Anticholinergics

Question 1

Medications

Answer 1

• Atropine (ANTIDOTE FOR CHOLINERGIC CRISIS)
• Dicyclomine
• Glycopyrrolate
• Ipratropium
• Meclizine
• Oxybutrin chloride
• Scopolamine
• Tiotropium
• Tolterodine

Question 2

Action

Answer 2

-Blocks the ACh receptors at the muscarinic cholinergic receptor site

Question 3

Indications

Answer 3

• Decrease secretions
• Decrease bronchospasm
• Restore cardiac rate and BP
• Pylorspasm and hyperactive bowel
• Relax uterine hypertonicity

Question 4

Contraindications

Answer 4

• Allergy
• Any condition that could be exacerbated by blocking the PNS: Glaucoma, stenosing peptic ulcer disease, prostatic hypertrophy, bladder obstruction

Question 5

Caution

Answer 5

• Breast feeding

- Spasticity and brain damage

Question 6

Adverse effects

Answer 6

• Can’t Spit, Can’t See, Can’t Spit, Can’t Poop
• Blurred vision
• Mydriasis (pupil dilation)
• Cycloplegia
• Photophobia
• Palpitation, tachycardia
• Dry mouth, altered taste perception
• Urinary hesitancy and retention
• Constipation
• Decreased sweating, risk for heat exhaustion

Question 7

Drug-Drug Interactions

Answer 7

• Any other drug with anticholinergic activity: Antihistimines, antiparkinsonism drugs, MAOIs, TCAs
• Phenothiazines
• Herbal therapies

Question 8

Assessment

Answer 8

• History and physical exam
• Check for any contraindications including myasthenia gravis, pregnancy, and impaired renal and hepatic function
• Neurological status, orientation, reflexes, papillary response
• VS, CV status, ECG as appropriate
• Bowel and bladder patterns
• Renal fx labs as appropriate

Question 9

Nursing Diagnoses

Answer 9

• Acute pain r/t GI, CNS, GU, and CV effects
• Decreased cardiac output r/t cardiovascular effects
• Constipation r/t GI effects
• Impaired urinary elimination r/t bladder relaxation
• Risk for injury r/t CNS effects
• Risk for hyperthermia r/t decreased ability to sweat
• Non-compliance related to adverse drug effects
• Deficient knowledge regarding drug therapy

Question 10

Implementation

Answer 10

• Ensure proper admin of drug
• Provide comfort measures to help tolerate drug effects
• Monitor pt response closely including BP, ECG, urine output, and cardiac output
• Offer support and encouragement to help with the drug regimen
• Provide pt teaching

Question 11

Evaluation

Answer 11

• Monitor pt response to drug (improvement in disorder being treated)
• Monitor for adverse effects
• Evaluate the effectiveness of the teaching plan
• Monitor the effectiveness of comfort measures/ compliance with drug regimen