{"id":221,"date":"2019-11-14T20:34:56","date_gmt":"2019-11-14T20:34:56","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/5-11-anticholinergics\/"},"modified":"2025-01-16T22:26:04","modified_gmt":"2025-01-16T22:26:04","slug":"5-11-anticholinergics","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/5-11-anticholinergics\/","title":{"raw":"5.11 Anticholinergics","rendered":"5.11 Anticholinergics"},"content":{"raw":"Ipratropium is an example of a short-acting anticholinergic. Tiotropium is an example of a long-acting anticholinergic. (See Figure 5.14[footnote]\u201cSpiriva HandiHaler-brand dry powder inhaler (open).png\u201d by RonEJ<\/a> at English Wikipedia<\/a> is licensed under CC0 1.0<\/a>[\/footnote]<\/sup> for an image of the inhaler cartridge in which the tiotropium dose is inserted.)\n\nMechanism of Action: <\/strong>Anticholinergics block the action of acetylcholine in bronchial smooth muscle, which reduces bronchoconstrictive substance release.\n\nIndications: <\/strong>Anticholinergics are used for maintenance therapy of bronchoconstriction associated with asthma, chronic bronchitis, and emphysema.\n\nNursing Considerations:\u00a0<\/strong>Nurses must be aware that anticholinergic medications commonly cause dry mouth and may result in constipation or blurred vision.\n\nSide Effects\/Adverse Effects: <\/strong>Anticholinergics 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]<\/sup>\n\nHealth Teaching & Health Promotion: <\/strong>Clients should be instructed to use the inhaler as directed and be careful not to exceed dosage recommendations. They should receive information regarding the onset of medication and differences in usage for short- and long-acting anticholinergics. Some long-acting anticholinergics may cause signs of angioedema, and the health care provider should be notified if this occurs.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\n[caption id=\"attachment_220\" align=\"aligncenter\" width=\"555\"]\"Photo Figure 5.14 Tiotropium, a Long-Acting Anticholinergic[\/caption]\n\nNow let's take a closer look at the medication grid for ipratropium and tiotropium in Table 5.11.[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). Abrams\u2019 clinical drug: Rationales for nursing practice\u00a0<\/em>(11th ed.). Wolters Kluwer.[\/footnote],[footnote]This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in 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.[\/footnote]<\/span><\/sup>\n\nTable 5.11 Ipratropium and Tiotropium Medication Grid\n\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Nursing Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Anticholinergics (short-acting)<\/th>\nipratropium<\/a><\/td>\nLong-term management of pulmonary disease\n\nSlower onset of action<\/td>\nBronchodilation<\/td>\nCough and drying of the nasal mucosa<\/td>\n<\/tr>\n
Anticholinergics (long-acting)<\/th>\ntiotropium<\/a><\/td>\nLong-term management of pulmonary disease\n\nSlower onset of action<\/td>\nPrevents bronchospasm and reduces exacerbations in COPD clients<\/td>\nCough and drying of the nasal mucosa<\/td>\n<\/tr>\n<\/tbody>\n<\/table>","rendered":"

Ipratropium is an example of a short-acting anticholinergic. Tiotropium is an example of a long-acting anticholinergic. (See Figure 5.14[1]<\/sup><\/a><\/sup> for an image of the inhaler cartridge in which the tiotropium dose is inserted.)<\/p>\n

Mechanism of Action: <\/strong>Anticholinergics block the action of acetylcholine in bronchial smooth muscle, which reduces bronchoconstrictive substance release.<\/p>\n

Indications: <\/strong>Anticholinergics are used for maintenance therapy of bronchoconstriction associated with asthma, chronic bronchitis, and emphysema.<\/p>\n

Nursing Considerations:\u00a0<\/strong>Nurses must be aware that anticholinergic medications commonly cause dry mouth and may result in constipation or blurred vision.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Anticholinergics should be used with caution with the elderly and can cause cough, drying of the nasal mucosa, nervousness, nausea, GI upset, headaches, and dizziness.[2]<\/sup><\/a><\/sup><\/p>\n

Health Teaching & Health Promotion: <\/strong>Clients should be instructed to use the inhaler as directed and be careful not to exceed dosage recommendations. They should receive information regarding the onset of medication and differences in usage for short- and long-acting anticholinergics. Some long-acting anticholinergics may cause signs of angioedema, and the health care provider should be notified if this occurs.[3]<\/sup><\/a><\/sup><\/p>\n

\"Photo
Figure 5.14 Tiotropium, a Long-Acting Anticholinergic<\/figcaption><\/figure>\n

Now let’s take a closer look at the medication grid for ipratropium and tiotropium in Table 5.11.[4]<\/sup><\/a>,[5]<\/sup><\/a>,[6]<\/sup><\/a>,[7]<\/sup><\/a><\/span><\/sup><\/p>\n

Table 5.11 Ipratropium and Tiotropium Medication Grid<\/p>\n\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Nursing Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Anticholinergics (short-acting)<\/th>\nipratropium<\/a><\/td>\nLong-term management of pulmonary disease<\/p>\n

Slower onset of action<\/td>\n

Bronchodilation<\/td>\nCough and drying of the nasal mucosa<\/td>\n<\/tr>\n
Anticholinergics (long-acting)<\/th>\ntiotropium<\/a><\/td>\nLong-term management of pulmonary disease<\/p>\n

Slower onset of action<\/td>\n

Prevents bronchospasm and reduces exacerbations in COPD clients<\/td>\nCough and drying of the nasal mucosa<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
  1. \u201cSpiriva HandiHaler-brand dry powder inhaler (open).png\u201d by RonEJ<\/a> at English Wikipedia<\/a> is licensed under CC0 1.0<\/a> ↵<\/a><\/li>
  2. Frandsen, G., & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer. ↵<\/a><\/li>
  3. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  4. 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> ↵<\/a><\/li>
  5. Frandsen, G., & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice\u00a0<\/em>(11th ed.). Wolters Kluwer. ↵<\/a><\/li>
  6. This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the Public Domain<\/a>. ↵<\/a><\/li>
  7. Adams, M., Holland, N., & Urban, C. (2020).\u00a0Pharmacology for nurses: A pathophysiologic approach\u00a0<\/em>(6th ed.). pp. 622-63. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":83,"menu_order":11,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-221","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":186,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/221","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/users\/83"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/221\/revisions"}],"predecessor-version":[{"id":222,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/221\/revisions\/222"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/186"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/221\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/media?parent=221"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=221"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/contributor?post=221"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/license?post=221"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}