Cholinergics, also known as antimyasthenic agents, are medications used to treat myasthenia gravis. They are also used after anesthesia to reverse the effects of the anesthetics. Occasionally after anesthesia the effects will not wear off, and the patient will either remain paralyzed, or urination and defecation will not resume. Cholinergics reverse the blockage of acetylcholine , the neurotransmitter involved in muscular control.
Cholinergics
Brand/Generic Drug Names
bethanechol, edrophonium, Prostigmin/neostigmine, Eserine/physostigmine, Mestinon/pyridostigmine
Common uses
myasthenia gravis, nondepolarizing neuromuscular blockade, postoperative bladder distention, postoperative ileus
Pharmacology
prevent destruction of acetylcholine exaggerating effects of acetylcholine and facilitating transmission of impulses across myoneuronal junction, stimulate acetylcholine receptors
Class contraindications
renal or intestinal obstruction
Class precautions
bradycardia, hypotension, seizure disorders, bronchial asthma, coronary occlusion, hyperthyroidism, breastfeeding, children
Interactions
varies by drug
Adverse Reactions
respiratory depression, bronchospasm, constriction, laryngospasm, respiratory arrest, convulsions, paralysis, nausea, vomiting, diarrhea
Additional Information
Assess vital signs every 8 hours
Assess intake and output
Monitor for toxicity (respiratory depression) or tolerance
Ensure atropine sulfate is available for cholinergic crisis
Evaluate therapeutic response: increased muscle strength, hand grasp, improved gait, absence of labored breathing
Date of most recent Update
August 28, 2002
Further information is available in the writeup for the
specific name(s) of this medication class