ACTIVITY 14. 1.

Drugs affecting the Mechanism of Indications Adverse Effects Important Nursing

CNS Action Considerations
Antipsychotic drugs
Antipsychotics Haloperidol is Elderly patients with Elderly patients with
block dopamine primarily dementia-related dementia-related
receptors in the indicated for psychosis treated psychosis treated with
brain. However, schizophrenia and with antipsychotic antipsychotic drugs
the precise Tourette’s drugs are at an should be closely
mechanism of disorder. increased risk of monitored for signs and
action has not been Risperidone is death due to symptoms of
clearly established. primarily cardiovascular or cardiovascular events or
Conventional indicated for infection-related infections such as
antipsychotics, schizophrenia but causes. pneumonia.
such as is also used for
haloperidol, block acute manic Conventional Haloperidol is
dopamine episodes and for antipsychotic contraindicated in
receptors in certain irritability caused medications have patients with Parkinson’s
areas of the CNS, by autism. Some several potential disease or dementia with
such as the limbic atypical serious adverse lewy bodies.
system and the antipsychotics are effects such
basal ganglia. also used as as tardive dyskinesia, Patients who are
These areas are adjunct therapy neuroleptic concurrently taking
associated with for depression. malignant syndrome lithium and
emotions, cognitive (NMS), antipsychotics should be
function, and and extrapyramidal monitored closely for
motor function, symptoms. These neurotoxicity (weakness,
and blockage thus adverse effects are lethargy, fever,
produces a due to the blockage tremulousness,
tranquilizing effect of alpha-adrenergic, confusion, and
in psychotic dopamine, extrapyramidal
patients. However, endocrine, symptoms) and
several adverse histamine, and symptoms should be
effects are also muscarinic immediately reported.
caused by this receptors. 
dopamine
blockade.

Second-generation,
or atypical,
antipsychotics
block specific
dopamine 2
receptors and
specific serotonin 2
receptors, thus
causing fewer
adverse effects
 Mood-Stabilizing Commonly used  Changes in Assessment and
drugs: to treat people weight and monitoring
They modulate the with bipolar appetite
activity of enzymes, mood  Tremor
ion channels, disorder and  Blurred vision  Mental status
arachidonic acid sometimes  Dizziness  Medication history
turnover, G protein people with  Baseline labs: BUN,
coupled receptors schizoaffective creatinine,
and intracellular disorder and electrolytes, TSH,
pathways involved borderline liver function, thyroid
in synaptic personality function, negative
plasticity and disorder. In some pregnancy test
neuroprotection. cases, they're
used to
supplement other Client education
Drugs for bipolar medications, such
disorders as  Take as prescribed;
antidepressants, do not crush or chew
to treat  Do not stop even if
depression. feeling better
 Take with meals or
milk
 Regular monitoring of
lithium levels
required
 Keep fluid and
sodium balance
consistent
 Report signs or
symptoms of toxicity

