contraindications, Nursing Implications (Assess, Check/Monitor)

Answer 4

Type

• Muscarinic Agonist

Direct/Indirect

• Direct

MOA

• Binds to cholinergic (muscarinic) receptor → ↑ muscle contractions (GI & GU tract) → ↑ smooth muscle tone & (digestive + urinary) contractions

Route

• IV/IM

Indications

• Urinary retention (post op, nonobstructive)

Therapeutic Effects

• Promote bladder emptying
  -> ↑ Urination
• ↑ GI motility

Side Effects

• ↑ abdominal cramping
• Hypotension
  -> fainting
• ↑ salivation & sweating

Contraindications

• Asthma
• Bradycardia
• Parkinsons
• Hyperthyroidism

Nursing Implications

Assess:

• Urine elimination b4 administration (baseline)

Check/Monitor:

• Voiding pattern
• Urinary retention after voiding

Question 5

What is the Trade name for donepezil

Answer 5

Aricept

Question 6

Describe: donepezil

Type, Direct/Indirect, MOA, Route, Indications,Therapeutic Effects, Side Effects, Contraindications, Nursing Implications (Monitor, Schedule)

Answer 6

Type

• Cholinesterase Inhibitors
• Anti-cholinesterase Agents

Direct/Indirect

• Indirect

MOA

• Inhibit AChE (enz that destroys ACh) → pvt breakdown of ACh → ↑ [ACh]

Route

• IV/IM

Indications

• Alzheimer DZ

Therapeutic Effects

• Reversal of life threatening delirium
• Reversal of anticholinergic toxicity

Side Effects

• ↑ Salivation
• ↑ GI motility
  -> Aaspe (discomfort)
• Pupil constriction
• Mucus
• Wet cough

Contraindications

• Asthma
• Bradycardia
  -> Cardiovascular DZ
• Diabetes

Nursing Implications

Monitor:

• Muscle strength/weakness
  neuromuscular status
• Ptosis (drooping of upper eyelid)
• Diplopia (double vision)
• Chewing

Schedule:

• Medication around mealtimes
• Activities to avoid fatigue

Question 7

What is the Trade name for neostigmine ?

Answer 7

Prostigmin

Question 8

Describe: 💊neostigmine

Type, Direct/Indirect, MOA, Route, Indications,Therapeutic Effects, Side Effects, Contraindications, Nursing Implications (Monitor, Schedule)

Answer 8

Type

• Cholinesterase Inhibitors
• Anti-cholinesterase Agents

Direct/Indirect

• Indirect

MOA

• Inhibit AChE (enz that destroys ACh) → pvt breakdown of ACh → ↑ [ACh]

Route

• IV/IM

Indications

*Myasthenia Gravis

Therapeutic Effects

• Reversal of life threatening delirium
• Reversal of anticholinergic toxicity

Side Effects

• ↑ Salivation
• ↑GI motility
  -> Aaspe (discomfort)
• Pupil constriction
• Mucus
• Wet cough

Contraindications

• Asthma
• Bradycardia
  -> Cardiovascular DZ
• Diabetes

Nursing Implications

Monitor:

• Muscle strength/weakness
  neuromuscular status
• Ptosis (drooping of upper eyelid)
• Diplopia (double vision)
• Chewing

Schedule:

• Medication around mealtimes
• Activities to avoid fatigue