Cholinergic Drugs Affecting Autonomic Nervous System
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| Prepares the body for stressful or energetic activity; "flight of fight" | Sympathetic Division
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| Dominates during times of rest and digestion | Parasympathetic Division
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| The parasympathetic division activates? | Cholinergic receptors
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| The sympathetic division activates? | Adrenergic receptors
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| Cholinergic receptors activate? | Muscarinic
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| Somatic nervous system controls? | Voluntary control over skeletal muscles
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| Autonomic nervous system controls? | Involuntary control over smooth and cardiac muscle and glands
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| The sympathetic division secretes____ from____ through_____? | Epinephrine & Norepinephrine
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| Direct acting cholinergic drugs bind: | To cholinergic receptors to produce the rest-and-digest response
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| Indirect acting cholinergic drugs: | Inhibit the action of AchE & have a high potential for serious adverse effects
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| Prototype drug: bethanechol (Urecholine) mechanism of action? | To activate the parasympathetic nervous system directly/indirectly, induce rest/digest response
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| bethanechol (Urecholine) is used for? | Glaucoma, urinary retention, myasthenia gravis, Alzheimer's disease
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| Adverse effects of bethanechol? | Profuse salivation, sweating, increased muscle tone, urinary frequency, bradycardia
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| What is physostigmine (Antilirium) used for? | Treatment of severe anticholinergic toxicity
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| 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.
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| Adverse effects of physostigmine (Antilirium)? | Unfavorable effects of physostigmine are bradycardia, asystole, restlessness, nervousness, seizures, salivations, urinary frequency, muscle twitching and respiratory paralysis
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| What should be monitored when taking a Direct acting cholinergic drugs ? | Monitor for intake and output ratio, blurred vision, orthostatic hypotension
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| 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
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| Cholinergic-Blocking Drugs.. | Inhibit parasympathetic impulses & Suppression of parasympathetic division induces fight-or-flight symptoms
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| Cholinergic-Blocking Drugs uses are? | Predictable extension of parasympathetic-blocking effects
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| The effects of cholinergic-Blocking Drugs include? | Pupil dilation (mydriasis),increasing heart rate,Drying glandular secretions, Relaxing bronchi (asthma)
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| 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?
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| Prototype drug: atropine (Atropair, Atropisol) Mechanism of action: | To inhibit the parasympathetic nervous system
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| The primary use of atropine include? | Peptic ulcers, irritable bowel syndrome, mydriasis and cycloplegia during eye examination, bradycardia, preanesthetic, asthma
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| What are the adverse effects of atropine? | Tachycardia, CNS stimulation, dry mouth, constipation, urinary retention, dry eyes, decreased sweating, photophobia
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| What to watch for in Anticholinergics? | Monitor for adverse effects, liver enzymes, Calculate and monitor doses, Assess and monitor for appropriate self-care administration
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| What should be monitored with Anticholinergics? | Monitor intake and output, Monitor patient for abdominal distention, and auscultate for bowel sounds
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| What assessment should be considered with drugs Affecting the Autonomic Nervous System? | Reason for drug
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| 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
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