Experts aren’t  For treatment  CNS:  Arrange to interrupt

exactly sure how of attention- nervousness, ins the drug periodically
CNS stimulants deficit omnia, dizziness, in children to
work, although disorders and headache, determine whether
they suspect they narcolepsy. blurred vision, symptoms recur and
increase levels of difficulty with therapy should be
one or more accommodation continued.
CNS stimulants
neurotransmitters  CV: hypertension  Arrange to dispense
in the brain, such , the least amount of
as dopamine, arrhythmias, ang drug possible to
norepinephrine, or ina minimize risk of
serotonin. They  GI: anorexia, overdose and abuse.
may also have nausea, weight  Administer drug
other effects, loss before 6 PM as
 depending on the  Skin rashes are ordered to reduce
actual drug. For common the incidence of
example, phenterm reactions. insomnia.
ine possibly  Physical and  Monitor weight, CBC,
indirectly increases psychological and ECG to ensure
leptin levels – dependence. early detection of
leptin is a adverse effects and
substance that tells proper interventions.
us we feel full.  Provide safety
measures (e.g.
adequate lighting,
raised side rails, etc.)
to prevent injuries.
 Educate client on
drug therapy to
promote
understanding and
compliance.
Antiparkinsonism Carbidopa/  Indicated for Hallucinations and  Carbidopa/
agents Levodopa: Parkinson’s psychotic-like Levodopa is
Administration of disease. It is also behavior have recommended for
dopamine is used to treat been reported with use in patients older
ineffective in the restless leg dopaminergic than age 18.  It can
treatment of syndrome. medications. take several weeks
Parkinson’s disease Patients taking to see positive
because it does not dopaminergic effects and this
cross the blood- medications may should be explained
brain barrier, but experience intense to patients and their
levodopa, the gambling urges, caregivers.
metabolic increased sexual  The drug is
precursor of urges, intense contraindicated for
dopamine, does urges to spend use with MAOIs. All
cross the blood- money, binge patients should be
brain barrier and eating, and/or observed carefully
presumably is other intense for the
converted to urges, and the development of
dopamine in the inability to control depression with
brain. Carbidopa is these urges. These concomitant
combined with urges stopped suicidal tendencies.
levodopa to help when the dosage  Patients taking
stop the was decreased or carbidopa and
breakdown of the medication levodopa have
levodopa before it discontinued. reported suddenly
is able to cross the A higher risk for falling asleep
blood-brain barrier. melanoma has without prior
Additionally, the been reported. warning of
incidence of Occasionally, dark sleepiness while
levodopa-induced red, brown, or
nausea and black color may engaged in activities
vomiting is less appear in saliva, of daily living
when it is urine, or sweat (including operation
combined with after ingestion of of motor vehicles).
carbidopa. carbidopa and Patients should be
levodopa. Although advised to exercise
the color appears caution while
to be clinically driving or operating
insignificant, machines during
garments may treatment with
become discolored carbidopa and
levodopa.
 Sporadic cases of
symptoms
resembling
neuroleptic
malignant
syndrome (NMS)
have been reported
in association with
dose reductions or
withdrawal of
certain
antiparkinsonian
agents. Therefore,
patients should be
observed carefully
when the dosage of
levodopa is reduced
abruptly or
discontinued.
 Periodic evaluations
of hepatic,
hematopoietic,
cardiovascular, and
renal functions are
recommended
during extended
therapy. The most
common adverse
effect of
carbidopa/levodopa
is dyskinesia, which
may require dosage
reduction.
 Patients should be
instructed to plan
their meal times
 around medication
times to improve
the ability to use
their utensils and to
avoid diets high in
protein due to
decreased
absorption of the
medication.

Selegiline:  Indicated as an Side effects are dose  Large doses of

Selegiline inhibits adjunct in the dependent, with selegiline may inhibit
MAO-B, blocking management of larger doses posing a MAO-A that
the breakdown of Parkinsonian hypertensive crisis promotes
dopamine patients being risk if there is metabolism of
treated with consumption of food tyramine in the GI
levodopa/carbid or beverages with tract, which can
opa who exhibit tyramine. cause a hypertensive
deterioration in crisis.
the quality of
their response
to this therapy.
There is no
evidence from
controlled
studies that
selegiline has
any beneficial
effect in the
absence of
concurrent
levodopa
therapy.

Amantadine: Used for Suicide ideation,  Use cautiously with

The exact Parkinson’s congestive heart renal impairment.
mechanism of disease, failure, and This drug may cause
action is medication- peripheral edema suicidal ideation
unknown. induced can occur. This and should not be
Amantadine is an extrapyramidal drug can cause stopped abruptly or
antiviral drug that symptoms, and intense gambling can cause
acts on dopamine influenza A. urges, increased Parkinsonian crisis.
receptors sexual urges, Neuroleptic
 intense urges to Malignant
spend money Syndrome (NMS)
uncontrollably, and has been reported
other intense urges in association with
with an inability to dose reduction or
control them. withdrawal of
There is an amantadine
increased risk of therapy.
melanoma.
Adverse reactions
reported most
frequently are
nausea, dizziness
(lightheadedness),
and insomnia. This
drug can also cause
anticholinergic side
effects, impaired
thinking, and
orthostatic
hypotension

