anticholinergics

Question 1

anticholinergic: SEs

Answer 1

• BUDCAT
  
  • blurred vision
  • urinary retention
  • dry mouth
  • constipation
  • anhydrosis
  • tachycardia

Question 2

atropine: class

Answer 2

• muscarinic antagonist
• anticholinergic

Question 3

atropine: MOA

Answer 3

• competitive blockade at muscarinic Rs
  
  • prevent receptor activation by endogenous acetylcholine

Question 4

atropine: indications

Answer 4

• preanesthetic medication
• disorders of the eyes: drug causes mydriasis and paralysis of ciliary Ms
• bradycardia
• intestinal hypertonicity and hypermotility
• muscarinic agonist poisoning

Question 5

atropine: SEs

Answer 5

• blurred vision
• urinary retention
• dry mouth
• constipation
• anhydrosis
• tachycardia

Question 6

atropine: ADRs

Answer 6

• elevation of intraocular pressure
• asthma

Question 7

atropine: nursing implications

Answer 7

• contraindicated: pts with glaucoma, intestinal atony, urinary tract obstruction, tachycardia
• moisten the mouth before administration
• relieve dry mouth by sipping fluids, chewing gum that is sugar free
• wear sunglasses outdoors
• void before taking medication
• inc fluids/fibers
• avoid vigorous exercise in warm environments

Question 8

oxybutynin transdermal patch: class

Answer 8

• anticholinergic
• urinary tract antispasmodic

Question 9

oxybutynin transdermal patch: MOA

Answer 9

• Inhibits the action of acetylcholine at postganglionic receptors.
• Has direct spasmolytic action on smooth muscle, including smooth muscle lining the GU tract, without affecting vascular smooth muscle.

Question 10

oxybutynin transdermal patch: indications

Answer 10

• Urinary symptoms that may be associated with neurogenic bladder including:
  
  • Frequent urination,
  • Urgency,
  • Nocturia,
  • Urge incontinence.
• Overactive bladder

Question 11

oxybutynin transdermal patch: SEs

Answer 11

• blurred vision
• urinary retention
• dry mouth
• constipation
• anhydrosis
• tachycardia
• application site rxns
• pruritis

Question 12

oxybutynin transdermal patch: ADRs

Answer 12

• angioedema
• anaphylaxis

Question 13

oxybutynin transdermal patch: nursing implications

Answer 13

• new patch applied 2x weekly to dry, intact skin of abdomen, hip, buttock
• Instruct patient that frequent rinsing of mouth, good oral hygiene, and sugarless gum or candy may decrease dry mouth.
• Remove slowly; fold in half, sticky sides together, and discard. Wash site with mild soap and water or a small amount of baby oil.
• void before taking
• inc fluid and fiber
• avoid working out outdoors in warm environments

Question 14

scopolamine transdermal: class

Answer 14

• anticholinergic
• anti-emetic

Question 15

scopolamine transdermal: MOA

Answer 15

• suppresses nerve traffic in the neuronal pathway that connects the vestibular apparatus of the inner ear to the vomiting center

Question 16

scopolamine transdermal: indications

Answer 16

• motion sickness
• post op nausea and vomiting

Question 17

scopolamine transdermal: SEs

Answer 17

• blurred vision
• urinary retention
• dry mouth
• constipation
• anhydrosis
• tachycardia
• application site rxns
• pruritis

Question 18

scopolamine transdermal: nursing implications

Answer 18

• Apply at least 4 hr before exposure to travel to prevent motion sickness.
• Wash hands and dry thoroughly before and after application.
• Apply to hairless, clean, dry area behind ear; avoid areas with cuts or irritation.
• Apply pressure over system to ensure contact with skin.
• System is effective for 3 days.
• If system becomes dislodged, replace with a new system on another site behind the ear.
• System is waterproof and not affected by bathing or showering.
• For perioperative nausea and vomiting, apply patch the night before surgery, or 1 hr prior to cesarean section to minimize exposure to infant.