Busy. Please wait.
Log in with Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password

Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Didn't know it?
click below
Knew it?
click below
Don't Know
Remaining cards (0)
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

pharm test 3

Pharm cholinergic agents ch. 19

cholinergic agents **cholinergic agonists; parasympathomimetics drugs that stimulate the parasympathetic nervous system (PSNS) **rest and digest **NT: acetylcholine (ACh)
cholinergic receptors -nicotinic and muscarinic **muscarinic: most responsible for having beneficial affects we are looking for in these drugs **nicotinic: causes more of the S/E we dont like to see
nicotinic receptors -located in the ganglia of both the PSNS and SNS -named "nicotinic" b/c it can be stimulated by the alkaloid nicotine
muscarinic receptors -located postsynaptically: smooth muscle, cardiac muscle, glands of the parasympathetic fibers, effector organs of cholinergic sympathetic fibers
indirect acting cholinergic agonists -inhibit the enzyme cholinesterase, which breaks down ACh; result is more ACh available at the receptors **anticholinesterase means youre making more ACh available for you to have a cholinergic response
DRUG EFFECTS of PNS SLUDGE **cholinergic makes you have lots of fluids (difficulty breathing); eyes running, nose running, hard to breathe -Salivation -Lacrimation -Urinary incontinence -Diarrhea -Gastrointestinal cramps -Emesis
DRUG EFFECTS of cholinergic -stimulate intestine & bladder: increased gastric secretions, increased gastrointestinal motility, increased urinary frequency -stimulate pupil: constriction (miosis), reduced intraocular pressure -increased salivation & sweating
DRUG EFFECTS of cholinergic -CV effects: decreased HR, vasodilation -respiratory effects: bronchial constriction, narrowed airways
DRUG EFFECTS of cholinergic -at recommended doses, the cholinergics primarily affect the muscarinic receptors -at high doses, cholinergics stimulate the nicotinic receptors
DRUG EFFECTS of cholinergic -desired effects: from muscarinic receptor stimulation -many undesirable effects are d/t stimulation of the nicotinic receptors
INDICATIONS: direct-acting agents -reduce intraocular pressure -useful for glaucoma & intraocular surgery (ACh, carbachol, pilocarpine)
INDICATIONS: direct-acting agents: bethanechol -increases tone & motility of bladder & GI tract -relaxes sphincters in bladder & GI tract, allowing them to empty
INDICATIONS: indirect-acting agents -cause skeletal muscle contractions -used for diagnosis & treatment of myasthenia gravis -used to reverse anticholinergic poisoning (antidote) ex: physostigmine, pyridostigmine
INDICATIONS: indirect-acting agents: donepezil (aricept) -used in treatment of mild to moderate alzheimer's disease -helps to increase or maintain memory & learning capabilities **helps to a certain point, does not last forever or cure it
side effects **a result of overstimulation of the PSNS CV: bradycardia, hypotension, conduction abnormalities (AV block & cardiac arrest) CNS: headache, dizziness, convulsions GI: abdominal cramps, increased secretions, nausea, vomiting RESP: increased bronchial secretions, bronchospasms
Interactions -anticholinergics, antihistamines, sympathomimetics: antagonize cholinergic agents, resulting in decreased responses -other cholinergic agents: additive effects
NURSING IMPLICATIONS -encourage patients with myasthenia gravis to take medication 20 min b4 eating to help improve chewing & swallowing -therapeutic effects of donepezil may not occur for up to 6 weeks
NURSING IMPLICATIONS **atropine is the antidote for cholinergics
Monitor for therapeutic effects -alleviated S/S of myasthenia gravis -in post-op pt. with decreased GI peristalsis, look for: increased bowel sounds, passage of flatus, occurrence of bowel movements
Monitor for therapeutic effects -in pt. w/ urinary retention/hypotonic bladder, urination should occur w/in 60 min of bethanechol administration
a patient is taking the direct acting cholinergic drug bethanechol (urecholine) before meals. after 3 days, he calls his health care provider's office & complains of occasional nausea & vomiting. the nurse should give which instruction? take this medication with meals to reduce GI upset
the family of a patient who has recently been diagnosed with alzheimer's disease is asking about the new drug perscribed to treat this disease. the patients wife says shes excited for him to start. what should the nurse reply "these drugs dont cure alzheimers disease. lets talk about what the physician said to expect with this drug therapy"
the nurse is giving a dose of bethanechol to post-op pt. the nurse is aware that contraindications to bethanechol include: peptic ulcer
a patient took an accidental overdose of a cholinergic drug while at home. he comes to ER w/ severe abd, cramping & bloody diarrhea. the nurse expects which drug will be used to treat this pt? atropine
a pt. w/ myasthenia gravis has received a perscription for pyridostigmine. the nurse should include which teaching point for this pt? the drug should be taken 30 min before eating meals
when giving IV cholinergic drugs, the nurse must watch for symptoms of a cholinergic crisis, such as: -hypotension -syncope -dyspnea
Created by: lissy11
Popular Nursing sets




Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
restart all cards