1What are cholinergic drugs?
agents that influence the activity of cholinergic receptors
most mimic or block the action of acetylcholine
cholinesterase inhibitors = prevent the breakdown of acetylcholine
2What are muscarinic agonists?
work by direct interaction with muscarinic receptors
PSNS response
another term parasymathomimetic agents
3What is the prototype for muscarinic agonists?
Bethanechol (Urecholine)
4Bethanechol (Urecholine)
Class: muscarinic agonist parasympathomimetic agent
Use: urinary retention and investigational gastrointenstinal uses
Adverse: hypotension, increased tone and motility, exacerbation of asthma
Nursing Implication: don't give to people w asthma
5What can muscarinic activation cause?
bradycardia
increased sweating, salivation, bronchial secretions, and secretion of gastric acid
contraction in lung (constriction)
6What is the toxicology of muscarinic agonists?
excessive activation of muscarinic receptors
profuse salivation, lacrimation (tearing), visual disturbances, diarrhea
treatment: atropine
7What are muscarinic antagonists?
competitively block the actions of acetylcholine at muscarinic receptors
aka parasympatholytic drugs, antimuscarinic drugs, muscarinic blockers anticholinergic drugs
8Atropine
Class: Muscarinic antagonist
Use: bradycardia (increases heart rate), paralysis of ciliary muscle of the eye (dilates pupils), preanestheric for procedures
Adverse: xerostomia (dry mouth), blurred vision and photophobia, elevation of intraocular pressure, urinary retetion
Nursing Implication: avoid giving atropine with other drugs capable of causing muscarinic blockade
9How can atropine given?
IM, IV, subq
atripen IM for cholinesterase inhibitor poisoing
eye drops and solutions
10Scopolamine
Class: muscarinic antagonist
Use: suppresses emsesis and motion sickness
Adverse: ?
Nurse implication: ?
11Oxybutynin ??
tone down the bladder
12What is the toxicology of muscarinic antagonists?
hot and dry
dry mouth, blurred vision
treatment: physostigmine