Cholinergic Drugs & Cholinergic Blockers

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Chapter 20 & 21 - Cholinergic And Cholinergic Blockers

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acetylcholine
 
neurotransmitter of the PSNS
acetylcholinersterase
 
the enzyme responsible for breaking down acetylcholine
nicotinic receptors
 
located in the ganglia of both PSNS and SNS, stimulated by alkaloid nicotine
muscarininc receptor
 
located postsynaptically in the effect organs of the PSNS, stimulated by the alkaloid muscarine
direct-binding cholinergic agonists
 
bind to cholinergic receptors, activating them
indirect-acting cholinergic agonists
 
inhibit the enzyme acetylcholinerstase, which breaks down ACh
reversible
 
bind to cholinesterase for a period of a few minutes to hours
irreversible
 
bind to cholinesterase and form a permanent covalent bond
miosis
 
constriction of the pupil
Alzheimer's treatment
 
acetylcholine effects and stimulates muscarinic receptors - donepezil (Aricept)
donepezil (Aricept)
 
indirect-acting cholinergic drug used to treat Alzheimer's
bethanechol
 
direct-acting cholinergic used to treat urinary retention
in-direct acting drugs
 
drugs that cause skeletal muscle contraction
myasthenia gravis
 
muscle disease that breaks down the acetylcholine resulting in muscle weakness
adverse effects of cholinergics
 
result of overstimulation of the PSNS
two important adverse effects of cholinergics
 
hypotension and bradycardia
nursing implication of cholinergics
 
therapeutic effects of anti-Alzheimer's drugs may not occur for up to 6 weeks
cholinergic effect on intestine & bladder
 
increased gastric secretions, increased GI motility, increased urinary frequency
cholinergic effects on cardiovascular
 
decreased heart rate, vasodilation
receptors effected at recommended doses of cholinergics
 
muscarinic
receptors effected at high doses of cholinergics
 
nicotinic
parasympatholytics
 
drugs that block or inhibit the actions of acetylcholine in the parasympathetic nervous system
mechanism of cholinergic blockers
 
block the action of the NT acetylcholine at the muscarininc receptors in the parasympathetic nervous system
mydriasis
 
dilation of the pupil
drug of choice for bradycardia
 
atropine
cardiovascular drug effect of cholinergic blocker
 
increased heart rate
Parkinson's treatment
 
cholinergic blockers because decreased muscle rigidity and tremors - benztropine (Cogentin)
benztropine (Cogentin)
 
drug used for treatment of Parkinson's disease
atropine
 
prototype cholinergic blocker
ipratropium (Atrovent)
 
inhaler - cholinergic blocker
classic side effect of cholinergic blocker
 
decreased salivation
nursing implication for cholinergic blocker
 
dry mouth may occur --> chew gum, frequent mouth care, hard candy
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