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Key facts about cholinergic agonists (4)
[Ex: Bethanechol (Duvoid, Myotonachol), pilocarpine (Isopto Carpine, Pilocar)]
- 1. directly stimulate cholinergic receptors
- 2. mimic the action of acetylcholine
- 3. metabolized by cholinestrerases in plasma and liver
- 4. excreted in urine
-
When to use cholinergic agonists (5)
[Ex: Bethanechol (Duvoid, Myotonachol), pilocarpine (Isopto Carpine, Pilocar)]
- glaucoma
- atonic bladder
- postoperative and postpartum urinary retention
- abdominal distention and GI atony
- salivary gland hypofunction
-
When NOT to use cholinergic antogonists (6)
[Ex: Bethanechol (Duvoid, Myonachol), pilocarpine (Isopto carpine, Pilocar)]
- prostate enlargement
- possible urinary or G obstruction
- hyperthyroidism
- bradycardia or AV conduction defects
- Asthma
- Coronary artery disease
-
Adverse reactions of cholinergic agonists
[Ex: Bethanechol (Ducoid, Myonachol), pilocarpine (Isopto Carpine, Pilocar)]
hypotension, h/a, sweating, increased salivation, abdominal cramps, nausea, vomiting, diarrhea, blurred vision, urinary frequency, decreased HR, SOB
-
key nursing actions for cholinergic agonists (5)
[Ex: Bethanechol (Duvoid, Myonachol), pilocarpine (Isopto Carpine, Pilocar)]
- assess urinary status
- assess bowel sounds and abdomen
- Administer P.O. or subQ; never give I.V. or I.M.
- Observe pt for 20-60 min after subQ administration
- Monitor for toxicity; administer atropine as an antidote as prescribed
-
Key facts about acetylcholinestrase inhibitors (3)
[Ex: Ambenonium (Mytelase), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmine (Antilirium), pyridostigmine (Mestinon, Regonol)
- inhibit acetylcholinesterase, the enzyme that inactivates acetylcholine; as acetylcholine builds up it stimulates the cholinergic receptors
- metabolized in plasma
- excreted in urine
-
When to use acetylcholinesterase inhibitors
[Ex: amenonium (MYetelase), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmine, Antilirium), pyridostigmine (Mestinon, Regonol)
- myastenia gravis
- glaucoma
- anticholinergic poisoning
- paralytic ileus
-
When NOT to use acetylcholinesterase inhibitors
[Ex: amenonium (Myetelase), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmine, Antilibrium), pyridostigmine (Mestinon, Regonol)
Possible urinary or GI obstruction
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