A 27-year-old male is taking an anticholinergic drug as adjunctive therapy to treat his peptic ulcer disease. The client comes to the clinic and tells the nurse that he "feels his heart beating." What adverse effect is the client experiencing from the anticholinergic medication?

Urinary Frequency

Tachycardia

Tachypnea

Hypotension

Answer and Explanation

The Correct Answer is B

B) Tachycardia:
Anticholinergic drugs, by blocking the action of acetylcholine at muscarinic receptors, can lead to increased sympathetic activity, resulting in tachycardia. Acetylcholine normally acts to moderate heart rate via vagal stimulation, so blocking its effects with anticholinergic medications can lead to an unopposed sympathetic response, causing an increase in heart rate.

A) Urinary Frequency:
Anticholinergic drugs typically cause urinary retention rather than urinary frequency. By blocking muscarinic receptors in the bladder, these medications can lead to decreased bladder contractility and urinary retention. Urinary frequency is not a common adverse effect of anticholinergic drugs.

C) Tachypnea:
Tachypnea, or rapid breathing, is not a typical adverse effect of anticholinergic medications. While anticholinergic drugs can affect respiratory secretions and cause drying of mucous membranes, leading to potential respiratory issues, tachypnea specifically is not commonly associated with their use.

D) Hypotension:
Anticholinergic drugs are more likely to cause hypertension rather than hypotension. By blocking the parasympathetic nervous system, these medications can lead to sympathetic dominance, resulting in increased blood pressure. Hypotension is not a typical adverse effect of anticholinergic drugs.

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Correct Answer is C

Explanation

A) Milk:
Milk is not known to interact significantly with verapamil. Therefore, there's no need for the client to avoid consuming milk while taking this medication.

B) Orange juice:
Orange juice does not typically interact with verapamil. However, calcium-containing foods and beverages, including orange juice, may reduce the absorption of verapamil when taken simultaneously. While the interaction is not severe, it's advisable for clients to separate the administration of verapamil from calcium-rich foods and beverages to optimize absorption.

C) Grapefruit juice:
This is the correct answer. Grapefruit juice contains compounds that inhibit the activity of cytochrome P450 enzymes, particularly CYP3A4, which are involved in the metabolism of many medications, including verapamil. Consuming grapefruit juice while taking verapamil can lead to elevated blood levels of the medication, increasing the risk of side effects and toxicity. Therefore, clients should avoid grapefruit juice while on verapamil therapy.

D) Coffee:
Coffee does not typically interact with verapamil. However, caffeine-containing beverages like coffee may exacerbate certain side effects of verapamil, such as dizziness or palpitations, due to their stimulant effects. Clients may be advised to limit caffeine intake or consume coffee in moderation while taking verapamil.

A. STAT administration of atropine B. administration of activated charcoal C. hemodialysis D. intravenous administration of pseudoephedrine

Correct Answer is A

Explanation

A) STAT administration of atropine:
This is the correct answer. Atropine is a cholinergic antagonist that can increase heart rate by blocking the action of acetylcholine on cardiac muscarinic receptors. In cases of severe bradycardia, especially if associated with symptoms such as dizziness, syncope, or hypotension, atropine is often administered to increase heart rate and improve cardiac output. The dose of atropine and frequency of administration depend on the severity of bradycardia and the clinical response.

B) Administration of activated charcoal:
Activated charcoal is used in cases of overdose or poisoning to absorb ingested toxins and prevent their absorption into the bloodstream. However, in this scenario, where the primary concern is bradycardia resulting from cholinesterase inhibitor (donepezil) toxicity, activated charcoal would not be effective in reversing the bradycardic effects of the medication.

C) Hemodialysis:
Hemodialysis is a renal replacement therapy used to remove toxins and waste products from the blood in individuals with kidney failure. While hemodialysis may be indicated in cases of severe drug overdose or poisoning to enhance toxin elimination, it is not typically used as a first-line intervention for bradycardia associated with cholinesterase inhibitor toxicity.

D) Intravenous administration of pseudoephedrine:
Pseudoephedrine is a sympathomimetic drug that acts as a vasoconstrictor and can increase heart rate and blood pressure. While it may be used to treat bradycardia in some cases, such as severe symptomatic bradycardia unresponsive to atropine, it is not the first-line treatment for cholinesterase inhibitor toxicity-induced bradycardia. Atropine is preferred due to its direct antagonism of muscarinic receptors in the heart.

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A 27-year-old male is taking an anticholinergic drug as adjunctive therapy to treat his peptic ulcer disease. The client comes to the clinic and tells the nurse that he "feels his heart beating." What adverse effect is the client experiencing from the anticholinergic medication?

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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication?

Correct Answer is C

Explanation

A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?

Correct Answer is A

Explanation

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