Chap 21 Cholinergic-Blocking Drugs

Question 1

Cholinergic-Blocking Drugs

Answer 1

Drugs that block* or inhibit* the actions of acetylcholine (ACh)*

Alka anticholinergics*, parasympatholytics, and antimuscarinic drugs

Question 2

Cholinergic-Blocking Drugs Toxicity and Overdose

Answer 2

Use Physostigmine as an Antidote

Question 3

Atropine

Answer 3

Uses: bradycardia,*
ventricular asystole,
antidote for anticholinesterase inhibitor toxicity* or poisoning,* and
preoperatively to reduce salivation and GI secretions

Question 4

Oxybutynin (Ditropan)

Answer 4

Uses: overactive bladder and antispasmodic for neurogenic bladder associated with spinal cord injuries and congenital conditions such as spina bifida

Question 5

Scopolamine Use/Contraindication/Adverse Effects

Answer 5

Uses: prevention of motion sickness and to help prevent postoperative, postanesthesia nausea and vomiting *

Contraindications:* angle-closure glaucoma*, advanced hepatic and renal dysfunction, hiatal hernia associated with reflux esophagitis, intestinal atony, obstructive GI or GU conditions, and severe ulcerative colitis

Adverse* effects: drowsiness, dry mouth, and blurred vision*

Question 6

Cholinergic-Blocking Agents:
Nursing Implications/Antiodote

Answer 6

Blurred* vision* will cause problems* with driving* or operating* machinery*.

Patients experience sensitivity* to light* and may want to wear dark glasses or sunglasses.

giving ophthalmic solutions, apply* pressure* to the inner* canthus* to prevent systemic absorption.

Dry mouth may occur; handled by chewing gum, frequent mouth care, and hard candy.

by older adult patients may higher risk for heatstroke because effects on heat-regulating mechanisms.

Teach patients to limit physical exertion/avoid high temps and strenuous exercise.

Emphasize adequate fluid and salt intake.

Patients report* symptoms to physician:
urinary hesitancy or retention,
constipation,*
tachycardia, *
palpitations,*
tremors,
confusion, *
sedation,
*hallucinations, and
*decreased sweating (leading to hot, dry skin).

Antidote* for atropine* overdose is physostigmine.*