Direct-Acting Cholinergic Agonists Flashcards
Direct-Acting Cholinergic Agonists
Drug Names
Bethanechol
Carbachol
Cevimeline
Pilocarpine
Indications
Urinary retention
Induce miosis
Treat dry mouth
Mechanism of Action
Acts at cholinergic receptors in the peripheral nervous system to mimic the effects of ACh and parasympathetic stimulation
Contraindications
Any condition that would be exacerbated by parasympathetic effects-bradycardia, hypotension
Known allergy, peptic ulcer disease
Intestinal obstruction or recent GI surgery
Asthma
Bladder obstruction
Epilepsy and parkinsonism
Adverse Effects
Nausea, vomiting, cramps, diarrhea, increase salivation, and involuntary defecation
Bradycardia, heart block, hypotension
Urinary urgency
Flushing or increased sweating
Drug-Drug Interactions
Acetylcholinesterase
Assessment
HX & Physical Exam: known allergy, bradycardia, vasomotor instability, peptic ulcer, and obstructive urinary or GI diseases; recent GI or genitourinary surgery; asthma; parkinsonism or epilepsy; vital signs, lung sounds, cardiac status, bowel sounds, and I&O