Centrally Acting  Primary  CNS: depression,  Assess for mentioned

Skeletal Muscle indication is drowsiness, fatig contraindications and
Relaxants: relief of ue, weakness, cautions (e.g.
They work in the discomfort confusion, drug allergy, cardiac
CNS to interfere associated headache, insom depression,
with reflexes that with acute, nia. rheumatic disorder,
cause muscle painful  CV: hypotension, pregnancy and
spasms. They musculoskel arrhythmias lactation, etc.) to
essentially etal  GI: nausea, prevent untoward
destroy or lyse conditions dry mouth, anor complication.
spasms and are as adjunct exia, constipatio  Conduct thorough
often referred to to rest, n. physical assessment
as spasmolytics. physical  GU: urinary (temperature, skin
Muscle relaxants
therapy, frequency, color and lesion, CNS
and other enuresis, urinary orientation, affect,
measures. urgency reflexes, bilateral grip
 Alleviation  Chlorzoxazone m strength, spasticity
of signs and ay turn urine evaluation; bowel
symptoms into purple-red sounds and urine
of spasticity, color. output) to obtain
may be of  Tizanidine has baseline data.
use in spinal been associated  Monitor liver and
cord injuries with liver toxicity renal function tests to
or spinal and hypotension  detect potential
cord in some patients. adverse effects
diseases.  Baclofen is  Provide additional
tapered over 1-2 spasm and pain relief
weeks to like rest periods, heat
prevent application, NSAIDs a
development of s ordered,
psychoses and and positioning to
hallucinations. augment the effects
of the drug at
relieving the
musculoskeletal
discomfort.
 Discontinue drug at
any sign of liver and
renal dysfunction to
prevent severe
toxicity.
 Monitor respiratory
status to evaluate
adverse effects and
arrange for
appropriate dose
adjustment or
discontinuation of the
drug.
 Provide comfort
measures to help
patient tolerate drug
effects.
 Provide safety
measures (e.g.
adequate lighting,
raised side rails, etc.)
to prevent injuries.
 Educate client on
drug therapy to
promote
understanding and
compliance.
 Monitor patient
response to therapy
(improvement in
muscle spasm and
relief of pain;
improvement in
muscle spasticity).
 Monitor for adverse
effects (e.g.CNS
changes, GI
depression, urinary
 urgency, etc).
 Evaluate patient
understanding on
drug therapy by
asking patient to
name the drug, its
indication, and
adverse effects to
watch for.
 Monitor patient
compliance to drug
therapy.

Direct Acting Children  CNS: drowsiness,  Assess for mentioned

Skeletal Muscle  Safety and fatigue, contraindications and
Relaxants: effectiveness weakness, cautions (e.g. drug
 They enter not confusion, allergy, cardiac
the muscle to established in headache, depression,
prevent children. insomnia, visual rheumatic disorder,
muscle  Dantrolene is disturbances pregnancy and
contraction used to treat  GI: GI lactation, etc.) to
directly. upper motor irritation, diarrhe prevent untoward
neuron a, constipation, complications.
spasticity in abdominal  Conduct thorough
children. cramps physical assessment
 Dose should  GU: urinary (temperature, skin
be accurately frequency, color and lesion, CNS
calculated enuresis, urinary orientation, affect,
based on urgency, reflexes, bilateral grip
body weight crystalline urine strength, spasticity
and it with pain or evaluation; bowel
increases burning on sounds and urine
over time. urination output) to obtain
 Children are  Others: acne, baseline data.
at increased abnormal hair gr  Monitor liver and
risk of CNS owth, rashes, renal function tests to
and GI photosensitivity, detect potential
toxicity. abnormal adverse effects.
Adult sweating, chills,  Assess area before
 They should nyalgia administering
be cautioned  Dantrolene can botulinum toxins
to avoid cause direct because area with
activities that hepatocellular active infection will
require damage and be exacerbated by
alertness (e.g. potentially injection.
driving) fatal hepatitis  Monitor intravenous
because  Botulinum access sites of
drugs can toxins are dantrolene for
 cause associated potential
confusion and with anaphylacti extravasation
drowsiness. c because drug is
 Pregnant and reactions charact alkaline and very
lactating erized by irritating to tissues.
women headache,  Periodically
should be dizziness, muscle discontinue
advised to pain, paralysis dantrolene for 2-4
use days as ordered to
contraception monitor therapeutic
and effectiveness.
alternative  Discontinue drug at
method of any sign of liver
feeding, dysfunction to
respectively. prevent adverse
 Premenopaus effects.
al women are  Provide comfort
at increased measures to help
risk for patient tolerate drug
hepatotoxicit effects.
y in  Provide safety
association measures (e.g.
with use adequate lighting,
of dantrolene raised side rails, etc.)
. to prevent injuries.
Older adults  Educate client on
 They are drug therapy to
more likely to promote
experience understanding and
adverse compliance.
effects  Monitor patient
associated response to therapy
with these (improvement in
drugs. spasticity, movement
 Older women and activities).
who are  Monitor for adverse
receiving effects (e.g. CNS
hormone changes, diarrhea,
replacement liver toxicity, etc).
therapy have  Evaluate patient
the same risk understanding on
for drug therapy by
hepatotoxicit asking patient to
y with name the drug, its
premenopaus indication, and
al women in adverse effects to
association watch for.
with use of  Monitor patient
 dantrolene. compliance to drug
therapy.

