Indirect-Acting Cholinergic Agonists Flashcards
1
Q
Medications for Myasthenia Gravis
A
- Neostigmine
- Pyridostigmine (has longer duration of action)
- Edrophonium (diagnostic agent)
2
Q
Medications for Alzheimer’s Disease
A
- Galantamine
- Rivastigmine
- Donepezil
3
Q
Action
A
-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
4
Q
Indications
A
- Myasthenia gravis
- Alzheimer’s disease
5
Q
Contraindications
A
- Allergy
- Bradycardia
- Intestinal or urinary blockage
- Pregnancy and lactation
6
Q
Caution
A
-Any condition that could be exacerbated by cholinergic stimulation
7
Q
Adverse effects
A
- Bradycardia
- Hypotension
- Increased GI secretions and activity
- Increased bladder tone
- Relaxation of sphincters
- Bronchoconstriction
- Pupil constriction
8
Q
Drug-Drug Interactions
A
- NSAIDs
- Cholinergic drugs
9
Q
Assessment
A
- History and physical exam
- Check for any contraindications
- Orientation, reflexes, ability to carry on ADLs
- VS, ECG as appropriate, urinary output, rena;/liver function tests
10
Q
Nursing Diagnoses
A
- Disturbed thought process r/t CNS effects
- Acute pain r/t GI effects
- Decreased cardiac output r/t BP changes, vasodilation, arrhythmias
- Deficient knowledge regarding drug therapy
- Risk for injury r/t CNS effects
- Diarrhea r/t GI stimulatory effects
11
Q
Implementation
A
- If given IV, administer slowly
- Maintain atropine on standby
- Discontinue if excessive salivation, diarrhea, emesis, or frequent urination
- Administer PO with meals
- Mark chart if pt is going to surgery
- Monitor for progress
- Arrange supportive care and comfort measures
- Provide pt teaching
12
Q
Evaluation
A
- Monitor pt response to drug (improvement of condition being treated)
- Monitor for adverse effects
- Evaluate effectiveness of teaching plan
- Monitor the effectiveness of comfort measures/compliance with regimen
