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37 Cards in this Set
- Front
- Back
What do anticholinergics do?
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competitively inhibit the action of acetylcholine
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What does atropine treat? (2)
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treats bradyarrhythmias
also used for an ophthalmic mydriatic) |
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What does ipratropium treat?
(2) |
bronchospasm (inhalation) rhinorrhea (intranasal)
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What does scopolamine treat? (2)
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nausea and vomiting related to motion sickness and vertigo
(also used as an ophthalmic mydriatic) |
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How does propantheline and glycopyrrolate work? (2)
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decreases gastric secretory
activity increases esophageal sphincter tone |
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Which two anticholinergics are used as ophthalmic mydriatics?
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atropine
scopolamine |
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Which 3 anticholinergics are used in the management of Parkinson's disease?
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benztropine
biperidin trihexyphenidyl |
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Which 2 anticholinergics are used as urinary tract spasmodics?
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oxybutynin
tolterodine |
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Which 4 drugs also have antimuscarinic properties?
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atropine
glycopyrrolate propantheline scopolamine |
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Define muscarinic?
(FYI: anticholinergics are ANTI-muscarinic |
pertaining to the effect of acetylcholine at parasympathetic postganglionic effector sites
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How do the following four drugs affect acetylcholine at their cholinergic nerve fiber sites?
atropine glycopyrrolate propantheline scopolamine |
they inhibit the action of acetylcholine at sites innervated by postganglionic cholinergic nerves
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Define cholinergic?
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an agent that produces the effect of acetylcholine
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What is the precursor to acetylcholine?
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choline
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Define acetylated?
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To bring an acetyl group into (an organic molecule)
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Define acetyl?
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The acetic acid radical CH3CO.
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Choline is acetylated at the axon terminals (now it's acetylcholine) and is stored in clear spherical vesicles until it is released where?
(2) |
at all motor terminals on
skeletal muscle at synapses in para- sympathetic and sympathetic ganglia (FYI: there are SOME sympathetic ganglionic nerve neurons that are cholinergic as well as some of the terminals of the efferent olivocochlear tract ending on cochlear hair cells) |
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Where are muscarinic receptors found?
(A&P pg 524) |
occur on all effector cells stimulated by postganglionic cholinergic fibers...meaning all parasympathetic target organs and a few sympathetic targets, such as eccrine sweat glands and some blood vessels of skeletal muscles
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What is the effect of ACh binding to muscarinic receptors? And give an example?
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BOTH inhibitory and excitatory depending on the target organ
for example, binding of ACh to cardiac muscle receptors slows heart activity, whereas ACh binding to receptors on smooth muscle of the GI tract increases its motility |
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What is vertigo and which medication is used to treat vertigo and motion sickness?
What therapeutic class does the medication fall in? What is the medication's pharmacological class? |
If the inner ear falls to receive enough blood flow, the more specific type of dizziness occurs-that is-vertigo. The inner ear is very sensitive to minor alterations of blood flow and all of the causes mentioned for poor circulation to the brain also apply specifically to the inner ear.
scopolamine antiemetic anticholinergic |
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Do not use anticholinergics under the following conditions (contraindications)? (5)
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hypersensitivity
narrow-angle glaucoma severe hemorrhage tachycardia (due to thyrotox- icosis or cardiac insufficiency) myasthenia gravis |
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Use anticholinergics cautiously in patients with?
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urinary tract pathology
GI obstruction risk chronic renal, hepatic, pulmonary, or cardiac disease |
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There may be additive anticholinergic effects with other agents possessing anticholinergic activity. Other anticholinergic drugs may include? (4)
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antihistamines
antidepressants quinidine disopyramide |
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Symptoms of an additive anticholinergic effect are?
(4) |
blurred vision
constipation dry mouth dry eyes |
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GI absorption of other drugs may be altered by anticholinergics because? (2)
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GI motility is inhibited
there is increased transit time |
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_______ may decrease absorption of orally administered anticholinergics.
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Antacids
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What should be assessed frequently during anticholinergic IV drug therapy?
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vital signs
ECG |
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What significant changes during anticholinergic IV drug therapy should be reported promptly?
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heart rate
blood pressure increase in ventricular ectopy or angina |
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When taking anticholinergics, what should be monitored in elderly or surgical patients as the drug may cause urinary retention?
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intake and output ratios
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What GI interventions should be taken while taking anticholinergics?
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assess for abdominal distention and auscultate for bowel sounds
constipation may become a problem increasing fluids and adding bulk to the diet may help alleviate constipation |
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Potential Nursing Diagnoses?
(3) |
Cardiac output, decreased
Oral mucous membrane, altered Constipation |
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Oral doses of atropine, glycopyrrolate, propantheline, or scopolamine should be administered when before meals?
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30 minutes
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How many hours before travel should Scopolamine transdermal patches be applied?
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at least 4 hours
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What might help relieve dry mouth associated with anticholinergic use? (4)
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frequent rinses
sugarless gum sugarless candy good oral hygiene |
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Anticholinergics may cause _____?
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drowsiness
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What should patients taking ophthalmic preparations know?
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they may cause blurred vision and impair ability to judge distances
dark glasses may be needed to protect eyes from bright light |
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Effectiveness of therapy can be demonstrated by? (6)
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increase in heart rate
decrease in nausea and vomiting related to motion sickness or vertigo dryness of mouth dilation of pupils decrease in GI motility resolution of signs and symptoms of Parkinson's disease |
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What are 15 anticholinergic drugs?
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atropine Atro-Pen
benztropine {Apo-Benztropine}, Cogentin biperidin Akineton dicyclomine Bentyl, {Bentylol}, {Formulex}, {Spasmoban} difenoxin/atropine Logen, Lomanate, Lomotil, Lonox diphenoxylate/atropine Motofen glycopyrrolate Robinul, Robinul-Forte hyoscyamine Anaspaz, A-Spas S/L, Cystospaz, Cystospaz-M, Donnamar, ED-SPAZ, Gastrosed, Levsinex, Levsin, Levbid, L-hyoscyamine, NuLev ipratropium Atrovent oxybutynin Ditropan, Ditropan XL propantheline Pro-Banthine scopolamine Isopto Hyoscine, Transderm-Scp, {Transderm-V} tolterodine Detrol, Detrol LA trihexyphenidyl Artane trimethobenzamide Arrestin, Benzacot, Brogan, Stemetic, Tebamide, Tegamide, T-Gen, Ticon, Tigan, Tiject-20, Triban, Tribenzagan, Trimazide |