cholinergic medications Flashcards
cholinergic meds
influence the activity of cholinergic receptors which mediate or control responses to acetylcholine.
this will affect:
-PSNS
-pre-ganglionic activity of the SNS
-skeletal muscle system thru the somatic motor system
what is cholinergic meds also referred as
parasympathomimetic
can also be stimulated using a sympatholytic
3 main receptr subtypes to the cholinergic system
Nicotinic (M) (neuromuscular)
Nicotinic (N) (ganglionic)
Muscarinic
Muscarinic receptor location
sweat glands
blood vessels
all organs regulated by the PSNS
Muscarinic receptor effects
↓HR
↑ exocrine gland secretion (sweat, saliva)
↑ bronchial secretions
smooth muscle contration (bronchi, GI, bladder)
miosis (pupil constriction)/ CXN of the ciliary muscles
*think PSNS
Muscarinic agonist vs antagonist
agonist = enhance PSNS (by stimulating)
antagonist = enhance SNS (by blocking)
cholinergic med
nursing considerations
take HR before administering
*national standard <60 bpm = hold and call provider
if give by eye drop then apply inner-canthus pressure
keep atropine on hand
atropine is reversal agent
Anticholinergic med
aka muscarinic antagonists
block the action of acetylcholine at the muscarinic sites
get the opposite effects of the muscarinic agonist
anticholinergic med name
atropine
anticholinergic med
atropine effects
↑ HR (main usage)
↓gland secretions
relaxation of the bronchi
↓tone of the bladder and GI tract
mydriasis (eye dilated)
think SNS
atropine (anticholinergic med)
SE/AR
dry mouth
blurred vision
elevated intraocular pressure
urinary retention
constipation
tachycardia (early sign you may have too much anticholinergic)
thing to help you remember antcholinergic toxic
blind as a bat (mydriasis)
mad as a hatter (confused, decreased LOC)
red as a beet (flushed, vasodilation)
dry as a bone (dry skin/membranes)
hot as a hare (hyperthermia)
stuffed as a pipe (urinary/bowel retention)
if not treated you may see:
seizures
rhabdomyolysis
dysrhythmias
tachycardia is early sign
other anticholinergic meds
scopolamine
*motion sickness
ipratropium bromide (atrovent)
*maintenance of COPD and asthma, short onset and long acting
dicyclomine (bentyl):
*spastic colon
oxybutynin (ditropan) and tolterodine (Detrol):
*overactive bladder
neuromuscular blocking agents
block acetylcholine from activating nicotinic (M) receptors
results in:
*profuse smooth muscle relaxation (paralysis)
*hypotension
must give sedative first bc its a paralytic
never give these meds unless pt is intubated or in the process
neuromuscular blocking agents
ultra-short acting
succinylcholine (anectine)
for ventilation
