Cholinergic Antagonists Nursing Notes PDF

Cholinergic Antagonists or Anticholinergics or Cholinergic blockers NUR 210/BSL 101 Unit 4  Action of anticholinergics – exactly opposite of cholinergic agonists Inhibits the action of acetylcholine...

Cholinergic Antagonists or Anticholinergics or Cholinergic blockers NUR 210/BSL 101 Unit 4  Action of anticholinergics – exactly opposite of cholinergic agonists Inhibits the action of acetylcholine Increases heart rate Bronchodilation, decreases secretions Anticholinergics Decrease motility and peristalsis, decrease GI secretions Increases bladder sphincter constriction Dilates pupils Decreases salivation and perspiration Decreases tremors and rigidity  Action Non-selective Inhibits acetylcholine by occupying receptors Anticholinergics Increases heart rate by blocking vagal - Atropine nerve stimulation Uses Decrease salivation and respiratory and GI secretions before surgery Increase heart rate when bradycardic Dilates pupils for eye exams  Side effects/Adverse reactions Dry mouth and skin Anticholinergics Inability to sweat - Atropine Flushing, blurred vision Constipation Urinary retention Palpitations Hypertension  Contraindications Glaucoma GI disorders that slow the GI tract Anticholinergics Tachycardia - Atropine Benign Prostatic Hypertrophy Myasthenia Gravis Interactions Can increase anticholinergic effects with antihistamines  Action Anticholinergic Blocks acetylcholine to the skeletal – muscles Blocks dopamine reuptake to allow Antiparkinson’s dopamine to work longer - Benztropine Uses Decrease involuntary muscle movement, tremors, and muscle rigidity Parkinson’s disease Pseudoparkinson’s Anticholinergic – Antiparkinson’s - Benztropine Side effects/Adverse reactions Very similar to atropine  Contraindications Anticholinergic Glaucoma – Tardive dyskinesia Antiparkinson’s Myasthenia gravis - Benztropine Caution Psychosis Interactions Other anticholinergic drugs, other drugs that increase the heart rate, blood pressure  Action Anticholinergic Selectively blocks cholinergic – Tolterodine receptors in the bladder Tartrate 1 Uses Overactive bladder – decreases urinary frequency, urgency, and incontinence  Side effects/Adverse reactions Anticholinergic Similar to Atropine – Tolterodine Tartrate Contraindications 1 Similar to atropine Interactions Grapefruit juice – can increase drug levels  Assessment Anticholinergic Vital signs Drugs Medication/medical history Know why it is being given Urine output  Interventions Monitor vital signs – report tachycardia Anticholinergic Monitor I & O (urinary retention) Drugs 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  Teach client to Avoid hot environments (unable to sweat and cool down) Anticholinergic Increase fluid intake and fiber Drugs 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  Evaluation Importance to know why the nurse gave the medication and to know if the drug has a therapeutic effect. Atropine – if client bradycardic – Anticholinergic heart rate increase Drugs *If before surgery – client complains of a dry mouth Benztropine – Decreased involuntary movement Tolteradine Tartrate – Decreased bladder irritability – fewer trips to the bathroom – I & O remain balanced