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NRSG Pharm CH 12

Cholinergic/Anticholinergic

QuestionAnswer
Neurotransmitter of parasympathetic, receptor @ effector organ in ANS Acetylcholine, cholinergic receptor
Neurotransmitter of sympathetic, receptor @ effector organ in ANS Norepinephrine, adrenergic receptor
Neurotransmitter and receptor type at ganglia in ANS Acetylcholine, nicotinic receptor, both symp/para- smooth muscle and gland secretion stimulations
Muscarinic receptors, action in heart para, @ target organs, stim smooth muscle, stim gland secretion. In heart: dec heart rate and force of contraction
Subclasses parasympathomimetic: Direct - bind to cholinergic receptors -> para effect Indirect - inhibit action of AchE, high potential for serious adverse effects
Prototype drug: bethanechol (Urecholine). Classes, mech, T: non-obstructive urinary retention drug P: Muscarinic cholinergic receptor drug Mech: Direct acting parasympathomimetic - most noted in GI/urinary, stim smooth-muscle contraction
bethanechol (Urecholine) admin alerts Monitor BP, HR, RR before admin and atleast 1hr post subcutaneous admin. Preg C
bethanechol (Urecholine) side effects / treatment OD Para stim. Inc salvation, sweating, abd cramps, hypotension -> fainting. Caution: pt with conditions that could be aggravated with inc GI contractions: suspected obstruction, active ulder, inflam disease, urinary obstruction, COPD OD atropine sulfate
donepezil (Aricept) Cholinesterase inhibitor, indirect, Alzheimer's disease
adverse effects cholinergic: brady, hypo, dysrhythmias, tremors, dizziness, headache, dyspnea, dec urinary output, abd pain, AMS
Effects anticholinergic: parasympatholytic: pupil dilation (mydriasis(, inc HR, drying glandular, relaxing smooth muscle - bronchodilation
Uses anticholinergic: PUD, ophthalmic, dysrhythmias, anesthesia adjuncts, asthma/COPD, overactive bladder, parkinson
Prototype: atropine (Atropair) classes, mech T: antidote for anticholinesterase poisoning P: Muscarinic cholinergic receptor blocker M: inhibit para by occupying muscarinic receptors - blocks para of Ach and inc symp response
Atropine (Atropair) primary uses: IBS, dilate pupils, brady, preanesthetic, asthma
Atropine (atropair) admin alerts: Monitor BR, HR, RR before and 1HR post subcutaneous admin
Atropine (atropair) side/adverse: Dry mouth, constipation, urinary retention, inc HR
Atropine (atropair) contraindications: glaucoma - may inc ocular pressure
Anticholinergic considerations: signs of anticholinergic crisis, changes in HR, BP, dysrhythmias, dry mouth, minimize cold/heat/strain, I/Os, abd distention/bowel sounds
anticholinergic drug tox indications: Seizures, V tach,
Anticholinergic adverse: tachy, hypertension, dysrhythmias, tremors, dizziness, headache, dec urinary output
Created by: kmulla
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