EXAM 3- Cholinergic drugs

Question 1

Ach is released:

Answer 1

nerve impulse passes

Question 2

For nerve impulse to be transmitted from one nerve ending to another-

Answer 2

neurohormone is needed

• Ach
• AchE

Question 3

Ach inactivated by

Answer 3

AchE

Question 4

Ach

Answer 4

transmits nerve impulses across the parasympathetic branch of the autonomic nervous system

Question 5

AChE

Answer 5

inactivates the neurotransmission of ACh

Question 6

glaucoma

Answer 6

disorder of increased pressure within anterior chamber of eye

Question 7

glaucoma prescribed with

Answer 7

-cholinergic drug: pilocarpine, which produces miosis (Constriction of iris), allowing for passage of fluid in chamber, thus reducing pressure

Question 8

Myasthenia Gravis

Answer 8

rapid fatigue of skeletal muscles due to lack of Ach released at the nerve endings of parasympathetic nerve fibers

Question 9

Myasthenia Gravis prescribed with

Answer 9

Pyridostigimine

Question 10

treatment of urinary retention by relaxing bladder sphincter

Answer 10

Bethanechol

Question 11

cholinergic drugs are not selective in action=

Answer 11

so many organs may experience the effect.

-N/D, abd cramping, salivation, muscle weakness, frequency.

Question 12

Nursing process: glaucoma

Answer 12

-observe redness, inflammation drainage or eye
-assure med reads “for Opthalmic Use”
-When administering eye drops:
head back, eyes up, dropper shouldn’t touch pt; place drop in conjunctival sac

Question 13

nursing process: urinary retention

Answer 13

• assess for bladder distention
• I&O
• assist bed pan or provide call bell
• observe for s&s of adverse reactions

Question 14

cholinergic-blocking drugs

Answer 14

-block Ach in PNS

also called anti-cholinergic, parasympathomimetic blocking

Question 15

cholinergic-blocking drugs: when PNS is inhibited-

Answer 15

Ach cannot access the receptors (nicotinic/muscarinic)

Question 16

cholinergic-blocking drugs: heart

Answer 16

increase HR

Question 17

cholinergic-blocking drugs: Respiratory tract

Answer 17

dry mucus membranes and cause bronchial dilation

Question 18

cholinergic-blocking drugs: GI tract

Answer 18

decrease GI motility, secretions, salivation

Question 19

cholinergic-blocking drugs: Urinary tract

Answer 19

decrease bladder contraction, resulting in urinary retention

Question 20

cholinergic-blocking drugs: eye

Answer 20

dilation, increase in intraocular pressure

Question 21

cholinergic-blocking drugs: ____ muscle rigidity and ____ tremors in ____ disease.

Answer 21

decreases, diminishes, Parkison’s.

Question 22

cholinergic-blocking drugs: used to inhibit the _____.

Answer 22

vagal stimulus

Question 23

cholinergic-blocking drugs: relaxation of smooth muscles in the bronchi

Answer 23

• Decrease airway resistance
• Bronchodilation
• used for IBS
• Neurogenic bladder and incontinence
• Reduce gastric and pancreatic secretions (help with acute pancreatitis)
• Used pre-op to reduce respiratory secretions

Question 24

adverse reactions of cholinergic-blocking drugs: Cardiovascular

Answer 24

• big increase in HR

- dysrhythmias

Question 25

adverse reactions of cholinergic-blocking drugs: CNS

Answer 25

- excitation - restlessness - irritability - disorientation - hallucinations

Question 26

adverse reactions of cholinergic-blocking drugs: Eye

Answer 26

- dilates pupils a lot | - bigger increase in intraocular pressure

Question 27

adverse reactions of cholinergic-blocking drugs: GI

Answer 27

- major decrease of salivation, gastric secretions, and motility - constipation

Question 28

adverse reactions of cholinergic-blocking drugs: GU

Answer 28

urinary retention

Question 29

adverse reactions of cholinergic-blocking drugs: respiratory

Answer 29

- major decrease in respiratory secretions

Question 30

concerns with elderly on cholinergic blocking drugs:

Answer 30

- confusion or excitement even with small doses - hallucinations, delirium - report unusual signs to physician asap

Question 31

special precautions of cholinergic-blocking in pt with: glaucoma

Answer 31

-because of mydriasis and increased ocular pressure

Question 32

special precautions of cholinergic-blocking in pt with enlarged prostate

Answer 32

since urinary retention may occur. | -caution includes OTC meds that may include atropine or other cholinergic drugs

Question 33

special precautions of cholinergic-blocking in pt with acute asthma or

Answer 33

other respiratory distress.

Question 34

nursing process for cholinergic-blocking:

Answer 34

- History of present disorders - What is reason for administering drug? - V/S - Any dehydration noted?

Question 35

cholinergic-blocking: If given for patient with heart block-

Answer 35

Cardiac monitor – (change in rate, rhythm)

Question 36

cholinergic-blocking: if used as pre-op med-

Answer 36

- Void before med is given - Usually given w 1 or 2 other meds as pre op med. - Inform patient that dry mouth is NORMAL and NOT to take fluids prior to surgery. - administer ON TIME so as to assure optimum effect of medication prior to admin of anesthesia

Question 37

cholinergic-blocking: for older patients-

Answer 37

- Might not be given to patients over 60 due to effects on eye and CNS - Watch for heat prostration in summer since ability to sweat has been effected. - Watch for excitement/confusion. - Assist with ambulation if on med routinely

Question 38

education with prolonged use of cholinergic-blocking:

Answer 38

-Inform provider of adverse reactions

Question 39

education with prolonged use of cholinergic-blocking: photophobia

Answer 39

wear sunglasses, soft light

Question 40

education with prolonged use of cholinergic-blocking: Dry mouth

Answer 40

take frequent sips of water during the day; chew gum or dissolve hard candy

Question 41

education with prolonged use of cholinergic-blocking: constipation

Answer 41

drink plenty of fluids, increase fiber in diet

Question 42

education with prolonged use of cholinergic-blocking: heat prostration

Answer 42

use fans, sponge bath.