Cholinergic Agonists and Bethanechol Chloride

• Cholinergic agonists stimulate the parasympathetic nervous system.
• They mimic acetylcholine.
• Muscarinic receptors are a type of receptor affected by cholinergic agonists.
• Cholinergic agonists affect smooth muscles and slow heart rate.
• Nicotinic receptors are also affected by cholinergic agonists.
• Cholinergic agonists affect skeletal muscles.

Effects of Cholinergic Agonists

• In the eye, cholinergic agonists constrict the pupil.
• In the lungs, cholinergic agonists constrict bronchioles and increase secretions.
• In the heart and blood vessels, cholinergic agonists decrease heart rate and dilate blood vessels.
• In the gastrointestinal system, cholinergic agonists increase peristalsis and secretions.
• In the bladder, cholinergic agonists constrict the bladder.
• In salivary and sweat glands, cholinergic agonists increase secretions.

Bethanechol Chloride

• It stimulates cholinergic receptors.
• This stimulation causes contraction of the bladder.
• It increases GI secretions and peristalsis.
• Bethanechol chloride increases bronchial secretions and bronchoconstriction.
• It constricts pupils.
• Bethanechol chloride treats urinary retention.
• Side effects/adverse reactions include blurred vision.
• Increased secretions in the lungs, GI tract, and sweat may occur.
• Orthostatic hypotension may occur
• Other side effects include bronchoconstriction, hypotension, and tachycardia.

Interventions for Bethanechol Chloride

• Monitor vital signs and watch for a decrease in BP and pulse.
• Monitor lung sounds.
• Monitor GI/GU status.
• Monitor and record intake & output.
• Administer 1 hour before or two hours after meals.
• Monitor for overdose.
• Signs and symptoms of overdose include muscular weakness & increased salivation.
• Atropine is an antagonist.

Teaching for Bethanechol Chloride

• Teach the client to monitor their BP and heart rate.
• Teach the client to rise slowly from a lying position to prevent orthostatic hypotension.
• Teach the client to take it on an empty stomach one hour before or two hours after meals.
• Teach the client to report increased muscle weakness or salivation.
• The evaluation is client able to empty bladder.

Pilocarpine

• Pilocarpine constricts the pupil, opening the canal of Schlemm to promote drainage of the aqueous humor.
• Pilocarpine use helps decrease pressure in the eye in diseases such as glaucoma.
• It is given as eye drops.

Cholinergic agonists stimulate the parasympathetic nervous system by mimicking acetylcholine. These agonists affect muscarinic and nicotinic receptors, influencing smooth muscles and heart rate. Bethanechol chloride, a specific cholinergic agonist, stimulates cholinergic receptors, causing bladder contraction and increased GI secretions.