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NURS 320 > Exam 1: Chapter 21: Cholinergic-Blocking Drugs > Flashcards

Exam 1: Chapter 21: Cholinergic-Blocking Drugs Flashcards

1
Q

Cholinergic Blocking Drugs

A

drugs that block the actions of acetylcholine in the PSNS

aka anticholinergics, parasympathomimetics, and antimuscarinic drugs

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2
Q

Cholinergic Blocking Drugs: MOA

A

Competitive antagonists

  • compete with ACh for binding at muscarinic receptors in the PSNS -> ACh is unable to bind to receptor site and cause a cholinergic effect
  • inhibits nerve transmission at these receptors
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3
Q

Examples of Cholinergic-Blocking Drugs

A 
atropine*
dicyclomine
glycopyrrolate
oxybutynin
scopolamine
tolterodine
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4
Q

Drug Effects: Cardiovascular

A

small doses: decrease heart rate

large doses: increase heart rate

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5
Q

Drug Effects: CNS

A

small doses: decrease muscle rigidity and tremors

large doses: drowsiness, disorientation and hallucinations

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6
Q

Drug Effects: Eye

A 
dilated pupils (mydriasis)
decreased accommodation caused by paralysis of ciliary muscles (cycloplegia)
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7
Q

Drug Effects: GI

A

relax smooth muscle tone of GI tract
decreases intestinal and gastric secretions
decrease motility and peristalsis

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8
Q

Drug Effects: GU

A

relaxed detrusor muscle
increased constriction of internal sphincter
result: urinary retention

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9
Q

Drug Effects: Glandular

A

decreased bronchial secretions, salivation and sweating

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10
Q

Drug Effects: Respiratory

A

decreased bronchial secretions

dilated bronchial airways

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11
Q

Indications: CNS

A

decreasing muscle rigidity and muscle tremors: Parkinson’s disease and drug-induced extrapyramidal reactions (ex. those associated with antipsychotic drugs)

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12
Q

Indications: Cardiovascular

A

Affects the heart’s conduction system:
low dose - slows the heart rate
high dose - block inhibitory vagal effects on SA and AV node pacemaker cells -> increased heart rate

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13
Q

Atropine

A

used primarily for cardiovascular disorders:

  • diagnosis of sinus node dysfunction
  • symptomatic second-degree heart block
  • severe sinus bradycardia w/ hemodynamic compromise (advanced life support)
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14
Q

Indications: Respiratory

A

blocking the cholinergic stimulation of the PSNS allows unopposed action of the SNS thus resulting in:

  1. decreased secretions from the nose, mouth, pharynx and bronchi
  2. relaxed smooth muscles in the bronchi and bronchioles
  3. decreased airway resistance
  4. bronchodilation
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15
Q

Cholinergic Blockers are used to treat

A

Exercise-induced bronchospasms
Chronic Bronchitis
Asthma
COPD

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16
Q

Indications: GI

A

The PSNS controls gastric secretions and smooth muscles that produce gastric motility. The blockade of PSNS results in:

  1. decreased secretions
  2. relaxation of smooth muscle
  3. decreased GI motility and peristalsis
17
Q

GI drugs are used to treat

A

Irritable bowel disease

GI hypersecretory states

18
Q

Indications: Genitourinary

A

reflex neurogenic bladder

incontinence

19
Q

Contraindications

A 
Known drug allergy
Angle-closure glaucoma
Acute asthma or other respiratory distress
Myasthenia gravis
Acute cardiovascular instability
GI or GU tract obstruction
20
Q

Adverse Effects: Cardiovascular

A

Increased heart rate

dysrhythmias

21
Q

Adverse Effects: CNS

A 
CNS excitation
restlessness
irritability
disorientation
hallucinations
delirium
22
Q

Adverse Effects: Eye

A 
dilated pupils (causing blurred vision)
iincreased intraocular pressure
23
Q

Adverse Effects: GI

A

decreased salivation
decreased gastric secretions
decreased motility (causing constipation)

24
Q

Adverse Effects: GU

A

urinary retention

25
Q

Adverse Effects: Glandular

A

decreased sweating

26
Q

Adverse Effects: Respiratory

A

decreased bronchial secretions

27
Q

Treatment of Toxicity and Overdose

A 
Symptomatic and supportive therapy
Continuous Electrocardiographic monitoring
Activated charcoal
Treatment of shock
Physostigmine
28
Q

Nursing Implications

A
  • Assess for allergies, presence of BPH, urinary retention, glaucoma, tachycardia, myocardial infarction, heart failure, hiatal hernia, and GI or GU obstruction.
  • Patients may experience sensitivity to light and may want to wear dark glasses or sunglasses.
29
Q

Antidote for atropine overdose is

A

physostigmine

30
Q

Monitor for therapuetic effects: for patients with parkinson’s disease

A

fewer tremors and decreased salivation and drooling

31
Q

Monitor for therapeutic effects: for patients with urologic problems

A

improved urinary patterns, less hypermotility, increased time between voiding

NURS 320 (28 decks)

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