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P A R T 5  Drugs acting on the autonomic nervous system

BIBLIOGRAPHY Farrell, M. & Dempsey, J. (2014). Smeltzer & Bare’s Textbook of Medical-Surgical Nursing (3rd edn). Sydney: Lippincott Williams & Wilkins. Goodman, L. S., Brunton, L. L., Chabner, B. & Knollmann, B. C. (2011). Goodman and Gilman’s Pharmacological Basis of Therapeutics (12th edn). New York: McGraw-Hill. Graudins, L. V. (2009). Preventing motion sickness in children. Australian Prescriber , 32 , 61–63. Kuteesa, W. (2006). Anticholinergic drugs for overactive bladder. Australian Prescriber , 29 , 22–24.

McKenna, L. (2012). Pharmacology Made Incredibly Easy (1st Australian and New Zealand edn). Sydney: Lippincott Williams & Wilkins. McKenna, L. & Mirkov, S. (2014). McKenna’s Drug Handbook for Nursing and Midwifery (7th edn). Sydney: Lippincott Williams & Wilkins. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Seale, J. P. (2003). Anitcholinergic bronchodilators. Australian Prescriber , 26 , 33–35. 4. Which of the following would the nurse or midwife be least likely to include when developing a teaching plan for a person who is receiving an anticholinergic agent? a. encouraging the person to void before dosing b. setting up a bowel program to deal with constipation c. encouraging the person to use sugarless lozenges to combat dry mouth d. performing exercises to increase the heart rate MULTIPLE RESPONSE Select all that apply. 1. A nurse or midwife would expect atropine to be used for which of the following? a. to depress salivation b. to dry up bronchial secretions c. to increase the heart rate d. to promote uterine contractions e. to treat myasthenia gravis f. to treat Alzheimer’s disease 2. Remembering that anticholinergics block the effects of the parasympathetic nervous system, the nurse or midwife would question an order for an anticholinergic drug for people with which of the following conditions? a. ulcerative colitis b. asthma c. bradycardia d. inner ear imbalance e. glaucoma f. prostatic hyperplasia

C H E C K Y O U R U N D E R S T A N D I N G

Answers to the questions in this chapter can be found in Appendix A at the back of this book.

MULTIPLE CHOICE Select the best answer to the following. 1. Anticholinergic drugs are used:

a. to allow the sympathetic system to dominate. b. to block the parasympathetic system, which is commonly hyperactive. c. as the drugs of choice for treating ulcers. d. to stimulate GI activity. 2. Atropine and hyoscine work by blocking: a. nicotinic receptors only. b. muscarinic and nicotinic receptors. c. muscarinic receptors only. d. adrenergic receptors to allow cholinergic receptors to dominate. 3. Which of the following suggestions would the nurse or midwife make to help a person who is receiving an anticholinergic agent reduce the risks associated with decreased sweating? a. covering the head and using sunscreen b. ensuring hydration and temperature control c. changing position slowly and protecting from the sun d. monitoring for difficulty swallowing and breathing