Narcotic Agonists:  Relief of  CNS: light- Children

React with opioid moderate to headedness,  Safety and
receptors in the severe dizziness, effectiveness has not
CNS; cause acute pain psychoses, anxie been established in
analgesia, or chronic ty, fear, children.
sedation, or pain; hallucinations, p  Narcotic agonists that
euphoria. preoperativ upil constriction, have established
e impaired mental pediatric dosage guid
medication; processes elines are codeine,
component  GI: nausea, fentanyl (except
of vomiting, constip transdermal),
combinatio ation, biliary hydrocodone,
n therapy spasm meperidine, and
for severe  GU: ureteral morphine only.
chronic spasm, urinary  Naloxone is the
pain; retention, antidote for narcotic
intraspinal hesitancy, loss of overdose and
to reduce libido reversal of narcotic
intractable  Others: effects.
pain. sweating, Adults
physical and  They should be
psychological informed and
Narcotic analgesics dependence reassured that
 Narcotic-induced associated abuse with
respiratory the use of narcotics in
center acute pain is remote.
depression: respi  They should be
ratory educated about the
depression importance of asking
with apnea, for pain medication
cardiac arrest, before the pain
shock becomes acute.
 Caution is advised for
pregnant and
lactating women
because of potential
adverse effects to the
fetus and the baby.
 Narcotics used
in labor include morp
hine,
meperidine, and oxy
morphone.
 All narcotic agonists
are pregnancy
 category B
except oxycodone (ca
tegory C) so it might
be the drug of choice
if one is needed
during pregnancy.
Older adults
 They are more
susceptible to drug
adverse effects
because of existing
medical conditions.
 Safety measures
should be established
(side rails, call light,
assistance to
ambulate).

Narcotic Agonists-  Relief of  CNS: light-  Assess for mentioned

Antagonists: moderate to headedness, cautions and
Stimulate certain severe pain; dizziness, contraindications
opioid receptors preanesthetic psychoses, (e.g. drug allergy,
but block other medication anxiety, fear, respiratory
such receptors. and a hallucinations, dysfunction, myocard
They exert similar supplement pupil ial infarction and
analgesic effect to constriction, CAD, hepatorenal
with that of surgical anest impaired mental dysfunction, etc.) to
morphine but hesia processes prevent untoward
they have less  May be  GI: nausea, complications.
potential desirable for vomiting,  Conduct pain
for abuse. relieving constipation, assessment with
However, they chronic pain biliary spasm patient to establish
are associated in patients  GU: ureteral baseline and evaluate
with more who are spasm, urinary effectiveness of drug
psychotic like susceptible to retention, therapy.
reactions. narcotic hesitancy, loss of  Perform thorough
dependence. libido physical (CNS, vital
 Others: signs, bowel sounds,
sweating, urine output) to
physical and establish baseline
psychological status before
dependence beginning therapy,
 Narcotic-induced determine drug
respiratory effectiveness and
center evaluate for any
depression: respi potential adverse
ratory effects.
depression with  Monitor laboratory
apnea, suppressi results (liver function,
on of cough refle kidney function) to
x determine need for
possible dose
adjustment and
identify toxic drug
effects.
 Perform baseline and
periodic pain
assessments with
patient to monitor
drug effectiveness
and provide
appropriate changes
in pain management
protocol as needed.
 Have a narcotic
antagonist and
equipment for
assisted ventilation re
adily available when
administering this
drug IV to provide
patient support in
case of severe
reaction.
 Monitor timing of
analgesic doses.
Prompt
administration may
provide a more
acceptable level of
analgesia and lead to
a quicker resolution
of the pain.
 Provide non-
pharmacological pain
measures like
breathing exercises,
back rubs, and stress
reduction to increase
drug effectiveness
and reduce pain.
 Provide comfort
measures (e.g. small,
frequent meals for GI
upset) to help patient
tolerate drug effects.
  Provide safety
measures (e.g.
adequate lighting,
raised side rails, etc.)
to prevent injuries.
 Educate client on
drug therapy to
promote
understanding and
compliance.
 Monitor patient
response to therapy
(relief of pain,
sedation).
 Monitor for adverse
effects (e.g. GI
depression,
respiratory
depression,
arrhythmias, etc).
 Evaluate patient
understanding on
drug therapy by
asking patient to
name the drug, its
indication, and
adverse effects to
watch for.
 Monitor patient
compliance to drug
therapy.

