Pharm Ch21 Cholinergic-Blocking Drugs

  1. Anticholinergic drugs block or inhibit the actions of _____ in the parasympathetic nervous system (PNS).
    acetylcholine (ACh)
  2. Cholinergic-Blocking Drugs are AKA as _____, _____, and _____.
    • anticholinergics
    • parasympatholytics
    • antimuscarinic drugs
  3. Cholinergic-Blocking eye drops cause _____ of the pupil and _____ of the ocular lens, both of which are important for eye surgery.
    • dilation
    • paralysis
  4. Cholinergic-blocking eye drops cause decreased ______ caused by paralysis of ciliary muscles (cycloplegia)
  5. Cholinergic-Blocking GI Drugs cause:
    there are 3
    • Relax smooth muscle tone of GI tract
    • Decrease intestinal and gastric secretions
    • Decrease motility and peristalsis
  6. Which finding would the nurse anticipate when assessing a patient with an atropine overdose?


    Atropine overdose is manifested by flushing, dry skin and mucous membranes, mydriasis, altered mental status, and fever. Other serious effects include sinus tachycardia, urinary retention, hypertension, hallucinations, and cardiovascular collapse. Activated charcoal is usually given along with supportive therapy.
  7. Cardiovascular effects of cholinergic-blockers in high doses include increased ___ ___ & _____. One indication for use is the treatment of _____ _____ accompanied by hemodynamic compromise
    • heart rate
    • dysrhythmias
    • sinus bradychardia
  8. Cardiovascular effects of cholinergic-blockers in low doses include _____ heart rate.
  9. _____ is used primarily for cardiovascular disorders. I.e. diagnosis of ____ ____ dysfunction and symptomatic ____-____ heart block
    • Atropine
    • sinus node
    • second-degree
  10. Anticholinergic drugs are given preoperatively to control ____ and __ _____ during surgery.
    • oral
    • GI secretions
  11. Cholinergic-Blocking Drugs are used for the respiratory system to _____ _____ from the nose, mouth, pharynx, and bronchi, relax the smooth muscles in the ____ & ____, which leads to decreased airway resistance and _____.
    • decrease secretions
    • bronchi and bronchioles
    • bronchodilation
  12. Glycopyrrolate (Robinul) and an opioid are administered to a patient before surgery in the preoperative area. What is the intended effect of the glycopyrrolate (Robinul)?


    Anticholinergics such as glycopyrrolate and atropine are given preoperatively to reduce or control secretions before and during surgery.
  13. Before administering tolterodine (Detrol), it is most important for the nurse to assess the patient for a history of which condition?


    Tolterodine (Detrol) may worsen pre-existing angle-closure glaucoma and urinary retention, so its use should be avoided in patients with these conditions.
  14. Anticholinergic drugs commonly cause the adverse effects of ___ ____, blurred vision, _____, and urinary retention. They also cause _____ dilation. The incidence of ___ ____ is much lower with the use of newer cholinergic blocker drugs i.e. darifenacin because the actions of these drugs are more specific for the _____ as opposed to the salivary glands. These drugs are contraindicated if narrow angle _____or urinary retention is present. The new cholinergic blocker drugs are not necessarily more effective.
    • dry mouth
    • constipation
    • pupillary
    • dry mouth
    • bladder
    • glaucoma
  15. _____is the antidote to an Atropine OD in pts who show extreme delirium or agitation and can conflict injury to themselves. Its routine use as an antidote for cholinergic blocker OD is controversial.
  16. The treatment of cholinergic blocker OD consists of symptomatic and supportive _____. The pt should be hospitalized, with continuous ______ monitoring. Activated _____ is effective in removing from the GI tract any drug that has not yet been absorbed. Fluid therapy and other standard measures used for the treatment of _____ are instituted as needed.
    • therapy
    • electrocardiographic
    • charcoal
    • shock
  17. Contraindications for Oxybutynin include:
    there are 3
    • drug allergy
    • urinary or gastric retention
    • uncontrolled angle-closure glaucoma
  18. Oxybutynin is a synthetic _____ drug.
  19. Oxybutynin's uses are for _____ _____ and antispasmodic for _____ _____ associated with spinal cord injuries and congenital conditions such as spina bifida.
    • overactive bladder
    • neurogenic bladder
  20. Tolterodine is used for _____ frequency/urgency, and urge incontinence caused by _____ over activity.
    • urinary
    • bladder
  21. Tolterodine is a _____ _____ blocker
    muscarinic receptor
  22. The Newer muscarinic receptor blocking drugs, like Tolterodine, are used for _____ frequency/urgency, and urge ______ caused by _____ over activity
    • urinary
    • incontinence
    • bladder
  23. Newer muscarinic receptor blocking drugs, that are used for urinary frequency, urgency, and urge incontinence caused by bladder over activity include:
    there are 5
    • fesoterodine (Toviaz)
    • Tolterodine
    • solifenacin (Vesicare)
    • darifenacin (Enablex)
    • trospium (Sanctura)
  24. Newer muscarinic receptor blocker drugs are associated with a much lower incidence of ___ _____, partly because of their pharmacologic specificity for the bladder as opposed to the salivary glands.
    dry mouth
  25. Elderly pts who take an anticholinergic drug need to be reminded that they are at greater risk for suffering ___ ____ because of decreased sweating and loss of normal ____ _____ mechanisms.
    • heat stroke
    • heat regulating
  26. You must teach patients who take anticholinergics to limit _____ exertion and avoid ____ temperatures and strenuous _____.
    • physical
    • high
    • exercise
  27. You must teach patients who take anticholinergics of the importance of adequate ____ and ____ intake.
    • fluid
    • salt
  28. 1. The nurse is providing education about cholinergic-blocking drug therapy to an older adult patient. Which is an important point to emphasize for this patient?

  29. The nurse is giving a cholinergic-blocking drug and will assess the patient for which contraindications to these drugs?

  30. When assessing for adverse effects of cholinergic-blocking drug therapy, the nurse knows that the patient may experience which drug effect? (Select all that apply.)

    a. Diaphoresis
    b. Dry mouth
    c. Dilated pupils
    d. Urinary frequency
    e. Constipation
    b, c, e
  31. The nurse administering a cholinergic-blocking drug to a patient who is experiencing drug-induced extrapyramidal effects would assess for which therapeutic effect?

  32. During the assessment of a patient about to receive a cholinergic-blocking drug, the nurse will determine whether the patient is taking any drugs that may potentially interact with the anticholinergic, including which of these?

  33. A patient has been given a prescription for transdermal scopolamine patches (Transderm-Scōp) for motion sickness for use during a vacation cruise. The nurse will include which instructions? (Select all that apply.)

    a. “Apply the patch as soon as you board the ship.”
    b. “Apply the patch 4 to 5 hours before boarding the ship.”
    c. “The patch needs to be placed on a nonhairy area just behind your ear.”
    d. “Change the patch every 3 days.”
    e. “Rotate the application sites."
    b, c, d, e
  34. The nurse is assessing a patient who has a prescription for dicyclomine (Bentyl). Which condition is considered a contraindication to this medication?

Card Set
Pharm Ch21 Cholinergic-Blocking Drugs
Ch21 Cholinergic-Blocking Drugs Exam2