Pharm 3: Cholinergic/ Cholinergic Blockers

Bethanechol (Urecholine)

• oral

• urinary retention, restores bladder tone and function

• monitor HR, BP, I&O

• (can cause dark stools and epigastric pain)

Donepezil (Aricept)

• Acetylcholinesterase Inhibitor

• Alzheimer’s disease

  • improves memory and cognitive function (and memory in patients with Alzheimer’s in relation to dementia)

Pyridostigmine (Mestinon)

• oral, IV, IM

• Increase muscle strength

  • improves acetylcholine levels at neuromuscular junction

• Myasthenia Gravis

• Reversal

  • tricyclic antidepressant overdose

  • nondepolarizing muscle relaxants

Atropine

• symptomatic stable bradycardia

• watch with Lomotil (can cause an increase in HR)

Dicyclomine (Bentyl)

• Antispasmodic medication

• IBS

• Monitor temperature - patient cannot sweat, or regulate their temperature

Oxybutynin (Ditropan)

• Control urinary urgency and frequency

• bladder dysfunction/neurogenic bladder

• monitor HR and temp

Scopolamine

• patch behind ear

• used for motion sickness and nausea

  • reduces dizziness and vertigo

• Pre-op nausea

  • 1 hr before and stays on 24-36 hours

  • 4-5hrs before travel

• Interaction with alcohol

Tolterodine (Detrol)

• Urinary issues

  • frequency

  • urgency

  • incontinence

• ae: dry mouth

Memantine (Namenda)

• Non an anticholinergic; used for Alzheimers

• NMDA receptor antagonist

  • no interactions (easy for pt to take)

  • given orally

• Temporary effects

What are some uncommon side effects of Memantine (Namenda)?

Hypotension, Gi upset fatigue