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NUR 210 PHARMACOLOGY > ANTI-CHOLINERGIC UNIT 4 > Flashcards

ANTI-CHOLINERGIC UNIT 4 Flashcards

1
Q

Which of the following drugs are Anti-cholinergics?
Select all that apply

A. Tolterodine Tartrate
B. Barbiturate
C.Atropine
D. Valproic acid
E. Lithium
F. Benztropine

A

A. Tolterodine Tartrate
C.Atropine
F. Benztropine

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2
Q

Action of ANTI-Cholinergics

A

Action of anticholinergics – exactly opposite of cholinergic agonists
* Inhibits the action of acetylcholine
* Increases heart rate
* Bronchodilation, decreases secretions
* Decrease motility and peristalsis, decrease GI secretions
* Increases bladder sphincter constriction
* Dilates pupils
* Decreases salivation and perspiration
* Decreases tremors and rigidit

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3
Q

Atropine Use

A

Action
* Non-selective
* Inhibits acetylcholine by occupying receptors
* Increases heart rate by blocking vagal nerve stimulation
* Uses
* Decrease salivation and respiratory and GI secretions before surgery
* Increase heart rate when bradycardic
* Dilates pupils for eye exams

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4
Q

Atropine Side effect

A

Drowsiness, dizziness, nausea, dry mouth, headache, confusion, insomnia, amnesia, constipation, flushing, hypohydrosis, blurred vision, mydriasis, anxiety, photophobia, palpitations, urinary retention, hyperreflexia, ataxia, weakness, dehydration, injection site reaction

Side effects/Adverse reactions
* Dry mouth and skin
* Inability to sweat
* Flushing, blurred vision
* Constipation
* Urinary retention

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5
Q

Atropine Adverse effect

A

Palpitations
* Hypertension

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6
Q

Who should you not use Atropine with or Anticholinergics , what type of patient?

A

CANT SEE
CANT POOP
CANT PEE
CANT SPIT

Hypersensitivity
Caution: Renal, hepatic, or respiratory impairment, COPD, cardiovascular disease, myocardial ischemia, tachycardia, GI obstruction, ileus, ulcerative colitis, GI disease, glaucoma, hyperthyroidism, urinary retention, dysrhythmias, tachycardia, myasthenia gravis

Contraindications
* Glaucoma
* GI disorders that slow the GI tract
* Tachycardia
* Benign Prostatic Hypertrophy
* Myasthenia Gravis

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7
Q

Should you take AntIhistamines with Anti-cholinergics

A. Yes
B. No

A

Interactions
* Can increase anticholinergic effects with antihistamine

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8
Q

Benztropine use

A

Action
* Blocks acetylcholine to the skeletal muscles
* Blocks dopamine reuptake to allow dopamine to work longer
* Uses
* Decrease involuntary muscle movement, tremors, and muscle rigidity
* Parkinson’s disease
* Pseudoparkinson’s

helps relieve symptoms of drooling for parkinson’s

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9
Q

Benztropine side effect

A

Nausea, vomiting, dry mouth, constipation, anhidrosis, dizziness, headache, drowsiness, blurred vision, confusion, depression, hallucinations, weakness, hyperthermia, and paresthesia, mydriasis, urinary retention

Side effects/Adverse reactions
* Dry mouth and skin
* Inability to sweat
* Flushing, blurred vision
* Constipation
* Urinary retention

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10
Q

Adverse Effect

A

Tachycardia, ocular hypertension Life threatening: Ileus

Tachycardia, paradoxical bradycardia, hypertension, hypotension, angina, dyspnea, pulmonary edema, respiratory depression, ileus, seizures Life threatening: Dysrhythmias, laryngospasm, coma

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11
Q

Bentropine Contraindications

A

Contraindications
* Glaucoma
* Tardive dyskinesia
* Myasthenia gravis
* Caution
* Psychosis
* Interactions
* Other anticholinergic drugs, other drugs that increase the heart rate, blood pressur

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12
Q

what is Tolterodine Tartrate use for

A

Tanya takes too many trips to the bathroom we want to reduce the amount of times she goes but not reduce her urine output

Action
* Selectively blocks cholinergic receptors in the bladder
* Uses
* Overactive bladder – decreases urinary frequency, urgency, and incontinence

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13
Q

Tolterodine Tartrate side effects

A

Drowsiness, dizziness, nausea, dry mouth, headache, confusion, insomnia, amnesia, constipation, flushing, hypohydrosis, blurred vision, mydriasis, anxiety, photophobia, palpitations, urinary retention, hyperreflexia, ataxia, weakness, dehydration, injection site reaction

Side effects/Adverse reactions
* Dry mouth and skin
* Inability to sweat
* Flushing, blurred vision
* Constipation
* Urinary retention

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14
Q

Tolterodine Tartrate Adverse effects

A

-Palpitations
* Hypertension

Tachycardia, paradoxical bradycardia, hypertension, hypotension, angina, dyspnea, pulmonary edema, respiratory depression, ileus, seizures Life threatening: Dysrhythmias, laryngospasm, coma

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15
Q

Contraindications and Interactions of Tolterodine Tartrate

A

Interactions
* Grapefruit juice – can increase drug level

Hypersensitivity
Caution: Renal, hepatic, or respiratory impairment, COPD, cardiovascular disease, myocardial ischemia, tachycardia, GI obstruction, ileus, ulcerative colitis, GI disease, glaucoma, hyperthyroidism, urinary retention, dysrhythmias, tachycardia, myasthenia gravis

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16
Q

Nursing Intervention of Anticholinergics

A

ANTICHOLINERGIC DRUGS
* Interventions
* Monitor vital signs – report tachycardia
* Monitor I & O (urinary retention)
* Monitor bowel status (constipation)
* Provide mouth care
* When giving atropine IV dilute in sterile water and give slowly IV push at least 1
mg/minute

17
Q

Patient teaching of Anticholinergics

A

Teach patient to
* Avoid hot environments (unable to sweat and cool down)
* Increase fluid intake and fiber
* Report a large decrease in urine output
* Use hard candy to help with dry mouth
* Good oral care
* Wear sunglasses in bright light
* Not drive until the action is known as it can cause drowsiness

18
Q

Evaluation of Anticholinergic drugs

A

Evaluation
* You need to understand why you gave it to know if the drug has a therapeutic
effect.
* Atropine – if patient bradycardic – heart rate increased
If before surgery – patient complains of a dry mouth
* Benztropine – Decreased involuntary movement
* Tolteradine Tartrate – Decreased bladder irritability – fewer trips to the bathroom
– I & O remain balanced

19
Q
  1. When benztropine is ordered for a patient, the nurse acknowledges that this drug is an effective treatment for which condition?
    a. Parkinsonism
    b. Paralytic ileus
    c. Motion sickness
    d. Urinary retention
A

a. Parkinsonism

20
Q
  1. The nurse teaches the patient receiving atropine to expect which side effect?
    a. Diarrhea
    b. Sweating
    c. Blurred vision
    d. Frequent urination
A

c. Blurred vision

21
Q
  1. Dicyclomine is an anticholinergic, which the nurse realizes is given to treat which condition?
    a. Mydriasis
    b. Constipation
    c. Urinary retention
    d. Irritable bowel syndrome
A

d. Irritable bowel syndrome

NUR 210 PHARMACOLOGY (82 decks)

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