Cholinergics Agonists - Parasympathomimetics

Question 1

Cholinergic Agonists- parasympathetic

Action:

Answer 1

stimulates parasympathetic nervous system
mimics NT, ACh
muscarinic receptors: affect smooth muscle; slow HR
nicotinic receptors: affect skeletal muscle

Question 2

Cholinergic Agonists- parasympathetic

Indications:

Answer 2

Major response to cholinergics:
stimulate bladder & GI tone, constrict pupils
increases neuromuscular transmission

Question 3

Cholinergic Agonists- parasympathetic

Bethanechol chloride:

Answer 3

Action: stimulates urination- Tx urinary retention

Question 4

Cholinergic Agonists- parasympathetic

Pilocarpine:

Answer 4

Action: causes pupillary constriction- used to Tx some types of glaucoma to decrease IOP

Question 5

Cholinergic Agonists- parasympathetic

Pyridostigmine

Answer 5

Action: stimulates NT- used to increase muscle strength in myasthenia gravis

Question 6

Cholinergic Agonists- parasympathetic
(ex. bifithicol chloride)
S.E.

Answer 6

blurred VI
hypotension
bradycardia
diarrhea
urinary freq
increased secretions
bronchoconstriction

Question 7

Cholinergic Agonists- parasympathetic
(ex. bifithicol chloride)
Adverse Reactions:

Answer 7

cardiac dysrhythmia

reflects tachycardia

Question 8

Cholinergic Agonists- parasympathetic
(ex. bifithicol chloride)
Contraindications:

Answer 8

bradycardia; hypotension
COPD/asthma (increase mucous in lungs)
peptic ulcer
Parkinson’s Dz

Question 9

Cholinergic Agonists- parasympathetic
(ex. bifithicol chloride)
Interactions:

Answer 9

other drugs that lower HR/BP

atropine

Question 10

Nursing Process

Assessment:

Answer 10

V.S.- monitor q8; q4; q12 hrs (depends on the values)
Assess urinary output
check for other BP lowering meds
What other conditions does pt have?

Question 11

Nursing Process

Interventions:

Answer 11

lung sounds- bc Rx increases mucous in lungs/can cause bronchoconstriction
Pt have diarrhea?
Are urinary issues improving? record I/Os
Admin this med on EMPTY STOMACH: (1 hr BEFORE meals OR 2 after meals)
Monitor for OD: s/s muscle weakness; increased salivation

Question 12

Nursing Process

Evaluation:

Answer 12

Pt should be able to empty bladder.

Question 13

Nursing Process

Pt Teaching:

Answer 13

Monitor BP/HR- teach pt how to take pulse
Pt to report increased muscle weakness or salivation (s/o toxicity)
“Get up slowly.”
“Take on empty stomach.”
If BP > 100/60 (for example): report to dr
If HR < 60 report to dr.