Drug facts, autonomic nervous system

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  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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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Drug facts, autonomic nervous system
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drug facts
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