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NURS 472 - PNS drugs

Muscarinic/cholinergic

QuestionAnswer
Bethanechol class, MOA direct acting muscarinic agonist, cholinergic effect. doesnt cross BBB
Bethanechol used for (post op) urinary retention, ileus bowel obstruction, abdominal distention
how doe we treat muscarinc overdose admin a muscarinic antagonist such as atropine
Atropine class, MOA muscarinic antagonist, crosses BBB
atropine indications (preop)pre-anesthetic to prevent brady, tx eye disorders-mydriasis, tx brady, asthma (bronchodil)
SEs of bethanachol cholinergic SwSLUDV BBHHM
SEs of atropine anticholinergic - opposite of SwSLUDV BBHHM
Dosing feature of atropine - low to high low dose --> decreased secretions, increased HR High dose --> bronchodil, decreased stomach acid secretions
other use for muscarinic antagonists OAB overactive bladder
action of a AChEI is synonomus with same as a cholinergic agonist (these are indirect acting cholinergics)
3 reversible AChEIs neostigmine, pyridostigmine, ambenonium
neostigimine reversible AChE inhibitor- oral/IV
pyridostigmine reversible AChE inhibitor-oral
ambenonium reversible AChE inhibitor - oral
what are AChEIs indicated for tx of myasthania gravis
what is myasthania crisis undermedicated, too little ACh-->profound muscle weakness, resp paralysis
what is cholinergic crisis overmedicated AChEI or cholinergic agonist. Too much ACH --> profound muscle weakness, cholinergic SEs (overstim receptors now unresponsive), tx with muscarinic antagonist atropine
Two classes of Nm blocking agents non-depolarizine, depolarizing
Indications of Nm blocking agents want to paralyze pt --> pre-op, intubation, ventilation
non-depoarlizing MOA (used most frequently) blocks ACh at Nm
name 5 non-depolarizing Nm blocking agents atracurium, cistracurium, pancuronium, rocuronium, vercuronium
SEs of non-depolarizing Nm blocking agents unusual HypoTN bwo histamine release-->vasodil. body compensates tachy, some dysrhythmias. Respiratory muscle paralysis
atracurium non-depolarizing Nm blocking agent
cistracurium non-depolarizing Nm blocking agent
pancuronium non-depolarizing Nm blocking agent
rocuronium non-depolarizing Nm blocking agent
vecuronium non-depolarizing Nm blocking agent
MOA of depolarizing Nm blocker sustained depolarization at Nm --> initial short phase contraction-->fatigue bwo receptor exhaustion
depolarizing Nm blocker indications this ultra-short acting drug for pre-op intubation
Name a depolarizing Nm blocker succinylcholine
Created by: lorrelaws