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Treatment of urinary tract infections
Oral Cholinergics
Prototype Med |
Bethanechol (Urecholine) |
Action: Agonist that acts on the bladder. Avtivates muscarinic reseptors in the detrusor muscle that lines the bladder causing it to contract.
Therapeutic Use
Treatment of urinary retention |
Adverse Drug Reactions
Hypotension, bradycardia |
Excessive gastric acid and salivation, diarrhea, fecal incontinence |
Bronchoconstriction |
Dizziness, fainting |
Nursing Interventions
Monitor blood pressure, heart rate, and bowel elimination patterns |
Monitor respiratory status. |
Monitor for dizziness. |
For in-patient use, have a bedpan or urinal readily available and assist with ambulation. |
Administration
Take orally three to four times a day. |
Take 1 hr before or 2 hr after meals. |
Patient Education
Report dizziness, difficulty breathing, or fainting |
Increase fluid intake to maintain hydration. |
Do not engage in dangerous activities if dizziness occurs or tends to recur. |
Sit or lie down if feeling dizzy. |
Contraindications
Hypotension, Hyperthyroidism |
Low cardiac output, Asthma, chronic obstructive pulmonary disease |
Gastric ulcers, Intestinal obstruction, Recent intestinal surgery |
Urinary tract obstruction or bladder wall weakness |
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Precautions
Bacteremia |
History of syncope |
Interactions
Cholinesterase inhibitors worsen cholinergic effects and increase the risk of toxicity |
Mecamylamine (Inversine) worsens abdominal symptoms and hypoten- sion. |
Procainamide (Pronestyl), quinidine, atropine, and epinephrine interfere with therapeutic effects. |
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