Direct-Acting Cholinergic Agonists

Question 1

Direct-Acting Cholinergic Agonists

Drug Names

Answer 1

Bethanechol
Carbachol
Cevimeline
Pilocarpine

Question 2

Indications

Answer 2

Urinary retention
Induce miosis
Treat dry mouth

Question 3

Mechanism of Action

Answer 3

Acts at cholinergic receptors in the peripheral nervous system to mimic the effects of ACh and parasympathetic stimulation

Question 4

Contraindications

Answer 4

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

Question 5

Adverse Effects

Answer 5

Nausea, vomiting, cramps, diarrhea, increase salivation, and involuntary defecation
Bradycardia, heart block, hypotension
Urinary urgency
Flushing or increased sweating

Question 6

Drug-Drug Interactions

Answer 6

Acetylcholinesterase

Question 7

Assessment

Answer 7

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