Home > Flashcards > Print Preview
The flashcards below were created by user
on FreezingBlue Flashcards. What would you like to do?
What are Cholinergic drugs?
They act like neurotransmitter acetylcholine or may inhibit release of enzyme acetylcholinesterase.
- Urinary retention (causes contraction of bladder smooth muscles)
- Tx of Glaucoma (produces miosis-constriction of the iris)
- Myasthenia gravis- this is rapid fatigue in skeletal muscles bcuz of lack of ACH.
What are the A/R of Cholinergic drugs?
- Nausea/diarrhea, ABD cramping
- Salivation flushing of the skin
- Cardiac arrhythmias
- Muscle weakness
- Topical administration A/R:
- Reduction of visual acuity
Who are Cholinergic drugs contraindicated in?
- Peeps with:
- Peptic ulcer disease
- Coronary artery disease
is contraindicated in those w/ mechanical obstruction of the GI or genitourinary tracts.
Opthalmic cholinergic preparations -
peeps w/ secondary glaucoma, iritis, corneal abrasion, or any acute inflammatory disease of the eye
What are the precautions in Cholinergic drugs?
- Used cautiously in peeps with:
- Cardiac arrythmias
- recent coronary occlusion
what drug interactions does CHOLINERGIC drugs have?
Aminoglycoside antibiotics(anti-infective) = INCREASED neuromuscular blocking effect
Corticosteroids(tx of inflammation/respiratory problems) =DECREASED effect of the CHOLINERGIC
What are the Preadministration assessment of Cholinergic drugs used for Glaucoma?
- Primary health care provider examines the eye
- Review the health care provider's dx and comments
- Take pt health hx, evaluate pt's ability 2 carry out ADLs
- After preadm assessment
- Nurse= Monitor 4 drug toxicity or cholinergic crisis, Check eye & area around eye daily 4 evidence of redness, inflammation, and excessive secretions
- when giving eye drops read rx label carefully when instilling
- chck name of drug, dosage, strength
- Using PILOCARPINE ocular system=question pt if they can self administer disc while in hospital
- change the PILOCARPINE ocular system every 7days unless Dr. directs otherwise
What is the preadministration assessment 4 Cholinergics used 4 Myasthenia Gravis?
- Assess 4 signs of muscle weakness examples:
- inability 2 chew or swallow
- drooping eyelids
- inabliltiy 2 perform repetitive movements
- difficulty breathing
- extreme fatigue
- After administration:
- Nurse=document any increase in symptoms of the A/R B4 giving each dose, Assess pt 4 presence or absence of the symptoms of MYASTHENIA GRAVIS b4 each dose
- Sustained-released tablets are available that allow less frequent dosing & help pt 2 have longer undisturbed periods during night
What are the preadministration assessment 4 Cholinergics used 4 urinary retention?
- Palpate ABD in pelvis area 2 determine if distention is present:
- Swelling over pelvis usually indicates retention & distended bladder
- Ongoing assessment:
- Nurse= I&0s, notify dr. if pt fails 2 void after administration, palpate bladder 2 determine its size
Place the call light & any other items the pt might need, such as urinal or bedpan w/in easy reach
What is the ongoing assessment of Cholinergic drugs?
Monitor 4 drug toxicity or cholinergic crisis.
- Cholinergic crisis includes:
- Severe ABD cramping
- excessive salivation
- muscle weakness
- clenching of the jaw
- NURSE REPORT THIS 2 DR ASAP CUZ PT NEEDS ANTIDOTE ATROPINE 0.4 T0 0.6 GIVIN BY IV
What is the monitoring & managing nursing duties of cholinergic drugs?
- Disturbed sensory perception- visual
- Drug-induced myopia may occur after instillation of drops 4 glaucoma
- Assist client in/out of bed or ambulating & remove obstacles that may be a fall risk 4 pt.
- Make sure bedside commode, bedpan, or bathroom, are readily available
- Keep record of fluid I&O and number, consistency, frequency of stools if diarrhea is present
What should you teach the patient & family when using Cholinergic drugs 4 glaucoma?
- Warn the pt the eye drops may sting when instilling in eye & is normalAdvise pt. 2 observe caution while driving or performing that requires vision
- Local irritation and headache may occur @ the beginning of therapy
Notify the Dr. provider if ABD cramping, diarrhea, or excessive salivation occurs
What should you teach the patient & family about Pilocarpine ocular system?
Nurse = notify dr. if eye secretions are excessive or irritation occurs
- Instruct pt 2 remove & replace system every 7days (ciz when u first put it in their is some short term vision impairment) or instructed by Dr.
- Check unit 4 placement b4 retiring @ night & in the morning on arising
What would you teach patient and family about taking these drugs 4 Myasthenia gravis?
- Recognize symptoms of overdosage and underdosage
- Instruct pt 2 keep a record of response 2 drug therapy (time of day, increased or decreased muscle strength, fatigue) & 2 bring recor 2 each appt.
- Tell client they must wear medic alert tag indicating they hv myasthenia gravis
What are the Cholinergic drugs used 4 myasthenia gravis?
- Edrophonium (enion, tensilon)
- Pyridostigmine bromide(mestinon regonol)
What cholinergic drugs are used 4 tx of urinary cholinergics?
Behtanechol chloride (duvoid urecholine)
What are cholinergic drugs used 2 tx glaucoma?
- Carbachol topical (miostat)
- pilocarpine HCI (pilopine)