cholinergic drugs: chapter 21

Question 1

how do cholinergic drugs have a direct action

Answer 1

directly bind to the receptor to activate it

Question 2

how to cholinergic drugs have an indirect action

Answer 2

stimulate the postsynaptic release of ach at the receptor site

Question 3

mechanism of action of cholinergic drugs

Answer 3

mimic the actions of ach which changes the permeability to allow sodium and calcium to enter the cell. this causes depolarization

Question 4

do cholinergic drugs stimulate the parasympathetic or sympathetic sysetm

Answer 4

parasympathetic

Question 5

effect of cholinergic drugs on the gi system

Answer 5

increase gastric secretions and gi motility

Question 6

effect of cholinergic drugs on the cv system

Answer 6

decrease hr and cause vasodilation

Question 7

effect of cholinergic drugs on the resp system

Answer 7

constrict bronchi of the lungs

Question 8

what are 3 direct acting cholinergic drugs

Answer 8

pilocarpine, bethanechol, succinylcholine

Question 9

indications for pilocarpine

Answer 9

reduce intraocular pressure in those with glaucoma, treat excessive dry mouth, salivary gland hypotension

Question 10

indications for bethanechol (4)

Answer 10

increase bladder and gi tract motility, increase movement of contents through badder the gi tract, relax sphincters in the bladder and gi tract, treat atony

Question 11

indication for succinycholine

Answer 11

neuromuscular blocker in general anesthesia

Question 12

3 general indications for indirect acting cholinergic drugs

Answer 12

increase ach concentrations at receptor sites, cause skeletal muscle contraction, diagnose and treat myasthenia gravis

Question 13

which cholinergic drug is used to treat alzehimers. why

Answer 13

donepezil as the increase in ach can help enhance or maintain memory and learning capbilities

Question 14

which cholinergic drug is used as the antidote for anticholinergic poisoning

Answer 14

physostigmine

Question 15

5 contraindications for cholinergic drugs

Answer 15

defect in cardiac impulse conduction, hyperthyroidism, epilepsy, hypotension, copd

Question 16

what are 5 early signs of a cholinergic crisis

Answer 16

abdominal cramps, salivation, flushing, nausea, vomiting

Question 17

5 severe outcomes of a cholinergic crisis

Answer 17

circulatory collapse, hypotension, bloody diarrhea, shock, cardiac arrest

Question 18

what are the 2 drugs used to treat a cholinergic crisis

Answer 18

atropine, epinephrine

Question 19

what is the acronym to remember the symptoms of cholinergic toxicity. what does the acronym stand for

Answer 19

SLUDGE. salivation, lacrimation, urinary incontinence, diarrhea, gastrointestinal cramps, emesis

Question 20

3 key cholinergic drugs

Answer 20

bethanechol, donepezil, pyridostigmine

Question 21

indications for bethanechol (2)

Answer 21

urinary retention, bladder dysfunction

Question 22

indication for pyridostigmine (2)

Answer 22

improve muscle strength and relieve symptoms of myasthenia gravis, tca overdose

Question 23

what non-pharmacological should be encouraged to achieve the full effects of cholinergic drugs

Answer 23

encourage early ambulation and increase intake of fluids and fibre

Question 24

when should cholinergic drugs be given in the case of myasthenia gravis

Answer 24

30min before meals

Question 25

how long can it take to see therapeutic effects of cholinergic drugs

Answer 25

6 weeks

Question 26

what is ginko used to treat (4)

Answer 26

prevent memory loss, peripheral arterial occlusive disease, vertigo, tinnitus

Question 27

3 adverse effects of ginko

Answer 27

stomach or intestinal upset, headache, bleeding

Question 28

6 drug interactions of ginko

Answer 28

aspirin, anti-inflammatories, warfarin, heparin, anticonvulsants, tca’s