{"id":250,"date":"2019-11-14T20:34:56","date_gmt":"2019-11-15T01:34:56","guid":{"rendered":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/5-11-anticholinergics\/"},"modified":"2023-08-15T13:01:46","modified_gmt":"2023-08-15T17:01:46","slug":"5-11-anticholinergics","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/5-11-anticholinergics\/","title":{"raw":"5.11 Anticholinergics","rendered":"5.11 Anticholinergics"},"content":{"raw":"

Anticholinergics<\/h1>\r\nIpratropium is an example of a short-acting anticholinergic. Tiotropium is an example of a long-acting anticholinergic. Additional information regarding anticholinergics can be found in the \"Autonomic Nervous System\" chapter. (See Figure 5.11[footnote]\"Spiriva HandiHaler\"-brand dry powder inhaler (open).png\" by RonEJ<\/a> at English Wikipedia<\/a> is licensed under CC0 1.0<\/a>[\/footnote] for an image of tiotropium.)\r\n\r\n[caption id=\"attachment_248\" align=\"aligncenter\" width=\"555\"]\"Spiriva Figure 5.11 Tiotropium, a long-acting anticholinergic[\/caption]\r\n

Mechanism of Action<\/h2>\r\nAnticholinergics block the action of acetylcholine in bronchial smooth muscle, which reduces Broncho-constrictive substance release.\r\n

Indications for Use<\/h2>\r\nAnticholinergics are used for maintenance therapy of bronchoconstriction associated with asthma, chronic bronchitis, and emphysema.\r\n

Adverse\/Side Effects<\/h2>\r\nAnticholinergics should be used with caution with the elderly and can cause cough, drying of the nasal mucosa, nervousness, nausea, GI upset, headaches, and dizziness.[footnote]Frandsen, G. & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer.[\/footnote]\r\n

Anticholinergic<\/span>\u00a0Drugs across the Life Span<\/h2>\r\nWheezing is an indication for using anticholinergic drugs but although we do see wheezing in infancy, using these drugs remains controversial.\u00a0 Most wheezing in infancy is in response to viral infections.\r\n

Client Teaching & Education<\/h2>\r\nClient should be instructed to use the inhaler as directed and be careful not to exceed dosage recommendations. They should receive education regarding the onset of medication and differences in usage for short- and long-acting anticholinergics. Clients with certain diseases should not use anticholinergics including Myasthenia gravis, hyperthyroidism, glaucoma, enlarged prostate, hypertension, urinary tract blockage, tachycardia and heart failure. Some long-acting anticholinergics may cause signs of angioedema and the healthcare provider should be notified if this occurs.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]\r\n

Ipratropium and Tiotropium Medication Card<\/h1>\r\nNow let's take a closer look at the medication card for ipratropium and tiotropium.[footnote]This work is a derivative of\u00a0Pharmacology Notes: Nursing Implications for Clinical Practice<\/a>\u00a0by\u00a0Gloria Velarde<\/a>\u00a0licensed under\u00a0CC BY-NC-SA 4.0<\/a>.[\/footnote],[footnote]Frandsen, G. & Pennington, S. (2018).\u00a0Abrams\u2019 clinical drug: Rationales for nursing practice\u00a0<\/em>(11th ed.). Wolters Kluwer.[\/footnote], [footnote]This work is a derivative of\u00a0Daily Med<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a>\u00a0in the public domain<\/a>. [\/footnote],[footnote]Adams, M., Holland, N., & Urban, C. (2020).\u00a0Pharmacology for nurses: A pathophysiologic approach\u00a0<\/em>(6th ed.). pp. 622-63 & 626. Pearson. [\/footnote]<\/span>\r\n
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Medication Card 5.11.1: Ipratropium and Tiotropium<\/h2>\r\n<\/header>\r\n
\r\n\r\nClass: <\/strong>Anticholinergics\r\n\r\nPrototypes: <\/strong>Ipratropium \u00a0(short acting anticholinergic)\r\n\r\nTiotropium (long acting anticholinergic)<\/strong>\r\n\r\nMechanism:\u00a0 <\/strong>Anticholinergics block the action of acetylcholine in bronchial smooth muscle, which reduces Broncho-constrictive substance release\r\n

Therapeutic Effects<\/h3>\r\n