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20. Superman suffers from urinary retention and a hypoactive urinary bladder. Be

ID: 72316 • Letter: 2

Question

20. Superman suffers from urinary retention and a hypoactive urinary bladder. Bethanechol is a drug that mimics acetylcholine autonomic effects and you prescribe it to manage his problem. First explain you rationale behind this prescription (muscarinic vs. nicotinic effects). Secondly what indirect consequences will superman have? Select all that apply: dizziness, hypotension tears, wheezing, increase mucous in bronchi, decrease salivation, diarrhea, cramping, sweating, undesired erection of penis. Explain

Explanation / Answer

Bethanechol is a parasympathomimetic (cholinergic) used for the treatment of acute postoperative and postpartum nonobstructive (functional) urinary retention and for neurogenic atony of the urinary bladder with retention. Bethanechol, a cholinergic agent, is a synthetic ester which is structurally and pharmacologically related to acetylcholine. It increases the tone of the detrusor urinae muscle, usually producing a contraction sufficiently strong to initiate micturition and empty the bladder.It stimulates  parasympathetic nervous system releases acetylcholine at the nerve endings. When spontaneous stimulation is reduced and therapeutic intervention is required, acetylcholine can be given, but it is rapidly hydrolyzed by cholinesterase and its effects are transient. Bethanechol chloride (bethanechol) is not destroyed by cholinesterase and its effects are more prolonged than those of acetylcholine. It stimulates gastric motility, increases gastric tone, and often restores impaired rhythmic peristalsis. Bethanechol chloride is not destroyed by cholinesterase and its effects are more prolonged than those of acetytcholine.

Bethanechol directly stimulates cholinergic receptors in the parasympathetic nervous system while stimulating the ganglia to a lesser extent. Its effects are predominantly muscarinic, inducing little effect on nicotinic receptors and negligible effects on the cardiovascular system.

SIDE EFFECTS: Dizziness, lightheadedness, nausea, vomiting, abdominal cramps/pain, diarrhea, increased saliva/urination, sweating, flushing, watery eyes, or headache may occur.