NUR 426 Lecture Notes - Lecture 2: Cardiac Arrhythmia, Psychoactive Drug, Agnosia
Document Summary
Indirect acting cholinergic drugs block acetylcholinesterase leading to increased ach in synapse. Occupy postsynaptic cholinergic receptors (sites for acetylcholine) stimulate cholinergic receptors. React with acetylcholinesterase (ache) and prevent it from breaking down. Increase levels of ach in synaptic cleft ach stimulates the cholinergic receptors: not limited to a specific site; therefore, associated with many undesirable systemic effects, most common side effects are gi side effects. Direct-acting cholinergic: therapeutic action: cholinergic (rest and digest) Heart - decrease rate, decrease bp, decrease contractility. Bladder increased detrusor muscle tone sphincter relaxes (urination) L - lacrimation: s salvation and sweating, u urination, d defecation, g gi cramps, e emesis, m miosis (constriction and muscle spasm, bethanechol (10-50mg po 2x/day 4x/day) Non-obstruction urinary retention (postop or postpartum); neurogenic bladder in adults or children >8. Contraindications and cautions: any condition that could be exacerbated by parasympathetic nervous system activation. Bradycardia (will lower hr further), hypotension, coronary insufficiency. Parki(cid:374)so(cid:374)"s: caution in pregnancy and breast feeding.
