Chapter 16- Cholinergic agonist and antagonist

Question 1

Muscarinic receptors

Answer 1

Affect smooth muscles

Question 2

Nicotinic receptors

Answer 2

Affect skeletal muscles

Question 3

Cholinergic effects on Cardiovascular

Answer 3

Bradycardia

Question 4

Cholinergic effects on GI

Answer 4

Increases motility, increases peristalsis, causes diarrhea and increases risk for ulcers due to increased gastric acid

Question 5

Cholinergic effects on GU

Answer 5

Contracts bladder, increases urination and frequency, relaxes sphincter muscles

Question 6

Cholinergic effects on Eyes

Answer 6

Constricts pupils- myosis

Question 7

Cholinergic effects on Lungs

Answer 7

Bronchial constriction, increased secretions

Question 8

Cholinergic effects on Glands

Answer 8

Increases salivation, perspiration and tears

Question 9

Cholinergic effects on Blood vessels

Answer 9

Dilates, decreases blood pressure, orthostatic hypotension

Question 10

Metoclopramide

Answer 10

Increases gastric emptying

Question 11

Metoclopramide uses

Answer 11

Post-op emesis and diabetic gastroparesis

Question 12

Metaclopramide side effects/ adverse reactions

Answer 12

diarrhea and EPS

Question 13

Pilocarpine

Answer 13

Constricts pupils to control intraocular pressure

Question 14

Bethanechol chloride

Answer 14

Contracts the bladder

Question 15

Bethanechol contraindications

Answer 15

Bradycardia, hypotension, COPD, peptic ulcer, parkinsonism, hyperthyroidism

Question 16

Bethanechol side effects and adverse reactions

Answer 16

Blurred vision, miosis, hypotension, bradycardia, sweating, increased salivation and gastric acid, nausea, vomiting, diarrhea, abdominal cramps, bronchoconstriction

Question 17

Signs of Cholinergic crisis

Answer 17

Diarrhea
Urination
Miosis
Bradycardia
Emesis
Lacrimation
Lethargy
Salivation

Question 18

The antidote for a Cholinergic crisis

Answer 18

Atropine sulfate

Question 19

Nursing process for Cholinergic Agonist: Assessment

Answer 19

1. Baseline Vitals
2. Urine output
3. Obtain history: asthma/COPD, peptic ulcer, urinary retention

Question 20

Nursing process for Cholinergic Agonist: Teaching

Answer 20

Rise in stages; Report difficulty breathing

Question 21

Anticholinergic effects on Heart

Answer 21

Large doses cause tachycardia

Question 22

Anticholinergic effects on Lungs

Answer 22

Bronchodilation, decreases secretions

Question 23

Anticholinergic effects on GI

Answer 23

Decreases motility and gastric secretions

Question 24

Anticholinergic effects on GU

Answer 24

Urinary retention

Question 25

Anticholinergic effects on the Eyes

Answer 25

Dilates pupils- midriosis

Question 26

Anticholinergic effects on Glands

Answer 26

Decreases salivation and perspiration

Question 27

Atropine action

Answer 27

Increase pulse, decrease motility and peristalsis, decreases salivary secretions

Question 28

Atropine contraindications

Answer 28

glaucoma and myasthenia gravis

Question 29

Atropine Side effects/ Adverse reactions

Answer 29

``` Tachycardia, palpitations Nasal congestion, flushing Photophobia, blurred vision Dry mouth and skin Abdominal distention, urinary retention, impotence ```

Question 30

Signs of atropine overdose

Answer 30

``` Mad as a hatter Red as a beat Blind as a bat Hot as a Hare Dry as a Bone ```

Question 31

Nursing process for Atropine: Assessment

Answer 31

1. Obtain vital signs 2. Asses urine output (urinary retention may occur) 3. Obtain med hx: narrow-angle glaucoma, myasthenia gravis

Question 32

Nursing process for Atropine: Teaching

Answer 32

Avoid Heat and physical exertion; Wear Sunglasses; Increase fluids, fiber, and ambulation; Ice chips, hard candy, sugarless gum, frequent oral care to help with dry mouth