McKenna's Pharmacology for Nursing, 2e - page 511

C H A P T E R 3 2 Cholinergic agonists 499
atony postoperatively or postpartum, and another
agent is available to increase GI secretions and relieve
the dry mouth of Sjögren’s syndrome.
■■All indirect-acting cholinergic drugs are
acetylcholinesterase inhibitors. They block
acetylcholinesterase to prevent it from breaking down
ACh in the synaptic cleft.
■■Cholinergic stimulation by acetylcholinesterase
inhibitors is due to an accumulation of the ACh
released from the nerve ending.
■■Myasthenia gravis is an autoimmune disease
characterised by antibodies to the ACh receptors.
This results in a loss of ACh receptors and eventual
loss of response at the neuromuscular junction.
■■Acetylcholinesterase inhibitors are used to
treat myasthenia gravis because they allow the
accumulation of ACh in the synaptic cleft, prolonging
stimulation of any ACh sites that remain.
■■Alzheimer’s disease is a progressive dementia
characterised by a loss of ACh-producing neurons
and ACh receptor sites in the neurocortex.
■■Acetylcholinesterase inhibitors that cross the blood–
brain barrier are used to manage Alzheimer’s disease
by increasing ACh levels in the brain and slowing the
progression of the disease.
■■Side effects associated with the use of these drugs
are related to stimulation of the parasympathetic
nervous system (bradycardia, hypotension, increased
GI secretions and activity, increased bladder tone,
relaxation of GI and genitourinary sphincters,
bronchoconstriction, pupil constriction) and may
limit the usefulness of some of these drugs.
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ONLINE RESOURCES
An extensive range of additional resources to enhance teaching
and learning and to facilitate understanding of this chapter may
be found online at the text’s accompanying website, located on
thePoint athttp://thepoint.lww.com.These include Watch and
Learn videos, Concepts in Action animations, journal articles,
review questions, case studies, discussion topics and quizzes.
WEB LINKS
Healthcare providers and patients may want to consult
the following Internet sources:
www.aihw.gov.au/dementia
Home page of the Australian Institute of Health and
Welfare National Health Priority Area—Dementia.
www.alzheimers.org.au
Information on resources, medical treatments, outreach
programs and local support groups involved with
Alzheimer’s disease.
www.myasthenia.org.au
Home page of the Australian Myasthenic Association in
NSW. Information and resources on myasthenia gravis
and treatments.
www.myastheniawa.info
Home page of the Myasthenia Gravis Friends and
Support Group, Western Australia. Information and
resources on myasthenia gravis and treatments.
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