NUR 521 ADV PHARM EXAM 1 Save
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exam 1 drugs NUR 521 AVD PHARM BLUEPRINT E... NUR 521 ADV PHARM EXAM 2 PROT... ***phar
42 terms 266 terms 564 terms 45 terms
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Terms in this set (517)
Bethanechol (Urecholine) Drug Class Muscarinic (Cholinergic) Agonist (Parasympathomimetic)
MOA for Bethanechol (Urecholine) Directly activate receptors of the parasympathetic nervous system
Mimics the effects of acetylcholine by binding with muscarinic receptors to elicit a
parasympathetic response
The principle structures affected by muscarinic activation Heart- bradycardia
by Bethanechol (Urecholine) are: Exocrine Glands- inc sweating, salivation, bronchial and GI secretions
Smooth Muscles- Lungs,GI/GU: promote contraction (Constrict bronchi and
increase tone/motility in GI; contract detrusor , relax trigone and sphincter to
empty bladder)
Vascular Smooth Muscle: relaxation causes vasodilation and hypotension
Eyes- constricts pupils (miosis) and contracts ciliary muscle for near vision
Dosage/Administration of Bethanechol (Urecholine) Tablets: 5, 10, 25, and 50 mg
10-50mg 3-4 times a day
Therapeutic uses for Bethanechol (Urecholine) Unobstructed Urinary Retention (post-op// postpartum)
The goal is that the patient will have an absence of bladder distention and
adequate urinary output
OFF LABEL: GERD (inc tone/ motility)
Contraindications for Bethanechol (Urecholine) - GI/ GU obstruction
- Gastric Ulcers (PUD)
- Bradycardia/ DEC CO
- Asthma
- Hyperthyroidism
Adverse effects of Bethanechol (Urecholine) CV: Hypotension, bradycardia, flushing
GI: Excessive salivation, INC gastric acid, ABD cramps, diarrhea
RESP: Bronchoconstriction
, Baseline data/ mnonitoring for Bethanechol(Urecholine) VS
I/O
Urinary history
Monitor for s/s of excessive muscarinic response (DUMBELS or SLUDGE and the
Killer Bs)
Antidote for Bethanechol (Urecholine) Atropine
Drug Interactions with Bethanechol (Urecholine) Cholinesterase inhibitors (like pyridostigmine) may INC AE
- Beta-blockers may enhance AE
· Quinidine and procainamide (may antagonize cholinergic effects)
· Additive cholinergic effects with cholinesterase inhibitors
· Ganglionic blocking agents (severe hypotension)
· DO NOT USE with depolarizing neuromuscular blocking agents
· Anticholinergics decrease effectiveness
Patient education for Bethanechol (Urecholine) - Take on an empty stomach to decrease n/v
- Teach about muscarinic toxicity (DUMBELS/ SLUDGEBBB)
Muscarninic (Cholinergic) Toxicity S/S (Bethanechol Diaphoresis/diarrhea/GI cramping
(Urecholine) and Pyridostigmine (Mestinon)) Urination
Miosis
Bradycardia/bronchospasm/bronchorrhea
Emesis
Lacrimation
Salivation
Bethanechol (Urecholine) Across the Life Span Peds: safety not established
OB: safety not established
BF: unknown
Older Adults: Due to DEC cardiac, hepatic, or renal function, evaluate on
individual basis
Drug Class for Pyridostigmine (Mestinon) Cholinesterase Inhibitors (Anticholinesterase or Acetylcholinesterase Inhibitors)
MOA of Pyridostigmine (Mestinon) Prevent degradation of acetylcholine by acetylcholinesterase
Increase the amount of acetylcholine available to activate receptors, enhancing
cholinergic action
Pyridostigmine (Mestinon) Across the Lifespan Peds: Safety not established
OB: Might be necessary during pregnancy and labor when treating MG
BF: Unkown
Older Adults: Most used in this population; renal dosing if needed
Dosage/ Administration of Pyridostigmine (Mestinon) Syrup: 60mg/5ml
IR Tab: 60 mg ; 60-1,500mg/day usually 600mg/day in 5 doses
ER Tab: 180mg; 180-540mg once or twice a day
IV: 1mg/ml in 2ml vials
IM for reversal of anticholinergic toxicity: adults 0.5-2mg, children 0.02mg/kg (can
repeat every 10-30 min PRN)
