Cholinergic Antagonists Overview Unit 4.4

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Questions and Answers

What is the opposite action of cholinergic agonists?

Anticholinergics

Which of these effects is NOT caused by anticholinergics? (Select all that apply)

Increased heart rate

Dilated pupils

Decreased salivation

Increased motility (correct)

Decreased secretions

What is the mechanism of action of anticholinergics?

They block acetylcholine receptors.

What is the name of the drug that is a non-selective anticholinergic?

Atropine Signup and view all the answers

What is a common use for atropine?

Decrease salivation and GI secretions before surgery Signup and view all the answers

Which of the following is NOT a common side effect of atropine?

Increased sweating Signup and view all the answers

Which drug is used to treat Parkinson's Disease?

Benztropine Signup and view all the answers

What is the main action of Benztropine?

Increases dopamine levels by blocking reuptake Signup and view all the answers

Benztropine's side effects are very similar to those of Atropine

True Signup and view all the answers

Which drug is used to treat overactive bladder?

Tolterodine Signup and view all the answers

What is a common intervention for patients on anticholinergic drugs?

Increasing fluid intake Signup and view all the answers

It is important to monitor the urinary output of patients on anticholinergics.

True Signup and view all the answers

What is a common teaching point for patients on anticholinergics?

Avoid hot environments Signup and view all the answers

What is the main purpose of evaluation for patients on anticholinergic drugs?

To assess if the drug is having its intended therapeutic effect. Signup and view all the answers

What should the nurse monitor for in a patient taking atropine?

Heart rate Signup and view all the answers

What should the nurse monitor for in a patient taking Benztropine?

Involuntary movements Signup and view all the answers

What should the nurse monitor for in a patient taking Tolterodine?

Urinary frequency and urgency Signup and view all the answers

Study Notes

Cholinergic Antagonists (Anticholinergics)

Cholinergic antagonists, also called anticholinergics or cholinergic blockers, act opposite to cholinergic agonists.
They inhibit the action of acetylcholine.
They increase heart rate.
They cause bronchodilation and reduce secretions.
They decrease gastrointestinal (GI) motility and peristalsis, reducing GI secretions.
They increase bladder sphincter constriction.
They dilate pupils.
They decrease salivation and perspiration.
They decrease tremors and rigidity.

Anticholinergics - Atropine

Action: Non-selective; inhibits acetylcholine by occupying receptors; increases heart rate by blocking vagal nerve stimulation.
Uses: Decreasing salivation and respiratory/GI secretions before surgery; increasing heart rate in bradycardia; dilating pupils for eye exams.
Side effects/Adverse reactions: Dry mouth and skin; inability to sweat; flushing; blurred vision; constipation; urinary retention; palpitations; hypertension.

Anticholinergic Antiparkinson's - Benztropine

Action: Blocks acetylcholine in skeletal muscles; blocks dopamine reuptake, allowing longer dopamine activity.
Uses: Decreasing involuntary muscle movement, tremors, and rigidity; Parkinson's disease; pseudoparkinsonism.
Side effects/Adverse reactions: Symptoms very similar to atropine.
Contraindications: Glaucoma; tardive dyskinesia; myasthenia gravis; psychosis.
Interactions: Other anticholinergic drugs; drugs increasing heart rate and blood pressure.

Anticholinergic - Tolterodine Tartrate

Action: Selectively blocks cholinergic receptors in the bladder.
Uses: Overactive bladder; decreasing urinary frequency, urgency, and incontinence.
Side effects/Adverse reactions: Similar to atropine.
Contraindications: Similar to atropine.
Interactions: Grapefruit juice can increase drug levels.

Anticholinergic Drug Assessment

Assessment: Vital signs; medication/medical history; reason for medication; urine output.

Anticholinergic Drug Interventions

Interventions: Monitor vital signs (especially for tachycardia); monitor intake and output (for urinary retention); monitor bowel status (for constipation); provide mouth care; dilute intravenous atropine in sterile water and administer slowly (at least 1 mg/minute).

Teaching Clients about Anticholinergic Drugs

Teach the client to: Avoid hot environments; increase fluid and fiber intake; report decreased urine output; use hard candy for dry mouth; practice good oral care; wear sunglasses; avoid driving until understanding the drug effects (which may cause drowsiness).

Anticholinergic Drug Evaluation

Evaluation: Important to understand why the nurse gave the medication and if it's having the desired effect (therapeutic effect).
Atropine: Evaluate if heart rate increased if bradycardic before surgery; evaluate if there are dry mouth complaints.
Benztropine: Evaluate for decreased involuntary movement.
Tolterodine Tartrate: Evaluate for decreased bladder irritability and fewer trips to the bathroom with balanced intake and output.

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Description

This quiz covers the essentials of cholinergic antagonists, also known as anticholinergics. Explore their mechanisms, effects on various body systems, and specific examples such as atropine. Understand the uses, side effects, and clinical significance of these medications.