{"id":160,"date":"2019-10-17T21:41:43","date_gmt":"2019-10-18T01:41:43","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/chapter\/4-7-muscarinic-antagonist\/"},"modified":"2022-03-16T12:58:18","modified_gmt":"2022-03-16T16:58:18","slug":"4-8-muscarinic-antagonist","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/chapter\/4-8-muscarinic-antagonist\/","title":{"raw":"4.8 Muscarinic Antagonists","rendered":"4.8 Muscarinic Antagonists"},"content":{"raw":"Atropine is a muscarinic antagonist.\r\n\r\n<strong>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.\r\n\r\n<strong>Indications for Use:<\/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.\r\n\r\n<strong>Nursing Considerations Across the Lifespan:<\/strong> As with all anticholinergics, use with caution with the elderly, because elderly clients 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.\r\n\r\nAtropine can be given to pediatric clients, with doses adjusted according to the child weight.\r\n\r\n<strong>Patient Teaching &amp; Education:\u00a0<\/strong>Advise clients that use of these medications may cause dizziness and drowsiness, so clients 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).<sup>[footnote]uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\r\n\r\nNow let's take a closer look at the medication card on atropine in Table 4.8.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a> by <a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. National Library of Medicine<\/a> in the <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener noreferrer\">public domain<\/a>.[\/footnote]<\/sup>[footnote]UpToDate (2021). <em>Atropine<\/em>. <a href=\"https:\/\/www.uptodate.com\/contents\/search\">https:\/\/www.uptodate.com\/contents\/search<\/a>[\/footnote] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.\r\n\r\nTable 4.8 <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=85225d12-3d96-427a-8027-a4530b8840b0&amp;audience=consumer\">Atropine<\/a> Medication Card\r\n\r\n<img class=\"aligncenter wp-image-1988 size-full\" src=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-scaled.jpg\" alt=\"Muscarinic antagonist drug card\" width=\"2560\" height=\"508\" \/>","rendered":"<p>Atropine is a muscarinic antagonist.<\/p>\n<p><strong>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<p><strong>Indications for Use:<\/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<p><strong>Nursing Considerations Across the Lifespan:<\/strong> As with all anticholinergics, use with caution with the elderly, because elderly clients 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<p>Atropine can be given to pediatric clients, with doses adjusted according to the child weight.<\/p>\n<p><strong>Patient Teaching &amp; Education:\u00a0<\/strong>Advise clients that use of these medications may cause dizziness and drowsiness, so clients 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).<sup><a class=\"footnote\" title=\"uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral\" id=\"return-footnote-160-1\" href=\"#footnote-160-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/sup><\/p>\n<p>Now let&#8217;s take a closer look at the medication card on atropine in Table 4.8.<sup><a class=\"footnote\" title=\"This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain.\" id=\"return-footnote-160-2\" href=\"#footnote-160-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/sup><a class=\"footnote\" title=\"UpToDate (2021). Atropine. https:\/\/www.uptodate.com\/contents\/search\" id=\"return-footnote-160-3\" href=\"#footnote-160-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a> Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.<\/p>\n<p>Table 4.8 <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=85225d12-3d96-427a-8027-a4530b8840b0&amp;audience=consumer\">Atropine<\/a> Medication Card<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1988 size-full\" src=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-scaled.jpg\" alt=\"Muscarinic antagonist drug card\" width=\"2560\" height=\"508\" srcset=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-scaled.jpg 2560w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-300x59.jpg 300w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-1024x203.jpg 1024w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-768x152.jpg 768w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-1536x305.jpg 1536w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-2048x406.jpg 2048w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-65x13.jpg 65w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-225x45.jpg 225w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/10\/atropine-350x69.jpg 350w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/p>\n<div class=\"media-attributions clear\" prefix:cc=\"http:\/\/creativecommons.org\/ns#\" prefix:dc=\"http:\/\/purl.org\/dc\/terms\/\"><h2>Media Attributions<\/h2><ul><li >atropine       <\/li><\/ul><\/div><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-160-1\">uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a> <a href=\"#return-footnote-160-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-160-2\">This work is a derivative of <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a> by <a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. National Library of Medicine<\/a> in the <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener noreferrer\">public domain<\/a>. <a href=\"#return-footnote-160-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-160-3\">UpToDate (2021). <em>Atropine<\/em>. <a href=\"https:\/\/www.uptodate.com\/contents\/search\">https:\/\/www.uptodate.com\/contents\/search<\/a> <a href=\"#return-footnote-160-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":103,"menu_order":8,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["open-resources-for-nursing-open-rn"],"pb_section_license":""},"chapter-type":[48],"contributor":[68],"license":[],"class_list":["post-160","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","contributor-open-resources-for-nursing-open-rn"],"part":138,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/160","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/users\/103"}],"version-history":[{"count":8,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/160\/revisions"}],"predecessor-version":[{"id":2619,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/160\/revisions\/2619"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/138"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/160\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=160"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=160"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=160"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=160"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}