Indirect-Acting Cholinergic Agonists

Question 1

Indirect-Acting Cholinergic Agonists

Drug Names

Answer 1

Neostigmine
Pyridostigmine
Edrophonium
Galantamine
Rivastigmine
Donepezil

Question 2

Drugs Used to Treat Myasthenia Gravis

Answer 2

Neostigmine
Pyridostigmine
Edrophonium

Question 3

Drugs Used to Treat Alzheimer’s Disease

Answer 3

Galantamine
Rivastigmine
Donepezil

Question 4

Indications

Answer 4

Myasthenia Gravis and Alzheimer’s disease

Question 5

Mechanism of Action

Answer 5

Blocks ACh at the synaptic cleft, which allows the accumulation of ACh released from the nerve endings and leads to increased and prolonged stimulation of ACh

Question 6

Contraindications

Answer 6

Allergy
Bradycardia
Intestinal or urinary tract obstruction
Pregnancy/lactation

Question 7

Adverse Effects

Answer 7

Bradycardia
Hypotension
Increased GI secretions and activity
Increased bladder tone
Relaxation of GI and genitourinary sphincters
Bronchoconstriction
Pupil constriction

Question 8

Drug-Drug Interactions

Answer 8

NSAIDs

Cholinergic drugs

Question 9

Assessment

Answer 9

HX & Physical: known allergy, arrhythmias, coronary artery disease, hypotension, urogenital and GI obstruction, or peptic ulcer, GI or GU surgery
Orientation, affect, reflexes, ability to carry on activities of daily living
Vital signs, ECG as appropriate, urinary output and renal/liver function tests