Urinary Drugs

Question 1

Drugs that block or inhibit the actions of acetylcholine (ACh) in the PNS.

Answer 1

Cholinergic-Blocking Drugs aka anticholinergics, parasympatholytics, and antimuscarinic drugs

Question 2

antidote to cholinergic drugs

Answer 2

atropine

Question 3

Anticholinergic drug effects

Answer 3

• Larger doses- increase HR
• small doses- decrease muscle rigidity and tremors (Parkinsons)
• Dilate pupils
• Decrease eye accomodation
• Decreases GI secretions
• Decrease motility and peristalsis (motion sickness)
• Urinary retention (decreased incontinence)
• Decreased bronchial secretions, salivation, sweating (watch for heat stroke in elderly)
• Decreased bronchial secretions when inflammation occurs.

Question 4

Never use anticholinergics with…?

Answer 4

Bowel or urinary obstruction

Question 5

Anticholinergic drug that decreases bronchial secretions when theres an inflammatory reaction

Answer 5

glycopyrrolate (Robinul)

Question 6

Antidote to anticholinergic drugs (atropine overdose)

Answer 6

physostigmine (Antilirium)

Question 7

A patient on anticholinergic drugs may want …?

Answer 7

• chewing gum, frequent mouth care, and candy because of dry mouth
• dark glasses because of light sensitivity
• Avoid high temps + strenuous exercise

Question 8

Patients should report which symptoms to a physician if they are are anticholinergic therapy?(9)

Answer 8

• urinary hesitancy/retention
• constipation
• tachycardia
• palpitations
• tremors
• sedation
• confusion
• hallucinations
• decreased sweating

Question 9

Drugs that stimulate the PNS by mimicking the PNS neurotransmitter ACh.

Answer 9

Cholinergic drugs (cholinergic agonists, parasympathomimetics)

Question 10

Effects of Cholinergic drugs : “rest and digest”(5)

Answer 10

• Increases Gi/GU secretions and motility (for urinary retention, bethanechol)
• Dilates pupils
• Reduces intraocular pressure
• Decreases HR + BP
• bronchial constriction and narrow airways

Question 11

A direct acting cholinergic drug that relaxes the bladder and GI tract. It is commonly used for post surgical atony of the bladder and GI tract.

Answer 11

Bethanechol (Urecholine)

Question 12

If Urecholine is given as a sub Q injection, what is the result?

Answer 12

urinate within 60 minutes- if no urination, atropine.

Question 13

An anticholinesterace drug that is used to treat mild-moderate Alzheimers disease.

Answer 13

donepezil (Aricept), Exelon

Question 14

Indirect acting cholinergic drugs

Answer 14

physostigmine (Antilirium)

pyridostigmine (Mestinon)

Question 15

These drugs are used for the treatment of myasthenia graves, used to reverse neuromuscular blocking drugs, and reverse anticholinergic poisoning.

Answer 15

Indirect acting cholinergic drugs

Question 16

When is donepezil given?

Answer 16

bedtime- fall risk due to syncope, bradycardia and dizziness adverse effects.

Question 17

Symptoms of cholinergic crisis

Answer 17

Salivation
Lacrimation
Urination
Defecation

Question 18

Cholinergic crisis antidote

Answer 18

ATROPINE

Question 19

What is the tension test used for?

Answer 19

To diagnose cholinergic crisis (negative) and myasthenia crisis (positive)

Question 20

Interactions of Gingko

Answer 20

• GI upset, headache bleeding

- drug interactions with: NSAIDS, Aspirin, Anticoagulants, Anticonvulsants

Question 21

This drug is not a cholinergic drug and can be taken with anticholinesterase drugs. They are used to treat Alzheimers.

Answer 21

memantine (Namenda)