Leave the first rating
Students also studied
exam 1 drugs NUR 521 AVD PHARM BLUEPRINT E... NUR 521 ADV PHARM EXAM 2 PROT... ***phar
42 terms 266 terms 564 terms 45 terms
kevsmom Preview Bayli_Patterson Preview Bayli_Patterson Preview meg
Terms in this set (517)
Bethanechol (Urecholine) Drug Class Muscarinic (Cholinergic) Agonist (Parasympathomimetic)
MOA for Bethanechol (Urecholine) Directly activate receptors of the parasympathetic nervous system
Mimics the effects of acetylcholine by binding with muscarinic receptors to elicit a
parasympathetic response
The principle structures affected by muscarinic activation Heart- bradycardia
by Bethanechol (Urecholine) are: Exocrine Glands- inc sweating, salivation, bronchial and GI secretions
Smooth Muscles- Lungs,GI/GU: promote contraction (Constrict bronchi and
increase tone/motility in GI; contract detrusor , relax trigone and sphincter to
empty bladder)
Vascular Smooth Muscle: relaxation causes vasodilation and hypotension
Eyes- constricts pupils (miosis) and contracts ciliary muscle for near vision
Dosage/Administration of Bethanechol (Urecholine) Tablets: 5, 10, 25, and 50 mg
10-50mg 3-4 times a day
Therapeutic uses for Bethanechol (Urecholine) Unobstructed Urinary Retention (post-op// postpartum)
The goal is that the patient will have an absence of bladder distention and
adequate urinary output
OFF LABEL: GERD (inc tone/ motility)
Contraindications for Bethanechol (Urecholine) - GI/ GU obstruction
- Gastric Ulcers (PUD)
- Bradycardia/ DEC CO
- Asthma
- Hyperthyroidism
Adverse effects of Bethanechol (Urecholine) CV: Hypotension, bradycardia, flushing
GI: Excessive salivation, INC gastric acid, ABD cramps, diarrhea
RESP: Bronchoconstriction
, Baseline data/ mnonitoring for Bethanechol(Urecholine) VS
I/O
Urinary history
Monitor for s/s of excessive muscarinic response (DUMBELS or SLUDGE and the
Killer Bs)
Antidote for Bethanechol (Urecholine) Atropine
Drug Interactions with Bethanechol (Urecholine) Cholinesterase inhibitors (like pyridostigmine) may INC AE
- Beta-blockers may enhance AE
· Quinidine and procainamide (may antagonize cholinergic effects)
· Additive cholinergic effects with cholinesterase inhibitors
· Ganglionic blocking agents (severe hypotension)
· DO NOT USE with depolarizing neuromuscular blocking agents
· Anticholinergics decrease effectiveness
Patient education for Bethanechol (Urecholine) - Take on an empty stomach to decrease n/v
- Teach about muscarinic toxicity (DUMBELS/ SLUDGEBBB)
Muscarninic (Cholinergic) Toxicity S/S (Bethanechol Diaphoresis/diarrhea/GI cramping
(Urecholine) and Pyridostigmine (Mestinon)) Urination
Miosis
Bradycardia/bronchospasm/bronchorrhea
Emesis
Lacrimation
Salivation
Bethanechol (Urecholine) Across the Life Span Peds: safety not established
OB: safety not established
BF: unknown
Older Adults: Due to DEC cardiac, hepatic, or renal function, evaluate on
individual basis
Drug Class for Pyridostigmine (Mestinon) Cholinesterase Inhibitors (Anticholinesterase or Acetylcholinesterase Inhibitors)
MOA of Pyridostigmine (Mestinon) Prevent degradation of acetylcholine by acetylcholinesterase
Increase the amount of acetylcholine available to activate receptors, enhancing
cholinergic action
Pyridostigmine (Mestinon) Across the Lifespan Peds: Safety not established
OB: Might be necessary during pregnancy and labor when treating MG
BF: Unkown
Older Adults: Most used in this population; renal dosing if needed
Dosage/ Administration of Pyridostigmine (Mestinon) Syrup: 60mg/5ml
IR Tab: 60 mg ; 60-1,500mg/day usually 600mg/day in 5 doses
ER Tab: 180mg; 180-540mg once or twice a day
IV: 1mg/ml in 2ml vials
IM for reversal of anticholinergic toxicity: adults 0.5-2mg, children 0.02mg/kg (can
repeat every 10-30 min PRN)
