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Flashcards in Cholinergic Drugs Deck (30):
0

Bethanechol (Urecholine)
(Functional Classification)

Urinary Tract Stimulant, Cholinergic

1

Bethanechol (Urecholine)
(Chemical Classification)

Synthetic Choline Ester

2

Bethanechol (Urecholine)
(Mechanism of Action)

Stimulates muscarinic ACH receptors directly; mimics effects of parasympathetic nervous system stimulation; stimulates gastric motility, micturition; increases lower esophageal sphincter pressure

3

Bethanechol (Urecholine)
(Uses)

Urinary retention (postoperative, postpartum), neurogenic atony of bladder with retention

4

Bethanechol (Urecholine)
(Contraindications)

Hypersensitivity, severe bradycardia, asthma, severe hypotension, hyperthyroidism, peptic ulcer, parkinsonism, seizure disorders, CAD, COPD, coronary occlusion, mechanical obstruction, peritonitis, recent urinary/GI surgery, GI/GU obstruction

5

Bethanechol (Urecholine)
(Side Effects)

CNS: dizziness, headache, malaise
CV: hypotension, bradycardia, reflex tachycardia, CARDIAC ARREST, CIRCULATORY COLLAPSE
EENT: miosis, increased salivation, lacrimation, blurred vision
GI: Nausea, Bloody Diarrhea, Belching, Vomiting, Cramps, Fecal Incontinence
GU: urgency
INTEG: rash, urticaria, flushing, increased sweating
RESP: ACUTE ASTHMA, DYSPNEA, BROCHOCONSTRICTION

6

Bethanechol (Urecholine)
(Nursing Considerations)

ASSESS:
-URINARY PATTERNS: retention, urgency
-BP pulse: observe after parenteral dose for 1 hr
-I&O ratio: check for urinary retention, urge incontinence
-TOXICITY: bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs

7

Bethanechol (Urecholine)
(Overdose Treatment)

Atropine 0.6-1.2mg IV or IM

8

Donepezil (Aricept)
(Functional Classification)

Anti-Alzheimer's agent

9

Donepezil (Aricept)
(Chemical Classification)

Reversible Cholinesterase Inhibitor

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Donepezil (Aricept)
(Mechanism of Action)

Elevate acetylcholine concentrations (cerebral cortex) by slowing degradation of acetylcholine released in cholinergic neurons; does not alter underlying dementia

11

Donepezil (Aricept)
(Uses)

Mild to severe dementia with Alzheimer's disease

12

Donepezil (Aricept)
(Contraindications)

Hypersensitivity to this product or piperdine derivatives

13

Donepezil (Aricept)
(Side Effects)

CNS: dizziness, Insomnia, somnolence, Headache, fatigue, abnormal dreams, syncope, SEIZURES, drowsiness, agitation, depression, confusion, fever, hallucinations
CV: ATRIAL FIBRILLATION, hypo/hypertension, SINUS BRADYCARDIA, AV BLOCK
GI: Nausea, Vomiting, anorexia, Diarrhea, abdominal pain, GI BLEEDING, weight loss
GU: urinary frequency, UTI, incontinence
INTEG: rash, flushing, diaphoresis, bruising
META: hyperlipidemia
MS: cramps, arthritis, arthralgia
RESP: rhinitis, URI, cough, pharyngitis, dyspnea

14

Donepezil (Aricept)
(Nursing Considerations)

ASSESS:
-BP: hypo/hypertension, heart rate
-Mental Status: affect, mood, behavior changes, depression, complete suicide assessment; neurologic status
-GI status: nausea, vomiting, anorexia, diarrhea; monitor weight
-GU status: urinary frequency, incontinence, I&O

PERFORM/PROVIDE
-Assistance with ambulation during beginning therapy; dizziness, ataxia may occur

15

Memantine
(Functional Classification)

Anti-Alzheimer agent

16

Memantine
(Chemical Classification)

NMDA-receptor antagonist

17

Memantine
(Mechanism of Action)

Antagonist action of CNS NMDA receptors that may contribute to the symptoms of Alzheimer's disease

18

Memantine
(Uses)

Moderate to severe dementia in Alzheimer's disease

19

Memantine
(Contraindications)

Children, hypersensitivity

20

Memantine
(Side Effects)

CNS: Dizziness, Confusion, somnolence, headache, hallucinations
CV: hypertension
GI: vomiting, constipation
HEMA: anemia
INTEG: rash
MISC: back pain, fatigue, pain
RESP: coughing, dyspnea

21

Memantine
(Nursing Considerations)

ASSESS:
-Alzheimer's dementia: affect, mood, behavioral changes; hallucinations, confusion, attention, orientation, memory

PERFORM/PROVIDE
-Assistance with ambulation during beginning therapy; dizziness may occur

22

Pyridostigmine
(Functional Classification)

Cholinergic; anticholinesterase

23

Pyridostigmine
(Chemical Classification)

Tertiary amine carbamate

24

Pyridostigmine
(Mechanism of Action)

Inhibits destruction of acetylcholine, which increases concentration at sites where acetylcholine is released; this facilitates the transmission of impulses across the myoneural junction

25

Pyridostigmine
(Uses)

Nondepolarizing muscle relaxant antagonist, myasthenia gravis, pretreatment for nerve gas exposure (military only)

26

Pyridostigmine
(Contraindications)

Bradycardia; hypotension; obstruction of intestine, renal system; bromide, benzyl alcohol sensitivity; adrenal insufficiency; cholinesterase inhibitor toxicity

27

Pyridostigmine
(Side Effects)

CNS: dizziness, headache, sweating, weakness, SEIZURES, incoordination, PARALYSIS, drowsiness, LOC
CV: tachycardia, dysrhythmias, bradycardia, AV block, hypotension, ECG changes, CARDIAC ARREST, syncope
EENT: miosis, blurred vision, lacrimation, visual changes
GI: Nausea, Diarrhea, Vomiting, Cramps, Increased Salivary and Gastric Secretions, Peristalsis
GU: urinary frequency, incontinence, urgency
INTEG: rash, urticaria, flushing
RESP: RESPIRATORY DEPRESSION, BRONCHOSPASM, CONSTRICTION, LARYNGOSPASM, RESPIRATORY ARREST
SYST: CHOLINERGIC CRISIS

28

Pyridostigmine
(Nursing Considerations)

ASSESS:
-MYASTHENIA GRAVIS: fatigue, ptosis, diplopia, difficulty swallowing, SOB, hand/gait before, after product; improvement should be seen after 1 hr
-VS, respiration q8hr
-I&O ratio; check for urinary retention or incontinence
-TOXICITY: bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs

29

Pyridostigmine
(Overdose Treatment)

Discontinue product, atropine 1-4mg IV