DRUG STUDY: NCM 106 PHARMACOLOGY
DRUG NAME MECHANISM INDICATION CONTRAINDICATIO ADVERSE NURSING
OF ACTION N EFFECTS INTERVENTIO
NS
Generic Name: Competes with Injection: Preop to Narrow-angle Overdose may Monitor changes
Atropine acetylcholine for inhibit salivation/ glaucoma, pyloric produce in B/P, pulse,
Drug common binding secretions; stenosis, prostatic tachycardia, temperature.
Classification: sites on treatment of hypertrophy. Cautions: palpitations, Observe for
Anticholinergic muscarinic symptomatic sinus Autonomic neuropathy, hot/dry/flushed tachycardia if pt
Available receptors located bradycardia; AV paralytic ileus, intestinal skin, absence of has cardiac
Dosage: on exocrine block; ventricular atony, severe ulcerative bowel sounds, abnormalities.
Injection glands, cardiac asystole; antidote colitis, toxic megacolon, increased Assess skin
(AtroPen): 0.25 and smooth for renal/ hepatic respiratory rate, turgor, mucous
mg/0.3 ml, 0.5 muscle ganglia, organophosphate impairment, myocardial nausea, vomiting, membranes to
mg/0.7 ml, 1 intramural pesticide ischemia, confusion, evaluate
mg/0.7 ml, 2 neurons. poisoning. hyperthyroidism, drowsiness, slurred hydration status
mg/0.7 ml. Therapeutic Adjuvant to hypertension, speech, dizziness, (encourage
Injection, Effect: Decreases decrease side tachyarrhythmias, HF, CNS stimulation. adequate fluid
Solution: 0.4 GI motility, effects during coronary artery disease, Overdose may also intake unless
mg/ml, 1 mg/ml. secretory activity, reversal of esophageal reflux or produce psychosis NPO for surgery),
Ophthalmic GU muscle tone neuromuscular hiatal hernia associated as evidenced by bowel sounds for
Ointment: 1%. (ureter, bladder); blockage. with reflux esophagitis; agitation, peristalsis. Be
Ophthalmic produces Ophthalmic: infants, children with restlessness, alert for fever
Solution: 1%. ophthalmic Produce mydriasis spastic paralysis or rambling speech, (increased risk of
cycloplegia, and cycloplegia for brain damage; elderly; visual hallucinations, hyperthermia).
mydriasis; examination of biliary tract disease, paranoid behavior, Monitor I&O,
abolishes various retina and optic chronic pulmonary delusions, followed palpate bladder
types of reflex disc; uveitis. disease. Ophthalmic: by depression. for urinary
vagal cardiac Spastic paralysis, brain Ophthalmic form retention.
slowing or injury, Down syndrome may rarely produce Monitor daily
asystole. increased IOP. pattern of bowel
activity, stool
consistency.
Generic Name: Blocks action of History of Worsening of angle- Monitor rate,
Ipratropium acetylcholine at Inhalation, hypersensitivity to closure glaucoma, depth, rhythm,
Drug parasympathetic Nebulization: atropine. Cautions: acute eye pain, type of
Classification: sites in bronchial Maintenance Narrow-angle hypotension occur respiration;
Bronchodilators smooth muscle. treatment of glaucoma, prostatic rarely quality, rate of
Available Therapeutic bronchospasm due hypertrophy, bladder pulse. Assess lung
Dosage: Effect: Causes to COPD, neck obstruction, sounds for
Aerosol for Oral bronchodilation, bronchitis, myasthenia gravis. rhonchi,
Inhalation inhibits nasal emphysema, wheezing, rales.
(Atrovent HFA): secretions. asthma. Not Monitor ABGs.
17 mcg/actuation. indicated for Observe lips,
Solution, immediate fingernails for
Intranasal Spray: bronchospasm cyanosis (blue or
0.03%; 0.06%. relief. Nasal Spray: dusky color in
Solution for Symptomatic relief light skinned pts;
Nebulization: of rhinorrhea gray in dark-
0.02% (500 mcg). associated with skinned pts).
the common cold Observe for
and retractions
allergic/nonallergi (clavicular,
c rhinitis. sternal,
intercostal), hand
tremor. Evaluate
for clinical
improvement
(quieter, slower
respirations,
relaxed facial
expression,
cessation of
retractions).
Monitor for
improvement of
rhinorrhea.
Generic Name:
Competitively Narrow-angle Frequent (Greater Monitor for
Scopolamine Prevention of
inhibits action of glaucoma. Cautions: Than 15%): Dry dehydration.
Drug motion sickness,
acetylcholine at Hepatic/renal mouth, drowsiness, Observe for
Classification: postop
muscarinic impairment, cardiac blurred vision. Rare improvement of
Antimuscarinics nausea/vomiting.
Available receptors. disease (hypertension, (5%– 1%): Dizziness, symptoms
OFF-LABEL:
Dosage: Reduces HF), seizures, restlessness,
Breakthrough
Transdermal excitability of psychoses, coronary hallucinations,
treatment of
System (Trans- labyrinthine artery disease, prostatic confusion, difficulty
nausea/vomiting
Derm Scop): 1.5 receptors, hyperplasia, urinary urinating, rash.
associated with
mg. depressing chemotherapy retention, reflux
conduction in esophagitis, ulcerative
vestibular colitis, hyperthyroidism.
cerebellar
pathway.
