Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
- 3rd side (hint)
What does a cholinergic receptor do?
|
Binds acetylcholine and mediates its action
|
|
|
What does cholinergic activate or release?
|
Acetylcholine (ACh)
|
|
|
Where do Acetylcholine go?
|
Cholinergic receptor sites
|
|
|
What neurotransmitter is responsible for transmission of nerve impulses to effector cells in PSN?
|
Acetylcholine
|
|
|
What are the two types of cholinergic receptors? How are they determined?
|
Nicorinic receptors
Muscarinic receptors Determined by LOCATION & ACTION ONCE STIMULATED |
End in "ic"
|
|
What is the location and stimulus for Nicotinic Receptors?
|
Location: Gangilia of both PNS & SNS
Stimulus: Nicotine |
|
|
At what dose does the cholinergic drug affect nicotinic receptors?
|
At high dosages
|
|
|
What is the location and stimulus for Muscarinic receptors?
|
Location: Postsynaptically in effector organs of PNS (smooth muscle, cardiac muscle, glands)
Stimulus: Alkaloid muscarine (found in mushrooms) |
|
|
What system does Cholinergic drugs stimulate?
|
Parasympathetic nervous system
|
|
|
What else happens to the body with PNS, besides rest and digest?
|
Repairing of the body
|
|
|
What are other names for Cholinergic drugs?
|
Cholinergic "agonists" (works with drugs)
Parasympathomimetics |
|
|
What is an Agonist?
|
Agonist causes an action, triggers response by the cell, mimic often natural occuring substance
|
|
|
Two types of cholinergic agonist?
|
Indirect and direct acting cholinergic agonist
|
|
|
MOA for Direct acting cholinergic agonist?
|
Bind to cholinergic receptors, activates them
|
|
|
MOA for indirect acting cholinergic agonist?
|
Inhibits acetylcholinesterase (breaks down acetylcholine), which results in more ACh available at receptors
|
|
|
The Indirect acting cholinergic drugs also known as Cholinesterase Inhibitors have two categories of inhibition?
|
Reversible: Bind to Cholinesterase for mins-hrs
Irreversible: Bind to Cholinesterase and form a permanent covalent bond (will work longer & better, bc it takes long to break up) |
|
|
What are some Drug effects of cholinergic receptors?
|
-Effects seen when PNS is stimulated
-Stimulates intestine and bladder -Stimulates pupils (reduces intraocular pressure) -At recommended doses, cholinergics primarily affect muscarinic receptors (desire affects muscarinic). At high doses, they stimulate nicotinic receptors (many undesirable effects). |
|
|
What are some contradictions to using Cholinergic drugs?
|
-Bradycardia
-GI Obstruction -Hypotension -COPD **BC cholinergic relaxes, slows down, and moves the body systems. |
|
|
What are Direct-cholinergic acting drugs used for?
|
-Reduce intraocular pressure
-Helps with GI, GU motility, postsurgical atony (lack of normal muscle tone) of bladder and GI tract |
|
|
What are the Indirect acting cholinergic drugs used for?
|
-Used for dx & tx of Myasthenia gravis (muscle weakness)
-Reverse neuromuscular blocking drugs -Reverse anticholinergic poisoning (antidote = Physostigmine) |
|
|
What is an indication for indirect acting anticholinesterase drugs?
|
-Used to treat Alzheimer's disease
-Helps improve memory, NOT A CURE for Alzheimer's |
|
|
What are drugs to help with Alzheimer's?
|
-Donepezil
-Galantamine* -Rivastigmine* -Memantine (not cholinergic drug) |
|
|
Direct acting cholinergic drugs?
|
-Echothiophate
-Carbachol -Pilocarpine* ^ topical to reduce intraocular pressure surgery -Bethanechol (muscles of urinary bladder & smooth muscle of GI) [urination should occur with 60 min] |
|
|
Acetylcholinesterase is also know as?
|
Cholinesterase
|
|
|
Indirect acting cholinergic drugs or cholinesterase inhibitors inhibit what action?
|
Acetylcholinesterase
|
|
|
Indirect acting drugs to help with myashthenia gravis?
|
-Physostigmine
-Pyridostigmine -Edrophonium* |
|
|
How do Indirect/Direct acting cholinergic drugs/ cholinesterasr inhibitors work?
|
They work by increasing ACh, by inhibiting acetylchlinesterase, which breaks down ACh.
|
|
|
What are Adverse effects of the cholinergic drugs?
|
They are the results of overstimulation of PNS.
*Think of going beyond the chart! |
|
|
What interactions with cholinergic drugs?
|
-Anticholinergics, antihistamines, sympathomimetics (Decrease response)
-Other cholinergic drugs increase response |
|
|
What is Ginko commonly used for?
|
Prevent memory loss, vertigo, tinnitus
|
|
|
What are adverse effects with Gingko?
|
Upset GI, headache, bleeding
|
|
|
Possible drug interactions with Gingko?
|
-Aspirin
-Nonsterodial antinflammatory drugs (NSAIDs) -Anticoagulant -Anticonvulsants |
|
|
What are nursing implications for cholinergic drugs?
|
-Spread dosage to optimize effects
-Those with Myasthenia Gravis should take medicine 30 min. before eating to improve chewing & shallowing -ATROPINE is antidote for cholinergic crisis -Therapeutic effects -Cholinergic Crises (overdose of cholinergic drugs) |
|
|
Early signs or Cholinergic crisis is SLUDGE, which stands for?
|
Salivation
Lacrimation Urination Defecation Gastric Upset Emesis (vomiting) *ATROPINE is antidote for cholinergic crisis!!! |
|