{"id":172,"date":"2019-10-17T21:41:43","date_gmt":"2019-10-17T21:41:43","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/4-7-muscarinic-antagonist\/"},"modified":"2021-12-07T11:10:38","modified_gmt":"2021-12-07T11:10:38","slug":"4-7-muscarinic-antagonist","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/4-7-muscarinic-antagonist\/","title":{"raw":"4.7 Muscarinic Antagonists","rendered":"4.7 Muscarinic Antagonists"},"content":{"raw":"Atropine is a muscarinic antagonist.\n\nMechanism of Action:<\/strong> Specific anticholinergic responses are dose-related. Small doses of atropine inhibit salivary and bronchial secretions and sweating. Moderate doses dilate the pupil, inhibit accommodation, and increase the heart rate (vagolytic effect). Large doses decrease motility of the gastrointestinal and urinary tracts, and very large doses will inhibit gastric acid secretion.\n\nIndications:<\/strong> Varying dosages are used preoperatively to diminish secretions, to stimulate the heart rate in conditions causing bradycardia, or to treat muscarinic symptoms of insecticide (organophosphorus or carbamate) poisoning or mushroom poisoning.\n\nNursing Considerations:<\/strong> As with all anticholinergics, use with caution with the elderly, because elderly patients may react with agitation or drowsiness. Heat stroke may occur in the presence of high temperatures. Immediately report symptoms of overdose: urine retention, abnormal heartbeat, dizziness, passing out, difficulty breathing, weakness, or tremors. Physostigmine has been used to reverse anticholinergic effects.\n\nPatient Teaching & Education:\u00a0<\/strong>Advise patients that use of these medications may cause dizziness and drowsiness, so patients should be aware of potential impact on their level of alertness.\u00a0 Additionally, use of medications may cause dry mouth, and frequent oral hygiene is encouraged.\u00a0 The use of atropine may cause urinary retention in males with benign prostatic hypertrophy (BPH).[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nNow let's take a closer look at the medication grid\u00a0 on atropine in Table 4.7.[footnote]This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>.[\/footnote]<\/sup>\n\nTable 4.7 Atropine Medication Grid\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Muscarinic Antagonist<\/th>\natropine<\/strong><\/a><\/td>\nUse with caution with elderly\n\nContraindicated in high environmental temperatures<\/td>\nDose dependent:\n\nsmall dose inhibits secretions; moderate dose increases heart rate; large dose decreases gastrointestinal motility<\/td>\nImmediately report symptoms of overdose: urine retention, abnormal heartbeat, dizziness, passing out, difficulty breathing, weakness, or tremors<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n ","rendered":"

Atropine is a muscarinic antagonist.<\/p>\n

Mechanism of Action:<\/strong> Specific anticholinergic responses are dose-related. Small doses of atropine inhibit salivary and bronchial secretions and sweating. Moderate doses dilate the pupil, inhibit accommodation, and increase the heart rate (vagolytic effect). Large doses decrease motility of the gastrointestinal and urinary tracts, and very large doses will inhibit gastric acid secretion.<\/p>\n

Indications:<\/strong> Varying dosages are used preoperatively to diminish secretions, to stimulate the heart rate in conditions causing bradycardia, or to treat muscarinic symptoms of insecticide (organophosphorus or carbamate) poisoning or mushroom poisoning.<\/p>\n

Nursing Considerations:<\/strong> As with all anticholinergics, use with caution with the elderly, because elderly patients may react with agitation or drowsiness. Heat stroke may occur in the presence of high temperatures. Immediately report symptoms of overdose: urine retention, abnormal heartbeat, dizziness, passing out, difficulty breathing, weakness, or tremors. Physostigmine has been used to reverse anticholinergic effects.<\/p>\n

Patient Teaching & Education:\u00a0<\/strong>Advise patients that use of these medications may cause dizziness and drowsiness, so patients should be aware of potential impact on their level of alertness.\u00a0 Additionally, use of medications may cause dry mouth, and frequent oral hygiene is encouraged.\u00a0 The use of atropine may cause urinary retention in males with benign prostatic hypertrophy (BPH).[1]<\/sup><\/a><\/sup><\/p>\n

Now let’s take a closer look at the medication grid\u00a0 on atropine in Table 4.7.[2]<\/sup><\/a><\/sup><\/p>\n

Table 4.7 Atropine Medication Grid<\/p>\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Muscarinic Antagonist<\/th>\natropine<\/strong><\/a><\/td>\nUse with caution with elderly<\/p>\n

Contraindicated in high environmental temperatures<\/td>\n

Dose dependent:<\/p>\n

small dose inhibits secretions; moderate dose increases heart rate; large dose decreases gastrointestinal motility<\/td>\n

Immediately report symptoms of overdose: urine retention, abnormal heartbeat, dizziness, passing out, difficulty breathing, weakness, or tremors<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

  1. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  2. This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":7,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-172","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":149,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/172","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/172\/revisions"}],"predecessor-version":[{"id":173,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/172\/revisions\/173"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/149"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/172\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=172"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=172"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=172"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=172"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}