How does bethanechol treat neurogenic bladder?

How does bethanechol treat neurogenic bladder?

Discussion Topics, Chapter 32, Cholinergic Agonists

Discussion Topics

Learning Objective(s)

1. James is 10 years old with a history of spina bifida. He has been performing self-catheterizations for the last 2 years. During his last clinic visit, he was started on bethanechol for neurogenic bladder.

a. How does bethanechol treat neurogenic bladder?

b. What are the adverse effects of bethanechol and other direct-acting cholinergic agonists?

2. Mrs. Smith has myasthenia gravis and will be switching from neostigmine to pyridostigmine to help with compliance. She is concerned about missing doses and taking the medication correctly.

a. What are some dosing concerns with pyridostigmine, and what are the key teaching points?

b. Mrs. Smith is scheduled for a follow-up diagnostic exam using edrophonium. Explain how edrophonium is used in diagnosing myasthenia gravis.