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Chapter 12
Cholinergic Drugs Affecting Autonomic Nervous System
| Question | Answer |
|---|---|
| Prepares the body for stressful or energetic activity; "flight of fight" | Sympathetic Division |
| Dominates during times of rest and digestion | Parasympathetic Division |
| The parasympathetic division activates? | Cholinergic receptors |
| The sympathetic division activates? | Adrenergic receptors |
| Cholinergic receptors activate? | Muscarinic |
| Somatic nervous system controls? | Voluntary control over skeletal muscles |
| Autonomic nervous system controls? | Involuntary control over smooth and cardiac muscle and glands |
| The sympathetic division secretes____ from____ through_____? | Epinephrine & Norepinephrine |
| Direct acting cholinergic drugs bind: | To cholinergic receptors to produce the rest-and-digest response |
| Indirect acting cholinergic drugs: | Inhibit the action of AchE & have a high potential for serious adverse effects |
| Prototype drug: bethanechol (Urecholine) mechanism of action? | To activate the parasympathetic nervous system directly/indirectly, induce rest/digest response |
| bethanechol (Urecholine) is used for? | Glaucoma, urinary retention, myasthenia gravis, Alzheimer's disease |
| Adverse effects of bethanechol? | Profuse salivation, sweating, increased muscle tone, urinary frequency, bradycardia |
| What is physostigmine (Antilirium) used for? | Treatment of severe anticholinergic toxicity |
| What is the mechanism of action for physostigmine (Antilirium)? | To reverse toxic & life threatening delirium caused by atropine, diphenhydramine, dimenhydrinate, Atropa belladonna (deadly nightshade) or jasmine weed. |
| Adverse effects of physostigmine (Antilirium)? | Unfavorable effects of physostigmine are bradycardia, asystole, restlessness, nervousness, seizures, salivations, urinary frequency, muscle twitching and respiratory paralysis |
| What should be monitored when taking a Direct acting cholinergic drugs ? | Monitor for intake and output ratio, blurred vision, orthostatic hypotension |
| What should be monitored when taking Cholinesterase Inhibitors? | Monitor muscle strength and neuromuscular status, ptosis, diplopia, and chewing, muscle weakness, Schedule medication around mealtimes, activities to avoid fatigue |
| Cholinergic-Blocking Drugs.. | Inhibit parasympathetic impulses & Suppression of parasympathetic division induces fight-or-flight symptoms |
| Cholinergic-Blocking Drugs uses are? | Predictable extension of parasympathetic-blocking effects |
| The effects of cholinergic-Blocking Drugs include? | Pupil dilation (mydriasis),increasing heart rate,Drying glandular secretions, Relaxing bronchi (asthma) |
| What are some uses of Cholinergic-Blocking Drugs? | Peptic ulcer disease, Ophthalmic procedures, Heart rhythm abnormalities, Anesthesia adjunct, Asthma and COPD, Overactive bladder, Parkinson’s disease. Dilates and reduces secretions. Is patient voiding hourly? |
| Prototype drug: atropine (Atropair, Atropisol) Mechanism of action: | To inhibit the parasympathetic nervous system |
| The primary use of atropine include? | Peptic ulcers, irritable bowel syndrome, mydriasis and cycloplegia during eye examination, bradycardia, preanesthetic, asthma |
| What are the adverse effects of atropine? | Tachycardia, CNS stimulation, dry mouth, constipation, urinary retention, dry eyes, decreased sweating, photophobia |
| What to watch for in Anticholinergics? | Monitor for adverse effects, liver enzymes, Calculate and monitor doses, Assess and monitor for appropriate self-care administration |
| What should be monitored with Anticholinergics? | Monitor intake and output, Monitor patient for abdominal distention, and auscultate for bowel sounds |
| What assessment should be considered with drugs Affecting the Autonomic Nervous System? | Reason for drug |
| Cautions and contraindications for drugs Affecting the Autonomic Nervous System? | Allergies, Drug history, Assess for therapeutic effect , Watch for adverse effects. Watch for patients with overactive bladder |