Prototype Drugs Module 2

Epinephrine — Drug Class

Nonselective adrenergic agonist, sympathomimetic, direct-acting endogenous catecholamine.

Epinephrine — Therapeutic Uses

Anaphylaxis, anaphylactic shock, bronchospasm, status asthmaticus, cardiogenic shock, cardiac arrest.

Epinephrine — Mechanism of Action

Stimulates alpha-1, beta-1, and beta-2 adrenergic receptors.

Epinephrine — Physiological Effects

Increases vasoconstriction, BP, HR, cardiac output; promotes bronchodilation.

Epinephrine — Key Side Effects

Dysrhythmias, tachycardia, hypertension, hyperglycemia, tremors, dizziness, oliguria.

Epinephrine — Contraindications

Closed-angle glaucoma, severe hypertension, coronary artery disease, existing dysrhythmias.

Epinephrine — Nursing Monitoring & Action

High-alert drug: monitor HR and BP continuously; inspect IV site for infiltration.

Epinephrine — Patient Education

Teach patient proper technique and immediate safety steps when using an EpiPen.

Atenolol — Drug Class

Beta-1 adrenergic blocker, sympatholytic.

Atenolol — Therapeutic Uses

Manage hypertension, angina, prophylaxis, acute myocardial infarction.

Atenolol — Mechanism of Action

Blocks beta-1 receptors, decreasing sympathetic outflow, heart rate, and blood pressure.

Atenolol — Key Side Effects

Depression, dizziness, drowsiness, erectile dysfunction.

Atenolol — Contraindications

Cardiogenic shock, bradycardia; caution in COPD; decreased effect with NSAIDs.

Atenolol — Nursing Considerations & Clinical Judgment

Assess baseline vitals and perfusion; monitor vital signs and respiratory status continuously.

Atenolol — Patient Education

Teach how to measure pulse, assess heart rate, and rise slowly to standing.

Bethanechol Chloride — Drug Class

Direct-acting cholinergic agonist, urinary stimulant.

Bethanechol Chloride — Therapeutic Uses

Treat non-obstructive urinary retention and neurogenic bladder.

Bethanechol Chloride — Mechanism of Action

Stimulates cholinergic muscarinic receptors to promote bladder contraction.

Bethanechol Chloride — Key Side Effects

Hypotension, diaphoresis, miosis, increased salivation/gastric acid, N/V, diarrhea, cramping, bronchospasms.

Bethanechol Chloride — Contraindications

Bradycardia, hypotension, peptic ulcer, parkinsonism, hyperthyroidism, urinary tract obstruction.

Bethanechol Chloride — Nursing Considerations

Monitor pulse and BP, observe for increased secretions, assess breath sounds.

Bethanechol Chloride — Patient Education

Rise slowly to avoid dizziness, practice good oral hygiene, report respiratory distress.

Atropine — Drug Class

Anticholinergic, muscarinic antagonist.

Atropine — Therapeutic Uses

Preoperative medication (decrease salivation), bradycardia (increase HR), cholinergic crisis, decrease GI motility.

Atropine — Mechanism of Action

Inhibits acetylcholine by occupying muscarinic receptors.

Atropine — Key Side Effects

Dry mouth, dehydration, headache, blurred vision, photophobia, urinary retention, constipation.

Atropine — Contraindications

Hypersensitivity and glaucoma.

Atropine — Nursing Considerations & Clinical Judgment

Recognize systemic drying, urinary retention, tachycardia; provide oral care.

Atropine — Patient Education

Educate on drying effects; avoid operating machinery due to vision issues.

Benztropine — Drug Class

Antiparkinson agent, anticholinergic agent.

Benztropine — Therapeutic Uses

Decreases involuntary movement, tremors, and muscle rigidity involved in Parkinsonism.

Benztropine — Mechanism of Action

Blocks acetylcholine receptors and dopamine reuptake, decreasing ACh to reduce excess cholinergic activity.

