EXAM 3- Cholinergic drugs Flashcards
Ach is released:
nerve impulse passes
For nerve impulse to be transmitted from one nerve ending to another-
neurohormone is needed
- Ach
- AchE
Ach inactivated by
AchE
Ach
transmits nerve impulses across the parasympathetic branch of the autonomic nervous system
AChE
inactivates the neurotransmission of ACh
glaucoma
disorder of increased pressure within anterior chamber of eye
glaucoma prescribed with
-cholinergic drug: pilocarpine, which produces miosis (Constriction of iris), allowing for passage of fluid in chamber, thus reducing pressure
Myasthenia Gravis
rapid fatigue of skeletal muscles due to lack of Ach released at the nerve endings of parasympathetic nerve fibers
Myasthenia Gravis prescribed with
Pyridostigimine
treatment of urinary retention by relaxing bladder sphincter
Bethanechol
cholinergic drugs are not selective in action=
so many organs may experience the effect.
-N/D, abd cramping, salivation, muscle weakness, frequency.
Nursing process: glaucoma
-observe redness, inflammation drainage or eye
-assure med reads “for Opthalmic Use”
-When administering eye drops:
head back, eyes up, dropper shouldn’t touch pt; place drop in conjunctival sac
nursing process: urinary retention
- assess for bladder distention
- I&O
- assist bed pan or provide call bell
- observe for s&s of adverse reactions
cholinergic-blocking drugs
-block Ach in PNS
also called anti-cholinergic, parasympathomimetic blocking
cholinergic-blocking drugs: when PNS is inhibited-
Ach cannot access the receptors (nicotinic/muscarinic)
cholinergic-blocking drugs: heart
increase HR
cholinergic-blocking drugs: Respiratory tract
dry mucus membranes and cause bronchial dilation
cholinergic-blocking drugs: GI tract
decrease GI motility, secretions, salivation
cholinergic-blocking drugs: Urinary tract
decrease bladder contraction, resulting in urinary retention
cholinergic-blocking drugs: eye
dilation, increase in intraocular pressure
cholinergic-blocking drugs: ____ muscle rigidity and ____ tremors in ____ disease.
decreases, diminishes, Parkison’s.
cholinergic-blocking drugs: used to inhibit the _____.
vagal stimulus
cholinergic-blocking drugs: relaxation of smooth muscles in the bronchi
- Decrease airway resistance
- Bronchodilation
- used for IBS
- Neurogenic bladder and incontinence
- Reduce gastric and pancreatic secretions (help with acute pancreatitis)
- Used pre-op to reduce respiratory secretions
adverse reactions of cholinergic-blocking drugs: Cardiovascular
- big increase in HR
- dysrhythmias
adverse reactions of cholinergic-blocking drugs: CNS
- excitation
- restlessness
- irritability
- disorientation
- hallucinations
adverse reactions of cholinergic-blocking drugs: Eye
- dilates pupils a lot
- bigger increase in intraocular pressure
adverse reactions of cholinergic-blocking drugs: GI
- major decrease of salivation, gastric secretions, and motility
- constipation
adverse reactions of cholinergic-blocking drugs: GU
urinary retention
adverse reactions of cholinergic-blocking drugs: respiratory
- major decrease in respiratory secretions
concerns with elderly on cholinergic blocking drugs:
- confusion or excitement even with small doses
- hallucinations, delirium
- report unusual signs to physician asap
special precautions of cholinergic-blocking in pt with: glaucoma
-because of mydriasis and increased ocular pressure
special precautions of cholinergic-blocking in pt with enlarged prostate
since urinary retention may occur.
-caution includes OTC meds that may include atropine or other cholinergic drugs
special precautions of cholinergic-blocking in pt with acute asthma or
other respiratory distress.
nursing process for cholinergic-blocking:
- History of present disorders
- What is reason for administering drug?
- V/S
- Any dehydration noted?
cholinergic-blocking: If given for patient with heart block-
Cardiac monitor – (change in rate, rhythm)
cholinergic-blocking: if used as pre-op med-
- Void before med is given
- Usually given w 1 or 2 other meds as pre op med.
- Inform patient that dry mouth is NORMAL and NOT to take fluids prior to surgery.
- administer ON TIME so as to assure optimum effect of medication prior to admin of anesthesia
cholinergic-blocking: for older patients-
- Might not be given to patients over 60 due to effects on eye and CNS
- Watch for heat prostration in summer since ability to sweat has been effected.
- Watch for excitement/confusion.
- Assist with ambulation if on med routinely
education with prolonged use of cholinergic-blocking:
-Inform provider of adverse reactions
education with prolonged use of cholinergic-blocking: photophobia
wear sunglasses, soft light
education with prolonged use of cholinergic-blocking: Dry mouth
take frequent sips of water during the day; chew gum or dissolve hard candy
education with prolonged use of cholinergic-blocking: constipation
drink plenty of fluids, increase fiber in diet
education with prolonged use of cholinergic-blocking: heat prostration
use fans, sponge bath.
