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Module 2 NURS 5343 > Muscarinic antagonists > Flashcards

Muscarinic antagonists Flashcards

1
Q

completely blocks the actions of acetylcholine at muscarinic receptors

A

muscarinic antagonists/anticholinergic agent

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2
Q

potentially inappropriate for this population, can cause confusion, blurred vision, tachycardia, urinary retention, and constipation. It can also cause complications with pre-existing conditions

A

older adults with the use of muscarinic antagonists

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3
Q

produces its effects through competitive blockade at muscarinic receptors, prevents receptor activation by endogenous acetylcholine

A

atropine mechanism of action

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4
Q

Does atropine increase or decrease heart rate?

A

increases by blocking the receptors

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5
Q

Does atropine increase or decrease secretion from glands?

A

decreases secretion from salivary glands, bronchial glands, sweat glands, and acid-secreting cells of the stomach

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6
Q

What effect does atropine have on the smooth muscle?

A

relaxation of the bronchi, decreased tone of the urinary bladder detrusor, and decreased tone and motility of the GI tract

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7
Q

dilation of the pupils and relaxation of the ciliary muscle

A

atropine effects on the eyes

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8
Q

bradycardia, intestinal hypertonicity and hypermotility, asthma, biliary colic, muscarinic agonist poisioning, disorders of the eyes

A

therapeutic effects of atropine

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9
Q

xerostomia

A

this is caused by the use of muscarinic receptors on salivary glands, causes dry mouth

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10
Q

what can patients do to help with dry mouth?

A

chew sugar-free gum, sip fluids, and use salivary stimulants (citrus-flavored or tart sugarless candies, maltose lonzenges)

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11
Q

constipation, xerostomia, blurred vision and photophobia, elevation of intraocular pressure, tachycardia, anhidrosis

A

adverse effects of atropine

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12
Q

What is different about scopolamine vs atropine?

A

scopolamine produces sedation effects, suppresses emesis and motion sickness, whereas atropine produce mild CNS excitation

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13
Q

What is Ipratroprium bromide used for?

A

Used to treat asthma, COPD, or rhinitis. This medication is an inhaler typically so adverse effects with typical anticholinergic drugs are not associated

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14
Q

can be treated with behavioral or drug therapy

A

Overactive bladder

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15
Q

behavioral therapy for OAB includes?

A

scheduled voiding, timing fluid intake, doing kegel exercises, and avoiding caffeine, and maybe a diuretic to help increase detrusor activity.

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16
Q

How does anticholinergic agents work on the bladder transducer to assist with OAB?

A

These drugs block muscarinic receptors on the bladder detrusor and thereby inhibit bladder contractions and the urge to void

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17
Q

M3 receptors

A

found in the salivary glands, the bladder detrusor, GI smooth muscle, and the eyes

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18
Q

Why is Long acting Oxybutynin preferred over short acting?

A

With short acting you have to take several doses a day do to a short half life and the side effects are more intense for the IR formulations (short acting)

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19
Q

What are some adverse effects of Oxybutynin?

A

dry mouth, constipation, tachycardia, urinary hesitancy, urinary retention, mydriasis, blurred vision, and dry eyes

20
Q

Which drug used for OAB displays the greatest degree of selectivity for M3 receptors?

A

Enablex (darifenacin)

21
Q

Which drugs have the greatest effect on the heart and blood vessels?

A

calcium channel blockers

22
Q

What is the site of action for the non-dihydropyridines of the CCBs?

A

act on arterioles and impact the heart rate, can decrease heart rate

23
Q

what is the site of action for dihydropyridines of the CCBs?

A

acts primarily on the arterioles, very little effect on HR or SA node conduction

24
Q

A patient comes in to the ER with A fib with a rapid ventricular rate. what med could you prescribe of the CCBs?

A

Diltiazem (cardizem) drip to decrease heart rate

25
Q

angina pectoris, HTN, and cardiac dysrhythmias are therapeutic indications for which drugs

A

verapamil and diltiazem

26
Q

What are the 6 other drugs besides nifedipine in its class of CCBs?

A

amlodipine, felodipine, isradipine, nicardipine, nimodipine, nisoldipine

27
Q

Can verapamil be used in infants to control dysrhythmias?

A

Yes

28
Q

What adverse effect can CCBs have on older adults?

A

chronic eczematous eruptions

29
Q

what can you combine with nifedipine to prevent reflex tachycardia?

A

beta-blocker

30
Q

Hydralazine is a drug from what class?

A

Vasodilator

31
Q

what are the 5 indications hydralazine can be used for?

A

HTN, hypertensive crisis, angina pectoris, heart failure, and MI

32
Q

if hydralazine is used to treat heart failure, what drug is best combined with it?

A

isosorbide dinitrate, this can be used short term to reduce afterload in patients with HF

33
Q

Drug that is reserved for patients with severe HTN, unresponsive to other drugs

A

Minoxidil

34
Q

Why do patients who develop hypertrichosis want to stop taking minoxidil?

A

hypertrichosis is excessive hair growth that begins on the face and later develops on the arms, legs, and back

35
Q

is made by ruling out probable specific causes of BP elevation

A

primary hypertension

36
Q

is defined as an elevation of BP brought on by an identifiable primary cause

A

secondary hypertension

37
Q

what is first line HTN therapy for a patient WITHOUT a compelling indication?

A

thiazide diuretic recommended for most patients, thiazides can reduce morbidity and mortality in HTN patients. ACEIs, ARBs, and CCBs can be first line but are not as effective at reducing morbidity and mortality

38
Q

when starting out with a blood pressure drug, what is important about the dosing?

A

dosage should be low initially and then gradually increased

39
Q

What drug class is not indicated for patients with advanced renal insufficiency?

A

thiazide diuretics

40
Q

in patients with diabetic nephropathy, ACEIs and ARBs can:

A

slow the progression of renal damage

41
Q

what is the first line choice for an African American?

A

diuretics, can decrease morbidity and mortality. CCBs and a/b blockers are also effective

42
Q

defined as the ratio of a drug’s LD50 to its ED50

A

therapeutic index. If a drug is truly safe, the highest dose required to produce therapeutic effects must be substantially lower than the lowest dose required to produce death

43
Q

affinity

A

refers to the strength of the attraction between a drug and its receptor

44
Q

intrinsic activity

A

refers to the ability of a drug to activate a receptor upon binding

45
Q

drugs with high intrinsic activity have

A

high maximal efficacy, which causes intense responses

46
Q

potency

A

amount of a drug we must give to elicit an effect

47
Q

maximal efficacy

A

is defined as the largest effect that a drug can produce

Module 2 NURS 5343 (1 decks)

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