Quiz 13: Cholinergic Agonists


The case study presents a patient who is undergoing nicotine replacement therapy as prescribed for her addiction to smoking for about 25 years. The patient still continues to have a craving for smoking in spite of the nicotine replacement therapy and the craving tends to increase while in the company of people who smoke. Addiction to smoking has both physiological and psychological basis which are complex. These factors include socio-cultural aspects and influences of peer groups. Thus, nicotine replacement therapy alone might not be sufficient to help people who have been smoking for about 25 years to quit the habit. This should be augmented by a strong will power to quit smoking. Hence, the patient in the given example should be informed that the craving for cigarettes is normal, but should be effectively addressed by a strong desire (conviction) to quit smoking.

Cholinergic agonists are agents which bind to cholinoceptors and will produce effects similar to that of acetylcholine. The receptors that these agonists can activate are the nicotinic and muscarinic receptors. Adrenergic agonists stimulate adrenergic receptors and cholinergic agonists have opposite effects when compared to that of the adrenergic agonists. Adrenergic antagonists prevent the stimulation of adrenergic receptors and cholinergic agonists have similar effects when compared to that of the adrenergic agonists. Cholinergic agonists have opposite effects as that induced by cholinergic antagonists.

The case study presents an 82-year-old patient who had undergone hip replacement surgery. The patient has been prescribed with bethanechol (Urecholine) to assist in the elimination of urine. The information as pertinent to bethanechol (Urecholine) that the patient should be informed includes the following: • The reason for prescribing the drug • The dosage and time of the day when the drug should be taken • The possible side effects such as heartburn, dizziness, and headache that the drug might induce • The possible drug interactions as can be caused by combining bethanechol with other drugs

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