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Anticholinergics

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Submitted By devraye
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An example of a group of antiparkinson drugs are anticholinergics. Two common names are Cogentin (benztropine), and Benadryl (diphenhydramine). As per Davis’s Drug Guide, the recommended dose for Cogentin is 1-2mg/day in 1-2 divided doses (range 0.5-6mg/day). The recommended dose for Benadryl (when used as an antidyskinetic such as in Parkinsonism) is 25-50mg q4h, not to exceed 400mg/day. Benadryl is an adjunctive agent for the treatment of Parkinson disease. I chose these two drugs because I give them a lot at work!

Nurses should assess:
*contraindications, such as anticholinergic allergies, and alcohol intolerance -avoid hypersensitivity reactions
*level of orientation and neurological status -such as gait, grip, and reflexes to evaluate CNS effects
*auscultate bowel sounds -assess for possible paralytic ileus or slowed motility
*monitor laboratory results -for possible dose adjustment and/or toxic effects especially in geriatric pts
*monitor pulse, b/p, and cardiac output -d/t adverse effects r/t blocking of suppressive action of heart
*avoid exposure to hot environment -may block pt’s reflex sweating

Nursing Diagnosis
Impaired mucous membranes related to anticholinergic effects
Risk for impaired thermoregulation related to anticholinergic effects
Constipation related to GI effects
Disturbed thought processes related to CNS effects
Risk for injury related to CNS effects
Deficient knowledge regarding drug therapy

Evaluation
Monitor patients response to the drug (improvement in S/S)
Monitor for adverse effects (GI slowing, decreased sweating)
Evaluate the effectiveness of the teaching plan (Pt can name possible adverse effects)

References

Deglin, J. H., & Vallerand, A. H. (2008). Davis's drug guide for nurses. (11 ed.). F A DavisCo. Karch, A.M. (2011). Focus on nursing pharmacology, (5th Edition). New York: Lippincott Williams & Wilkins.

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