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Chapter 12

Cholinergic Drugs Affecting Autonomic Nervous System

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
Created by: alyxinwndrland
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