cholinergics

Question 1

S/Es of cholinergic drugs

Answer 1

• DUMBBELS
  
  • Diarrhea
  • Urination
  • Miosis/muscle weakness
  • Bronchorrhea
  • Bradycardia
  • Emesis
  • Lacrimation
  • Salivation/sweating

Question 2

Bethanechol: class

Answer 2

• muscarinic agnoist
• cholinergic

Question 3

Bethanechol: MOA

Answer 3

• direct acting muscarinic agonist
  
  • reversibly binds to muscarinic cholinergic Rs to cause activation

Question 4

bethanechol: Indication

Answer 4

• urinary retention: activates muscarinic Rs of urinary tract to relax the Ms and inc voiding pressure
• research for use for GERD, abdominal distention, gastric atony

Question 5

bethanechol: SEs

Answer 5

• Diarrhea
• Urination
• Miosis/muscle weakness
• Bronchorrhea
• Bradycardia
• Emesis
• Lacrimation
• Salivation/sweating

Question 6

bethanechol: ADRs

Answer 6

• Hypo TN
• bradycardia
• inc pressure w/in the urinary tract
• bronchoconstriction
• dysrhythmias in hyperthyroid pts

Question 7

bethanechol: nursing implications

Answer 7

• contraindicated: physical obstruction of GI tract, low BP, low CO, urinary tract obstruction or weakness of bladder wall, hyperthyroidism
• take 1 hour before meals or 2 hours after

Question 8

donepezil: class

Answer 8

• anti Alzheimer’s
• cholinesterase inhibitors

Question 9

donepezil: MOA

Answer 9

• causes reversible inhibition of AChE
  
  • more selective for the form in the brain than in the periphery

Question 10

donepezil: Indication

Answer 10

• mild, moderate, severe Alzheimer’s

Question 11

donepezil: SEs

Answer 11

• nausea
• diarrhea
• fainting
• headache

Question 12

donepezil: ADRs

Answer 12

• bradycardia
• falls, fall related fxs
• bronchoconstriction
• CV effects

Question 13

donepezil: nursing implications

Answer 13

• do not take more than prescribed
• make sure pt gets up slowly b/c can cause dizziness

Question 14

neostigmine: class

Answer 14

• reversible cholinesterase inhibitors
• cholinergic
• anti myasthenic

Question 15

neostigmine: MOA

Answer 15

• Inhibits the breakdown of acetylcholine so that it accumulates and has a prolonged effect.

Question 16

neostigmine: indication

Answer 16

• myasthenia gravis
• reversal of competitive (non depolarizing) neuromuscular blockade

Question 17

neostigmine: SEs

Answer 17

• Diarrhea
• Urination
• Miosis/muscle weakness
• Bronchorrhea
• Bradycardia
• Emesis
• Lacrimation
• Salivation/sweating

Question 18

neostigmine: ADRs

Answer 18

• neuromuscular blockade: cholinesterase inhibitors can cause accumulation of ACh in amounts sufficient to produce depolarizing neuromuscular blockade
  
  • paralysis of respiratory Ms can result

Question 19

neostigmine: nursing implication

Answer 19

• contraindications: obstruction of the GI tract, obstruction of urinary tract, PUD, asthma, coronary insufficiency, hyperthyroidism
• if experience symptoms of excessive cholinergic crisis, can suppress with atropine
• wear a medic alert bracelet if have myasthenia gravis

Question 20

physostigmine: class

Answer 20

• reversible cholinesterase inhibitors
• cholinergic

Question 21

physostigmine: MOA

Answer 21

• Inhibits the breakdown of acetylcholine so that it accumulates and has a prolonged effect.
  
  • readily crosses membranes (neostigmine does not)

Question 22

physostigmine: indication

Answer 22

• poisoning by atropine and other drugs when muscarinic blockade occurs
  
  • other drugs: antihistamines, antipsychotics, but NOT TCAs

Question 23

physostigmine: SEs

Answer 23

• Diarrhea
• Urination
• Miosis/muscle weakness
• Bronchorrhea
• Bradycardia
• Emesis
• Lacrimation
• Salivation/sweating

Question 24

physostigmine: ADRs

Answer 24

• seizures

Question 25

physostigmine: nursing implications

Answer 25

• contraindications: obstruction of the GI tract, obstruction of urinary tract, PUD, asthma, coronary insufficiency, hyperthyroidism
• if experience symptoms of excessive cholinergic crisis, can suppress with atropine