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Pharm test 1

ANS

QuestionAnswer
Bethanechol (Urecholine) "muscarinic" Cholinergic MOA-cholinomimetic that is selective to smooth muscle of the gi tract and urinary bladder
Indications: postoperative and postpartum urinary retention or increase peristalsis
To avoid nausea take 1 hour prior to meals or 2 hours after meals
Side Effects: abdominal discomfort, salivation, flushed skin, nausea, vomiting
Toxic reactions: intense cramping, diarrhea, urination, bradycardia and bronchoconstriction
Contraindication: COPD, asthma, hyperthyroidism, peptic ulcer.
Neostigmine (Prostigmin) "anticholinesterase" acetylcholinterase inhibitors. MOA: produces reversible inhibition of AChE, ionized and does not cross blood-brain barrier
Indication: used in the treatment of myasthenia gravis
Side effects: nausea, diarrhea, excessive salivation. Caution in patients with asthma
Tacrine (cognex) Donepezil (Aricept) "anticholinesterase" acetylcholinterase inhibitors. MOA: centrally acting reversible cholinesterase inhibitor leading to increased levels of acetylcholine in the brain
Indication: treatment of mild to moderate dementia
Pharmacokinetics: given orally, Tacrine has low bioavailability, given 4 times daily and requires weekly liver fuction tests. Donepezil, given once daily, half-life 70 hrs, does not require LFTs. Should be taken in the evening, disintegrating tablets.
Side effects: related to increased cholinergic effects including nausea, vomiting, diarrhea, urinary urgency, anorexia, bradycardia. No evidence that drug leads to sustained improved function.
Atropine or Scopolamine "antimuscarnic" MOA: anticholinergic competitively antagonize the effects of ACh simply by blocking the receptor site.
Marked CNS depressant effects, elderly may be very sensitive. Similar to atropine.
Indications and use: preoperative to protect heart from vagal reflexes and prevent excessive respiratory secretions
In aerosol form, ipratropium (Atrovent) used as a bronchodilator
Oxybutynin (Ditropan, Oxytrol, Gelniue) "antimuscarnic" Indications: overactive bladder. Forms- tablets, transdermal patches or ointments. Do not shower for 1 hour after application, partners use caution with skin to skin contact. Side effects: constipation, urinary retention, blurred vision.
Tolterodine (detrol) "antimuscarnic" Indications: overactive bladder. Bioavailability is high variable(10-70%). Warning: blurred vision, dizziness, or drowsiness.
Characteristics of the autonomic nervous system visceral, vegetative, involuntary nervouse system no
Sympathetic nervous system what is the most effective way to stop norepinepherin reuptake and stored in the neuron or destroyed by Mona amine oxidase or if it floats away MAO and comt in the liver destroy to prevent sympathetic respanse
Created by: jlacklen