Therapeutic
Effect: Prevents
motion-induced
nausea/vomiting.
Generic Name: Children younger than 3
Benztropine Selectively blocks yrs. Cautions: Overdose may Be alert to
Drug central Treatment of Glaucoma, heart produce severe neurologic
Classification: cholinergic Parkinson’s disease, hypertension, anticholinergic effects:
Anticholinergic receptors, assists disease, drug hypotension; pts with effects (drowsiness, headache,
Available in balancing tachycardia,
induced tachycardia, drowsiness,
Dosage:
cholinergic/ extrapyramidal arrhythmias, prostatic paralytic ileus, mental
Injection,
dopaminergic reactions (except hypertrophy, malignant confusion,
Solution: 1
activity. tardive hepatic/renal hyperthermia, agitation. Assess
mg/ml. Tablets:
Therapeutic dyskinesia). impairment, obstructive urinary retention, for clinical
0.5 mg, 1 mg, 2
Effect: Reduces diseases of GI/GU tract, dyspnea, skin reversal of
mg
incidence/severit urinary retention, flushing, dryness of symptoms
y of akinesia, elderly, myasthenia mouth/nose/throat) (improvement of
rigidity, tremor. gravis, use during hot . Severe paradoxical tremor of head
weather or during reactions and hands at rest,
exercise. (hallucinations, mask-like facial
tremor, seizures, expression,
toxic psychosis) may shuffling gait,
occur. muscular
rigidity). Monitor
daily pattern of
bowel activity,
stool consistency,
esp. constipation.
Monitor I/O.
Assess for urinary
retention
Generic Name:
Trihexyphenidyl Cautions: Glaucoma,
Drug Direct inhibitory Be alert to
renal/hepatic Hypersensitivity
Classification: effect on Direct inhibitory neurologic effects
impairment, reaction (eczema,
Anticholinergic parasympathetic effect on cardiovascular disease, pruritus, rash, (headache,
Available nervous system; parasympathetic prostatic hyperplasia, cardiac arrhythmias, lethargy, mental
Dosage: relaxes smooth nervous system; obstructive diseases of photosensitivity) confusion,
Elixir: 2 mg/5 ml. muscle. relaxes smooth GI tract, excessive may occur. agitation).
Tablets: 2 mg, 5 Therapeutic muscle. activity during hot Overdosage may Monitor elderly
mg. Effect: Decreases Therapeutic Effect: weather, exercise. vary from CNS
salivation, relaxes closely for
Decreases Pregnancy Category C. depression
smooth muscle. salivation, relaxes paradoxical
(sedation, apnea,
reaction. Assess
smooth muscle. cardiovascular for clinical
collapse, death) to reversal of
severe paradoxical symptoms
reaction (improvement of
(hallucinations, tremor of
tremor, seizures). head/hands at
rest, mask-like
facial expression,
shuffling gait,
muscular
rigidity).
Generic Name:
Flavoxate
Drug
Classification:
Antimuscarinics
Available
Dosage:
Generic Name:
Drug
Classification:
Available
Dosage:
Generic Name:
Drug
Classification:
Available
Dosage:
DRUG NAME MECHANIS INDICATIO CONTRAINDICATI ADVERSE EFFECTS NURSING
M OF N ON INTERVENTI
ACTION ONS
Generic Name: Direct Relief of Pts with or at risk for Overdose produces CNS Monitor for
Oxybutynin antispasmodi symptoms uncontrolled narrow- excitation (nervousness, symptomatic
Drug c effect on (urgency, angle glaucoma, restlessness, relief. Monitor
Classification: smooth incontinence, urinary retention, hallucinations, I&O; palpate
Anticholinergi muscle; frequency, gastric retention, or irritability), bladder for urine
c inhibits action nocturia, conditions with hypotension/hypertensio retention.
Available of urge severely decreased GI n, confusion, tachycardia, Monitor daily
Dosage: acetylcholine incontinence motility. Cautions: facial flushing, respiratory pattern of bowel
Syrup: 5 mg/5 on smooth ) associated Renal/hepatic depression. activity, stool
ml. Tablets: 5 muscle. with impairment, pts with consistency.
mg. Topical Gel Therapeutic uninhibited bladder outflow
(Gelnique): 100 Effect: neurogenic obstruction, treated
mg/unit dose Increases bladder, narrow-angle
sachet. (3% bladder reflex glaucoma,
Gel): 30 mg/ml. capacity, neurogenic hyperthyroidism,
Transdermal delays desire bladder. coronary artery
(Oxytrol for to void. Extended- disease, HF,
Women): 3.9 Decreases release also hypertension,
mg. Tablets urgency and indicated for arrhythmias, prostatic
(Extended- frequency. treatment of hyperplasia,
Release symptoms myasthenia gravis,
[Ditropan XL]): associated reduced GI motility,
5 mg, 10 mg, 15 with gastroesophageal
mg. detrusor reflux.
overactivity
due to
neurologic
disorder
(e.g., spina
bifida).
