Drugs Affecting the ANS Cholinergic Drugs

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Effects of Parasympathetic Stimulation

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Description and Tags

Nursing

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1

Effects of Parasympathetic Stimulation

-Miosis

-Stimulated saliva flow

-Decreased HR

-Bronchoconstriction

-Stimulates peristalsis & secretion

-Bladder Constriction

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2

Parasympathetic Response

-Dilation of blood vessels

-Pupil constriction

-Decreased HR and BP

-Decreased respirations and O2 consumption

-Digestion

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3

Physiology of PNS Stimulation

-Cholinergic nerves synthesize acetylcholine

-Acetylcholine is released from the nerves where it can bind to cholinergic receptors in target organs

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4

What do Cholinergic agnosit drugs do

-Inhibit action of acetylcholinesterase

-Stimulate cholinergic receptors

-Mimic effects of acetylecholine

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5

Direct acting cholenergic drugs to know

-Carbachol

-Pilocarpine

-Bethanechol

-Succinylcholine

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6

Indirect acting cholinergic drugs to know

-Donepezil

-Edrophonium

-Pyridostigminne

-Revastigmine

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7

Trade name of Donepezil

Aricept

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8

Trade name of Rivastigmine

Exelon

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9

Indications for Cholinergic Drugs

-GI Indications: increased GI motility, increased gastric secretions, dry mouth

-GU Indications: Urinary retention

-Opthalmic indications: glaucoma-reduced intraocular pressure, occular surgery

-Cardiovascular indiciation: reduced HR, vasodilation

-Neuro: Myasthenia Gravis, Alzheimer’s disease

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10

What is the purpose of Bethanechol

-Direct Acting Cholinergic Agonist

-Stimulate muscarinic receptors in bladder

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11

What is Bethanechol used for

-Acute post-op and postpartum urinary retention

-Increase tone of detrusor muscle

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12

Adverse Effects of Bethanechol

-Syncope

-Hypotension with reflex tachy

-Seizures

-Asthmatic attacks

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13

What is the purpose of Donepezil

Acetylcholinesterase inhibitor

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14

What is Donepezil used for

-Alzheimer’s Disease

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15

Adverse Effects of Donepezil

-Risk for GI Bleeds and ulcers

-Bradycardia

-Syncope

-Hypotension with reflex tachy

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16

What is mematine

A non-cholinergic drug that is used for alzheimers and blocks the NMDA receptor to reduce degeneration of cognitive function

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17

What is the purpose of Pyridostigmine

-Indirect acting cholenergic drug

-Inhibits acetylecholinsterase

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18

What is Pyridostigmine used for

-Improve muscle strength and reduce symptoms of Myasthenia Gravis

-Reverse neuromuscluar blocking drugs

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19

What is Edrophonium

An indirect acting cholinergic drug used to diagnose Myasthenia Gravis

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20

What are Adverse Effects of Pyridostigmine

-GI Upset

-Excessive salivation

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21

What is the antidote for a cholinergic crisis

Atropine followed by pralidoxime

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22

What does the acronymn SLUDGEM stand for

-S: Salivation

-L: Lacrimation

-U: Urinary Incontinence

-D: Diarrhea

-G: GI Cramps

-E: Emeiss

-M: Miosis

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23

What causes a cholinergic crisis

-Overstimulation of muscarinic and nicorinic receptors

-Related to inhabition of acetylcholinesterase

-Exposure to nerve gas, pesticides, and insecticides

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24

Nursing considerations for Cholinergic Agonist

-Monitor CBC

-Don’t give cholinergic drugs if patient has a bowel obstruction

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25

What do blocking anticholinergic drugs do

Block acetylcholine at muscarinic receptors in PNS

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26

What are anticholinergic effects

-Sedation, dizziness, confusion, hallucinations

-Urinary Retention

-Dry throat, mouth, and constipation

-Feeling hot, decreased sweating

-Tachycardia

-Blurred vision, dry eyes

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27

Nine Anticholinergic drugs to know

-Atropine

-Belladonna

-Scopolamine

-Benztropine

-Dicyclomine

-Oxybutynin

-Tolterodine

-Ipratropium

-Benztropine

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28

Indications for Anticholinergic drugs

-Changes to HR

-Opthalmic

-Bronchospasms, asthma, COPD

-Pre-op to reduce salivary secretions

-GI antispasmodic

-Overactive bladder

-Parkinson Disease

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29

Contraindications of Anticholinergic drugs

-Allergy

-Angle closure glaucome

-Acute asthma attack

-Myasthenia gravis

-GI obstructions

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30

Adverse effects of Anticholinergic drugs

-Dry mouth

-Blurred vision

-Delerium in older adults

-tachycardia

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31

Nursing interventions for anticholinergic drugs

-Chew gum

-Wear sunscreen

-Drink plenty of water

-Prevent heat stroke

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32

Anticholinergic drug reactions

-Amantadine

-Antihistamines

-Tricyclic antidepressants

-Digoxin

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33

What is the purpose of Atropine

-Blocks acetylcholine at muscarinic receptors

-Relax muscle in prostate and bladder

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34

What is Atropine used for

-Pre-op reduce secretions

-Cardiac emergencies

-Antitode for mushroom poisoning

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35

Adverse Effects of Atropine

-Heart rate issues

-Eye Issues

-Nervousness

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36

What is the trade name of Dicyclomine

Bentyl

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What is the purpose of Dicyclomine

Binds to muscarinic receptors blocks PNS

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38

What is Dicyclomine used for

Irritable Bowel Syndrome

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39

Adverse effects of Dicyclomine

-Dizziness

-Dry mouth

-Vision blurred

-Nausea

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40

What is the purpose of Scopolamine

Anti-muscarinic receptors in brain

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41

What is Scopolamine used for

Motion Sickness

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42

Adverse Effects of Scoplomaine

-Dry Mouth

-Drowsiness

-Vision blurred

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43

What is the trade name of Oxybutynin

Ditropan

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44

What is the purpose of Oxybutynin

Anti-muscarinic receptors in bladder

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45

What is oxybutynin used for

Overactive bladder

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46

Adverse effects of oxybutynin

-Dry mouth

-Dizziness

-Constipation

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