CHOLINERGIC UNIT 4 Flashcards
What are the two drugs that are Cholinergics? Select all that apply
A. Pilocarpine
B. Timolol
C. Atropine
D. Digoxin
E. Bethanechol Chloride
E. Bethanechol Chloride
A. Pilocarpine
What system does Cholinergic’s stimulate?
A. Parasympathetic
B. Sympathetic
C. Central
D. Peripheral
A. Parasympathetic
- STIMULATE THE PARASYMPATHETIC NERVOUS SYSTEM
- MIMIC THE NEUROTRANSMITTER ACETYLCHOLINE
- MUSCARINIC RECEPTORS
- AFFECT SMOOTH MUSCLES, SLOW HEART RATE
- NICOTINIC RECEPTORS
- AFFECT SKELETAL MUSCLES
What are the effect that Cholingeric’s have on the body systems?
EYE
* CONSTRICTS PUPIL
* LUNGS
* CONSTRICTS BRONCHIOLES, INCREASES SECRETIONS
* HEART AND BLOOD VESSELS
* DECREASED HEART RATE AND DILATED BLOOD VESSELS
* GASTROINTESTINAL
* INCREASES PERISTALSIS AND SECRETIONS
* BLADDER
* CONSTRICTS THE BLADDER
* SALIVARY AND SWEAT GLANDS
* INCREASES SECRETIONS
RELAX AND DIGEST
Bethanecol Chloride use
ACTION
* STIMULATES THE CHOLINERGIC RECEPTORS
* THIS STIMULATION CAUSES CONTRACTION OF THE BLADDER
* OTHER ACTIONS
* INCREASES GI SECRETIONS AND PERISTALSIS
* INCREASES BRONCHIAL SECRETIONS AND BRONCHOCONSTRICTION
* CONSTRICTS PUPILS
- USES
- TREATS URINARY RETENTION
Side effects of Bethanecol Chloride
Nausea, vomiting, diarrhea, abdominal cramps, hypersalivation, diaphoresis, headache, dizziness, flushing, urinary urgency and frequency, weakness, miosis, lacrimation
Adverse effect of Bethanecol Chloride
Tachycardia, hypotension
Life threatening: Bronchospasm, wheezing, seizures
Contraindications of Bethanecol Chloride
Contraindicated: Intestinal or urinary tract obstruction, Irritable bowel syndrome, bradycardia, hypotension, COPD, asthma, peptic ulcer, hyperthyroidism, seizures, parkinsonism
Interactions of Bethanechol Chloride
INTERACTIONS
* OTHER DRUGS THAT LOWER THE HEART RATE/BLOOD PRESSURE
* ATROPINE(ANTI-CHOLINERGIC)
Should Bethanecol be taken with food
A. Yes
B. No
B. No
Bethanechol also increases peristalsis in the GI tract and gastric emptying time, and the drug should be taken on an empty stomach 1 to 2 hours before meals to minimize nausea and vomiting.
Assessment for Bethanecol Chloride
CHOLINERGIC AGONIST – BETHANECHOL
CHLORIDE
* ASSESSMENT
* VITAL SIGNS
* ASSESS URINE OUTPUT
* MEDICATION/MEDICAL HISTORY
Nursing Interventions for Bethanecol Chloride
INTERVENTIONS
* MONITOR VITAL SIGNS – WATCH FOR A DECREASE IN BP AND PULSE
* MONITOR LUNG SOUNDS
* MONITOR GI/GU STATUS
* MONITOR AND RECORD INTAKE & OUTPUT
* GIVE 1 HOUR BEFORE OR TWO HOURS AFTER MEALS
* MONITOR FOR OVERDOSE
* SIGNS AND SYMPTOMS INCLUDE MUSCULAR WEAKNESS & INCREASED SALIVATION
* ANTAGONIST - ATROPINE
Patient Teaching for Bethanecol Chloride
TEACH PATIENT TO
* MONITOR THEIR BLOOD PRESSURE AND HEART RATE AND PARAMETERS TO REPORT
* RISE SLOWLY FROM A LYING POSITION TO PREVENT ORTHOSTATIC HYPOTENSION
* TAKE ON AN EMPTY STOMACH ONE HOUR BEFORE OR TWO HOURS AFTER MEALS
* REPORT INCREASED MUSCLE WEAKNESS OR SALIVATION (SIGN OF OVERDOSEEEEEEE)
* EVALUATIONS
* PATIENT ABLE TO EMPTY BLADDER
PILOCARPINE ACTION
CHOLINERGIC AGONIST - PILOCARPINE
* ACTION
* CONSTRICTS THE PUPIL WHICH OPENS THE CANAL OF SCHLEMM TO PROMOTE
DRAINAGE OF THE AQUEOUS HUMOR
* USES
* DECREASE PRESSURE IN THE EYE IN DISEASES SUCH AS GLAUCOMA
* GIVEN AS EYE DROPS – REVIEW CHAPTER 10 FOR PROPER EYE DROP
ADMINISTRATION
- The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg. The nurse will perform which action?
a. Administer the drug and monitor urine output.
b. Administer the medication and monitor vital signs frequently.
c. Give the medication and notify the provider of the increased heart rate.
d. Hold the medication and notify the provider of the decreased blood pressure.
ANS: D
Bethanechol treatment can result in hypotension. The nurse should hold the drug and notify the provider of the low blood pressure.
- The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or gastrointestinal pain. blood pressure is 110/70 mm Hg. The nurse will perform which action?
a. Notify the provider of bethanechol adverse effects.
b. Record the urine output and the blood pressure and continue to monitor.
c. Request an order for intravenous atropine sulfate.
d. Suggest another dose of bethanechol to the provider.
ANS: B
The patient is exhibiting desired effects and mild side effects of bethanechol, so the nurse should record information and continue to monitor the patient. There is no need to notify the provider, give an antidote, or repeat the dose.
