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NURS 472 - PNS drugs
Muscarinic/cholinergic
| Question | Answer |
|---|---|
| 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
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