Cholinergic and Adrenergic Agents: Detailed
Mechanisms of Action, Therapeutic Uses, Off-
Label Applications, Adverse Effects,
Contraindications, Precautions, Toxicology,
Drug Interactions, and Clinical Monitoring
Considerations for Muscarinic Agonists,
Muscarinic Antagonists, Cholinesterase
Inhibitors, and Adrenergic Agonists Including
Cardiovascular, Respiratory, Gastrointestinal,
Neuromuscular, Ophthalmic, and Central
Nervous System Effects Exam Questions
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Example of Muscarinic Agonist (3)
Bethanechol
Cevimelin
Pilocarpine
main therapeutic use of muscarinic agonist?
Urinary retention
off label use of muscarinic agonist
GERD
CV adverse effect of muscarinic agonist
hypotension and bradycardia
which medication class has an adverse effect of excessive salivation
increase secretion of gastric acid, abd cramps, diarrhea, Muscarinic agonist
, muscarinic agonist is CI with which patients
that may cause ruptured bladder, patients with UTI or weak bladder wall
why does muscarinic agonist CI in pt w/ latent or active asthma
bronchoconstriction
Muscrarinic agonist are CI in pts with hyperthyroidism d/t what?
opposite effect due to reflex
Urinary adverse effects of muscarinic agonist
increased bladder pressure --> ruptured bladder
how do you minimize adverse effects of muscarinic agonist?
take on empty stomach
what meds reduce adverse effects of muscarinic agonist
atropine
toxicology mnemonic for muscarinic agonist (10)
DUMBELS (diaphoresis/diarrhea urination miosis bradycardia/bronchospams/bronchorrhea,
emesis, lacrimation, salivation)
muscarinic agonist that treats xerostomia and manages keratoconjuctivitis sicca
cevimeline
muscarinic agonist that is mainly used for topical therapy of glaucoma
pilocarpine
examples of muscarinic antagonist (4)
atropinescopolamineipratropium bromidedicyclomine
therapeutic goal for muscarinic antagonist
treatment of bradycardia/AV blockantidote to anticholinesterase poisoningpreanesthetic
medication
High risk patients for muscarinic antagonist (4)
nonbradycardic dysrthmias (tachydysrhythmias) and MIrisk for glaucomarisk for myasthenia
crisis in pts with myasthenia gravisurinary retention in BPH