| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|
| Atropine SO4—PO, Subcu, IM, IV 0.3–1.2 mg; ophthalmic 0.5%–1.0% up to 6 times daily | Peptic ulcer; spasms of GI tract, Stokes-Adams syndrome; control excessive secretions during surgery | Blocks parasympathomimetic effects of acetylcholine on effector organs | Dry mouth, tachycardia, blurred vision, drowsiness, skin flushing; urinary retention; contraindications: glaucoma and paralytic ileus |
| NURSING IMPLICATIONS: Observe for postural hypotension in clients who are ambulating; administer cautiously in aged; and monitor vital signs for pulse and respiratory rate changes |
| Dicyclomine (Bentyl)—PO 10–20 mg 3–4 times/day | Diverticulosis | Antispasmodic | Blurred vision; constipation; dry eyes, dry mouth |
| NURSING IMPLICATIONS: Report symptoms listed under side effects, abdominal pain |
| Glycopyrrolate (Robinul)—PO 1–2 mg 2–3 times per day; IM, IV 4.4 mcg/kg (preop); 100–200 mcg 4 times a day (ulcer) | Inhibit salivation and respiratory secretions; peptic ulcer disease | Inhibits action of acetylcholine (antimuscarinic action) | Tachycardia; dry mouth; urinary hesitancy |
| NURSING IMPLICATIONS: Give 30–60 min before meals; do not give within 1 hr of antacids; IM or IV may be given undiluted |
| Hyoscyamine (Levsinex)—PO 0.125–0.5 mg 3–4 times/day; or PO 0.375 mg twice a day in extended-released tablets | Diverticulosis | Manages spasms of irritable bowel syndrome | Constipation; dry mouth, blurred vision |
| NURSING IMPLICATIONS: Monitor for: pain, bleeding, constipation, drug reaction |
| Propantheline bromide (Pro-Banthine)—PO 15 mg 4 times daily; IM, IV 30 mg | Decreases hypertonicity and hypersecretion of GI tract; ulcerative colitis; peptic ulcer | Blocks neural transmission at ganglia of autonomic nervous system and at parasympathetic effector organs | Nausea, gastric fullness, constipation; mydriasis |
| NURSING IMPLICATIONS: Give before meals; observe urinary output to avoid retention, particularly in elderly; mouth care to relieve dryness; contraindicated with glaucoma |
| Tincture of belladonna—PO 0.3–0.6 mL 3 times daily | Hypermotility of stomach; bowel, biliary, and renal colic; prostatitis | Blocks parasympathomimetic effects of acetylcholine | Dry mouth, thirst; dilated pupils; skin flushing; elevated temperature; delirium |
| NURSING IMPLICATIONS: Administer 30–60 min before meals; observe for side effects; physostigmine salicylate is antidote |
| Tolterodine tartrate (Detrol LA)—PO 2 mg twice daily; 4 mg sustained release (SR) daily | Overactive bladder | Selective muscarinic urinary bladder receptor antagonist | Dry mouth; back pain; fatigue, weight gain |
| NURSING IMPLICATIONS: Report eye pain promptly. Blurred vision, sensitivity to light, and dry mouth should be reported if bothersome |