Direct-Acting Cholinergic Agonists Flashcards
1
Q
Medications
A
- Bethanechol
- Carbachol
- Cevilmeline
- Pilocarpine
2
Q
Action
A
-Act at cholinergic receptors in the peripheral nervous system to MIMIC the effects of ACh and PNS stimulation (rest and digest)
3
Q
Indications
A
- Urinary retention
- Induce miosis (pupil constriction)
- Treat dry mouth
4
Q
Contraindications
A
- Any condition exacerbated by parasympathetic effects: bradycardia, hypotension
- Known allergy
- Peptic ulcer disease
- Intestinal obstruction or recent GI surgery
- Asthma
- Bladder obstruction
- Epilepsy and Parkinsons
5
Q
Caution
A
Pregnancy and lactation
6
Q
Adverse effects
A
- Nausea/vomiting, cramps, diarrhea, increased salivation, involuntary defecation
- Bradycardia, heart block, hypotension
- Urinary urgency
- Flushing or increased sweating
7
Q
Drug-Drug Interactions
A
Acetylcholinesterase Inhibitors
8
Q
Assessment
A
- History and physical exam
- Check for any of the contraindications
- VS, lung sounds, cardiac status, bowel sounds, and I&O
9
Q
Nursing Diagnoses
A
- Acute pain r/t GI effects
- Decreased cardiac output r/t cardiovascular effect
- Impaired urinary elimination r/t the effect on the bladder
- Risk for injury r/t blurred vision and changes in visual acuity
- Potential for diarrhea r/t GI stimulatory effect
- Deficient knowledge regarding drug therapy
10
Q
Implementation
A
- Ensure proper administration of ophthalmic agents
- Administer PO drug on empty stomach
- Monitor pt closely
- Provide safety precautions (for visual acuity)
- Monitor urinary output
- Provide patient teaching
11
Q
Evaluation
A
- Monitor pt response to drug (improvement in bladder function, increased salivation, miosis)
- Monitor for adverse effects
- Evaluate the effectiveness of the teaching plan
- Monitor the effectiveness of comfort and safety measures/compliance with regimen
