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Pharmacology for Advanced Practice Nurses > Module 4 Pearls Deck 2 > Flashcards

Module 4 Pearls Deck 2 Flashcards

1
Q

Cholinergic Antagonists/Blockers also known as

A

anticholinergics, parasympatholytics,

muscarinic antagonists

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2
Q

Cholinergic Antagonists/Blockers block

A 
of acetylcholine (ACh) in the cholinergic
synapses, and prevent ACh from binding at receptor sites
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3
Q

Cholinergic Antagonists/Blockers produce many

A

Produce many of the same effects in the body as

adrenergic agonists

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4
Q

two main types of Cholinergic Antagonists/Blockers

A

Muscarinic antagonists and Nicotinic antagonists

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5
Q

Muscarinic MOA

A

block Ach from binding to muscarinic receptors in the parasympatheitc nervous system and inhibit some transmission in the sympathetic nervous system as well

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6
Q

Nicotinic MOA

A

block Ach from binding to the nicotinic receptors in the ganglia of the para and sympatheitc nervous systems

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7
Q

Cholinergic antagonists have the opposite effect

A

of cholinergic agonists

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8
Q

Cholinergic Antagonists: General Effects on the Body

Cholinergic antagonists

A

Increase blood pressure and pulse rate
• Increase bronchial dilation
• Produce mydriasis (dilated pupils) and cycloplegia (paralysis of ciliary muscle)
• Decrease sweating
• Reduce secretions and dry out mucous membranes
• Decrease gastric motility
• Increase urinary retention

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9
Q

Muscarinic antagonists are NOT considered

A

first line due to side effects:

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10
Q

side effects of muscarinic antagonists

A

Tachycardia and arrhythmias
• Mydriasis and cycloplegia, resulting in photophobia and increased intraocular pressure
• Dry eyes
• Dry mouth (xerostomia)
• Urinary retention, which poses a threat to males with prostate problems
• Decreased sweating that can lead to hyperthermia if the body cannot regulate its temperature

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11
Q

muscarinic receptors are found in

A

many different organ systems

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12
Q

specific cholinergic Antagonists examples

A

(atropine, ipratropium bromide (Atrovent)

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13
Q

Central acting cholinergic antagonists examples and use

A

Parkinson’s

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14
Q

Uses of Cholinergic Blocking Drugs

A

Block vagal impulses to heart
• Suppress or decrease
– Respiratory secretions (preoperative medication)
– Bladder spasms
• Relax sphincter muscle of iris
• Treat tremors/rigidity of parkinsonism
• Treat side effects of psychotropic medications

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15
Q

Cholinergic crisis is a serious condition that can result from

A

overdosage of AChE
inhibitors. This condition is also caused by poisoning from chemical agents such as:
– Sarin, a toxic nerve agent used in chemical warfare
– Malathion, parathion, and other organophosphate insecticides

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16
Q

_____ an anticholinergic and muscarinic antagonist, is the primary drug
used to treat cholinergic crisis.

A

Atropine

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17
Q

Atropine is used with ___ as an antidoe for sarin or insecticide poisening

A

Pralidoxime chloride (2-PAM, Protopam Chloride)

18
Q

Pralidoxime chloride is classified as a

A

cholinesterase receptor
agonist and a detoxification agent. It helps restore normal transmission at
neuromuscular junctions.

19
Q

Cholinesterase Inhibitors

A

Indirect cholinergic agnonists

Prevents the destruction of ACh by inhibiting AChE thus increasing ACh activity

20
Q

Seizure

A

Abnormal discharge of neurons
• Disruption of neuron stability may trigger abnormal activity
and seizures

21
Q

factors that precipitate seizures

A

Sleep deprivation, high caffeine intake, hyperventilation, stress,
hormonal changes, sensory stimuli, drug/alcohol use,
infections, fever, metabolic disorders

22
Q

Three terms used interchangeably for seizures

A

Anti-seizure drugs
– Antiepileptic drugs (AEDs)
– Anticonvulsants

23
Q

Anti-seizure drugs act by

A

suppressing the brain’s neuronal

discharges.

24
Q

Anti-seizure medications are
sometimes classified according to
their mechanism of action:

A 
Slowing neuronal firing rates by
increasing gamma-aminobutyric
acid (GABA) levels
• Blocking the channels
responsible for neuronal firing
• Blocking AMPA receptors, by
medications such as
Perampanel (Fycompa)
25
Q

Examples of drugs that work on gaba

A

benzodiazapines, phenobarbitol

26
Q

Muscle Relaxants and Antispasmodics

Centrally acting

A

baclofen (Lioresal) cyclobenzaprine (Flexeril),

carisoprodol (Soma),
chloroxazone (Paraflex, Parafon Forte), metaxalone (Skelaxin), methocarbamol
(Robaxin), orphenadrine (Banflex, Norflex), and tizanidine
(Zanaflex)

27
Q

Muscle Relaxants and Antispasmodics direct acting examples

A 
dantrolene (Dantrium) and botulinum toxin
type A (Botox)
28
Q

Centrally Acting Skeletal Muscle Relaxants MOA

A

Unknown

29
Q

Centrally Acting Skeletal Muscle Relaxants Contraindication

A

specfic for each drug, all are contraindicated in pregnancy

30
Q

Centrally Acting Skeletal Muscle Relaxants ADR

A

CNS sedation, respiratory
depression; chloroxazone may
be hepatotoxic

31
Q

Centrally Acting Skeletal Muscle Relaxants Interactions and patient educaton

A

Drug interactions: additive
sedation with CNS depressants (respiratory depression) this is why there are drug interactions and why its important to discuss this with patients
• Patient education: appropriate
use, CNS sedation

32
Q

Decrease in pain from centrally acting skeletal muscle relaxants is due to

A

decrease in spasm not anelgesic properties

33
Q

Direct acting muscle relaxants: Dantrolene: used to treat

A

spasticity associated with upper neuron

disorders

34
Q

dantroline contraindicated in

A

active liver diseases

35
Q

dantroline ADR

A

CNS depression, confusion

36
Q

dantroline patient education

A

titration schedule

37
Q

Botulinum toxin type a

A

injected to provide localized reduction in muscle activity

38
Q

botulinum toxin type a may

A

spread from the site of injection to mimic boulism may require mechanical ventilation

39
Q

botox works by

A

blocking the release of AcH

40
Q

dantroline works by blocking

A

dantroline release

41
Q

danroline helps relax

A

sacromeres

42
Q

botox can be used for

A

migraines

Pharmacology for Advanced Practice Nurses (50 decks)

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