Benztropine — Key Side Effects

Dry mouth/skin, headache, blurred vision, tachycardia, ocular hypertension, urinary retention, constipation.

Benztropine — Nursing Considerations & Clinical Judgment

Assess neuromuscular status; monitor for anticholinergic side effects and urinary retention.

Benztropine — Patient Education

Instruct patient to report difficulty voiding immediately.

Tolterodine Tartrate — Drug Class

Antimuscarinic, anticholinergic, antispasmodic.

Tolterodine Tartrate — Therapeutic Uses

Decreases urinary frequency, urgency, and nocturia in overactive bladder syndrome (non-UTI).

Tolterodine Tartrate — Mechanism of Action

Blocks muscarinic receptors in the bladder.

Tolterodine Tartrate — Key Side Effects

Dry mouth/eyes, fatigue, weight gain, urinary retention, angioedema, chest pain, tachycardia, Stevens-Johnson syndrome.

Tolterodine Tartrate — Contraindications

Urinary retention, narrow-angle glaucoma, severe GI motility issues.

Tolterodine Tartrate — Nursing Considerations & Clinical Judgment

Monitor voiding patterns and heart rate; evaluate for decreased frequency and urgency.

Solifenacin — Drug Class

Urinary antimuscarinic, anticholinergic.

Solifenacin — Therapeutic Uses

Treat overactive bladder and urinary incontinence.

Solifenacin — Mechanism of Action

Blocks muscarinic receptors in the bladder.

Solifenacin — Key Side Effects

Dry mouth, abdominal issues, cystitis, urinary retention, peripheral edema.

Solifenacin — Contraindications

Glaucoma, gastroparesis, GI obstruction, or urinary retention.

Solifenacin — Nursing Considerations & Clinical Judgment

Recognize cues: elimination pattern, drying cues, and heart rate.

Solifenacin — Patient Education

Report extreme voiding; decreased salivation and perspiration are expected.

Potassium Chloride (KCl) — Drug Class

Electrolyte, major intracellular cation.

Potassium Chloride (KCl) — Therapeutic Uses

Electrolyte replacement.

Potassium Chloride (KCl) — Key Side Effects & Adverse Reactions

Side effects: nausea, vomiting, diarrhea. Adverse reactions: hyperkalemia, cardiac dysrhythmias.

Potassium Chloride (KCl) — Nursing Considerations & Clinical Judgment

Dilute IV; monitor ECG and K+; give oral forms with meals and 8 oz water/juice.

Calcium (Ca) — Drug Class

Electrolyte.

Calcium (Ca) — Therapeutic Uses

Electrolyte replacement.

Calcium (Ca) — Mechanism & IV Action

Monitor for IV infiltration; note that calcium can enhance digoxin effects.

Calcium (Ca) — Key Side Effects & Adverse Effects

Side effects: nausea, vomiting, constipation, pain. Adverse: ECG changes, renal failure, cardiac arrest.

Calcium (Ca) — Nursing Considerations & Clinical Judgment

Check serum calcium, baseline vitals, ECG; evaluate for decreased sensation and tetany cessation.

Crystalloid & Colloid Solutions — Drug Class

IV fluid.

Crystalloid Solutions — Therapeutic Use

Short-term maintenance to treat dehydration and electrolyte imbalance.

Colloid Solutions — Therapeutic Use

Plasma expanders to increase blood volume.

Crystalloid Solutions — Mechanism of Action

Hypotonic swells cells, isotonic does not change them, hypertonic shrinks cells.

Colloid Solutions — Mechanism of Action

Large molecules that cannot pass through capillary walls.

Crystalloid & Colloid Solutions — Key Side Effects

General risk for fluid volume overload; crystalloids have lower risk for allergic reactions.

Crystalloid & Colloid Solutions — Nursing Considerations & Clinical Judgment

Take daily weight, monitor fluid intake and output, evaluate for perfusion.