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a_nclex > Cholinergic Drugs > Flashcards

Cholinergic Drugs Flashcards

1
Q

Bethanechol (Urecholine)

Chemical Classification

A

Synthetic Choline Ester

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2
Q

Bethanechol (Urecholine)

Mechanism of Action

A

Stimulates muscarinic ACH receptors directly; mimics effects of parasympathetic nervous system stimulation; stimulates gastric motility, micturition; increases lower esophageal sphincter pressure

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3
Q

Bethanechol (Urecholine)

Uses

A

Urinary retention (postoperative, postpartum), neurogenic atony of bladder with retention

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4
Q

Bethanechol (Urecholine)

Contraindications

A

Hypersensitivity, severe bradycardia, asthma, severe hypotension, hyperthyroidism, peptic ulcer, parkinsonism, seizure disorders, CAD, COPD, coronary occlusion, mechanical obstruction, peritonitis, recent urinary/GI surgery, GI/GU obstruction

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5
Q

Bethanechol (Urecholine)

Side Effects

A

CNS: dizziness, headache, malaise
CV: hypotension, bradycardia, reflex tachycardia, CARDIAC ARREST, CIRCULATORY COLLAPSE
EENT: miosis, increased salivation, lacrimation, blurred vision
GI: Nausea, Bloody Diarrhea, Belching, Vomiting, Cramps, Fecal Incontinence
GU: urgency
INTEG: rash, urticaria, flushing, increased sweating
RESP: ACUTE ASTHMA, DYSPNEA, BROCHOCONSTRICTION

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6
Q

Bethanechol (Urecholine)

Nursing Considerations

A

ASSESS:

  • URINARY PATTERNS: retention, urgency
  • BP pulse: observe after parenteral dose for 1 hr
  • I&O ratio: check for urinary retention, urge incontinence
  • TOXICITY: bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs
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7
Q

Bethanechol (Urecholine)

Overdose Treatment

A

Atropine 0.6-1.2mg IV or IM

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8
Q

Donepezil (Aricept)

Functional Classification

A

Anti-Alzheimer’s agent

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9
Q

Donepezil (Aricept)

Chemical Classification

A

Reversible Cholinesterase Inhibitor

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10
Q

Donepezil (Aricept)

Mechanism of Action

A

Elevate acetylcholine concentrations (cerebral cortex) by slowing degradation of acetylcholine released in cholinergic neurons; does not alter underlying dementia

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11
Q

Donepezil (Aricept)

Uses

A

Mild to severe dementia with Alzheimer’s disease

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12
Q

Donepezil (Aricept)

Contraindications

A

Hypersensitivity to this product or piperdine derivatives

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13
Q

Donepezil (Aricept)

Side Effects

A

CNS: dizziness, Insomnia, somnolence, Headache, fatigue, abnormal dreams, syncope, SEIZURES, drowsiness, agitation, depression, confusion, fever, hallucinations
CV: ATRIAL FIBRILLATION, hypo/hypertension, SINUS BRADYCARDIA, AV BLOCK
GI: Nausea, Vomiting, anorexia, Diarrhea, abdominal pain, GI BLEEDING, weight loss
GU: urinary frequency, UTI, incontinence
INTEG: rash, flushing, diaphoresis, bruising
META: hyperlipidemia
MS: cramps, arthritis, arthralgia
RESP: rhinitis, URI, cough, pharyngitis, dyspnea

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14
Q

Donepezil (Aricept)

Nursing Considerations

A

ASSESS:

  • BP: hypo/hypertension, heart rate
  • Mental Status: affect, mood, behavior changes, depression, complete suicide assessment; neurologic status
  • GI status: nausea, vomiting, anorexia, diarrhea; monitor weight
  • GU status: urinary frequency, incontinence, I&O

PERFORM/PROVIDE
-Assistance with ambulation during beginning therapy; dizziness, ataxia may occur

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15
Q

Memantine

Functional Classification

A

Anti-Alzheimer agent

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16
Q

Memantine

Chemical Classification

A

NMDA-receptor antagonist

17
Q

Memantine

Mechanism of Action

A

Antagonist action of CNS NMDA receptors that may contribute to the symptoms of Alzheimer’s disease

18
Q

Memantine

Uses

A

Moderate to severe dementia in Alzheimer’s disease

19
Q

Memantine

Contraindications

A

Children, hypersensitivity

20
Q

Memantine

Side Effects

A 
CNS: Dizziness, Confusion, somnolence, headache, hallucinations 
CV: hypertension
GI: vomiting, constipation
HEMA: anemia 
INTEG: rash 
MISC: back pain, fatigue, pain 
RESP: coughing, dyspnea
21
Q

Memantine

Nursing Considerations

A

ASSESS:
-Alzheimer’s dementia: affect, mood, behavioral changes; hallucinations, confusion, attention, orientation, memory

PERFORM/PROVIDE
-Assistance with ambulation during beginning therapy; dizziness may occur

22
Q

Pyridostigmine

Functional Classification

A

Cholinergic; anticholinesterase

23
Q

Pyridostigmine

Chemical Classification

A

Tertiary amine carbamate

24
Q

Pyridostigmine

Mechanism of Action

A

Inhibits destruction of acetylcholine, which increases concentration at sites where acetylcholine is released; this facilitates the transmission of impulses across the myoneural junction

25
Q

Pyridostigmine

Uses

A

Nondepolarizing muscle relaxant antagonist, myasthenia gravis, pretreatment for nerve gas exposure (military only)

26
Q

Pyridostigmine

Contraindications

A

Bradycardia; hypotension; obstruction of intestine, renal system; bromide, benzyl alcohol sensitivity; adrenal insufficiency; cholinesterase inhibitor toxicity

27
Q

Pyridostigmine

Side Effects

A

CNS: dizziness, headache, sweating, weakness, SEIZURES, incoordination, PARALYSIS, drowsiness, LOC
CV: tachycardia, dysrhythmias, bradycardia, AV block, hypotension, ECG changes, CARDIAC ARREST, syncope
EENT: miosis, blurred vision, lacrimation, visual changes
GI: Nausea, Diarrhea, Vomiting, Cramps, Increased Salivary and Gastric Secretions, Peristalsis
GU: urinary frequency, incontinence, urgency
INTEG: rash, urticaria, flushing
RESP: RESPIRATORY DEPRESSION, BRONCHOSPASM, CONSTRICTION, LARYNGOSPASM, RESPIRATORY ARREST
SYST: CHOLINERGIC CRISIS

28
Q

Pyridostigmine

Nursing Considerations

A

ASSESS:

  • MYASTHENIA GRAVIS: fatigue, ptosis, diplopia, difficulty swallowing, SOB, hand/gait before, after product; improvement should be seen after 1 hr
  • VS, respiration q8hr
  • I&O ratio; check for urinary retention or incontinence
  • TOXICITY: bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs
29
Q

Pyridostigmine

Overdose Treatment

A

Discontinue product, atropine 1-4mg IV

30
Q

Bethanechol (Urecholine)

Functional Classification

A

Urinary Tract Stimulant, Cholinergic

a_nclex (40 decks)

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