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Cholinergic (Atropine (Mechanism of action:Relief of involuntary muscle…
Cholinergic
Atropine
Mechanism of action:
Relief of involuntary muscle spasms: most forms of smooth muscle spasms.
Indications:
Atropine is indicated for patients with Hypersalivation, broncial secretions or bradycardia.
Contra-indications:
patients pre-disposed to narrow angle glaucoma.
Side Effects:
Dry mouth, constipation,difficulty with micturition(in the elderly) and paralysis of ocular accomadation are common.
Storage conditions:
keep in the dry place away from the sun and out of reach of children.
Route of Administration
: intravenous administration is usually preferred. but subcutaneous, intramuscular, and endotracheal administration are possible.
Nursing Consideration
: It must not be taken by a person who has a history of Hypersensitivity to anticholinergic, severe ulcerative colitis, toxic megacolon, myocardial ischemia, hypertension and brain damage.
Hyoscine
Mechanism of action:
is a CNS depressant, used for its central as well as peripheral and also used for anti-emetic.
Indications:
It is an anticholinergic agent, prescribed for gastrointestinal disorders and mydriasis. it dilates the pupil in the eye.
Contra-Indications:
Should not be administered to patients with Myasthenia Gravis, megacolon and narrow angle Glaucoma, they should not be given to patients with known hypersensitivity to Hyoscine-N-butylbromide.
Side Effects:
Dizziness, drowsiness, dry skin, rash, painful urination, urinary retention, photophobia, pupil dilation.
Storage conditions:
stored at room temperature
Route of Administration:
taken orally, intramuscular and sub-cutaneous
Nursing Consideration
: Drug compatibility should be monitored close in patients requiring adjunctive therapy, avoid strict heat. oerdose may cause curare-like effects such as respiratory paraslysis. keep emergency equipment available.
Neostigmine
Mechanism of action
: a choligernic that prevents destruction of acetylcholine by inhibiting the enzyme acetylcholinesterase, thus enhancing impulse transmission across the the myoneutral junction. it improves the intestinal and skeletal muscle tone: stimulates salivary and sweat gland secretion.
Indications:
Myasthenia gravis, diagnoses of myasthenia gravis,prevention of postoperative urinary retentiomn, postoperative abdominal distention and urine retention, reversal of neuromuscular blockage(with Atropine)
Contraindications
:GI or Genitourinary obstruction, peritonitis, hypersensitivity
Side effects:
muscarinic effects( diarrhea, diapphoresis, increased salivation, neausea, vomiting, abdominal cramps or pain.ocassional urinary urgency or frequency, increased bronchial secretions, miosis, lacrimation.)
Storage conditons
: store in a room temperature, protect from light.
Route of administration:
can be administered intraveneously and orally
Nursing consideration:
Notify the phuysician of diarrhea, difficulty breathing, muscle weakness, increased salivation, irregular heartbeat, severe abdominal pain increased sweating.monitor vital signs, muscle strength and fluid intake and output.
Pilocarpine Hydrochloride
Mechanism of action:
increases exocrine gland secrestions by stimulating cholinergic receptors. improves symptoms of dry mouth in patients with salivary glanfa hypofunction
Indications
:treat dry mouth associated with radiation treatment for head and neck cancer, hepatic impairment, glaucoma or ocular hypertension
Contraindications:
Known hypersensitivity to pilocarpine: conditions in which miosi is undersirable, such as acute iritis and angle-closure glaucoma, uncontrolled asthma
Side effects:
Frequent Diaphores, occasional headache, dizziness,urinary frequency, neusea, asthenia, visual disturbances.
Storage conditions:
store in room temperature, protect from excessive heat.
Route of administration:
eye drops
Nursing consideration:
use with caution in pregnancy and lactation, adequate hydration should be maintained. patient must avoid task that require mental alertness or motor skills until response to the drug have been established.