Narcotic  Indicated for  CNS: excitement,  Assess for mentioned

Antagonists: complete or reversal of cautions and
Bind strongly to partial analgesia contraindications
opioid receptors reversal of  CV: (e.g. drug allergy,
without causing narcotic tachycardia, bloo history of narcotic
receptor depression; d pressure addiction, myocardial
activation. They diagnosis of changes, infarction, etc.) to
block opioid suspected dysrhythmias, prevent untoward
receptor effects opioid pulmonary complications.
as well as effects overdose. edema  Conduct pain
of too much  Acute assessment with
opioids in the narcotic abstinen patient to establish
system. ce syndrome: na baseline and evaluate
usea, vomiting, effectiveness of drug
sweating, therapy.
tachycardia, hyp  Perform thorough
ertension, physical (neurological
tremulousness, status, respiratory
feelings of rate and rhythm, vital
anxiety. signs) to establish
A naloxone baseline status before
challenge should beginning therapy,
be administered determine drug
before giving effectiveness and
naltrexone to evaluate for any
help to avoid potential adverse
acute reactions. effects.
 Obtain an
electrocardiogram as
appropriate to
evaluate for cardiac
effects.
 Maintain open airway
and provide artificial
ventilation and
cardiac massage as
needed to support
the patient.
 Administer
vasopressors as
ordered and as
needed to manage
narcotic overdose.
 Administer naloxone
challenge before
giving naltrexone
because of the
serious risk of acute
withdrawal.
 Provide comfort
measures to help
patient cope with
withdrawal
syndrome.
 Provide safety
measures (e.g.
adequate lighting,
raised side rails, etc.)
to prevent injuries.
 Ensure that patients
receiving naltrexone
have been narcotic-
free for 7-10 days to
prevent severe
 withdrawal
syndrome.
 Educate client on
drug therapy to
promote
understanding and
compliance.
 Monitor patient
response to therapy
(reversal of opioid
effects, treatment of
alcohol dependence).
 Monitor for adverse
effects (e.g. CV
changes, arrhythmias,
hypertension, etc).
 Evaluate patient
understanding on
drug therapy by
asking patient to
name the drug, its
indication, and
adverse effects to
watch for.
 Monitor patient
compliance to drug
therapy.

Ergot derivatives:  Ergot  CNS: numbness, Children

Decrease the derivatives ar tingling of  Both classes are not
pulsation of e indicated extremities, mus recommended for
cranial arteries for the cle pain children.
and cause prevention  CV:  Ergot derivatives
constriction of or abortion of pulselessness, have a lot of adverse
cranial blood migraine or weakness, chest effects and there is
vessels by vascular pain, arrhythmia, no sufficient clinical
blocking alpha- headaches. Er localized edema experience to prove
adrenergic and gotamine was and itching, MI that triptans can be
Antimigraine drugs
serotonin- the drug of  Direct recommended for
receptor sites. As choice for stimulation of children’s use.
a result, the migraines CTZ: GI upset, Adults
hyperperfusion of before nausea,
the basilar artery triptans were vomiting, diarrhe  Careful assessment of
developed. a headache should be
vascular bed is
 Ergotism: done before
reduced.
nausea, antimigraine agents
vomiting, severe can be indicated.
thirst,
 hypoperfusion,  Both classes are
chest pain, blood contraindicated to
pressure change pregnancy and
s, confusion, lactation.
drug Older adults
dependency,
drug withdrawal  They are more likely
syndrome to have their chronic
conditions be
exacerbated by
antimigraine agents
so utilization with
extreme caution is
exercised.
 The dose should be
the least amount
possible and safety
precautions are
extremely important.

Triptans:  Triptans are  CNS: numbness,  Assess

A relatively new indicated for tingling, burning aforementioned
antimigraine agent the treatment sensation, cautions and
that causes cranial of acute feelings of contraindications
vascular migraine and coldness or (e.g. drug allergy,
constriction and are not used strangeness, history of myocardial
relief of migraine for dizziness, infarction and CAD,
headache pain. prevention of weakness, hepatorenal
They do this by migraines.  myalgia, vertigo dysfunction, etc.) to
binding to  CV: blood prevent untoward
serotonin pressure complications.
receptors. alterations,  Perform thorough
tightness or physical (neurological
pressure in the status, vital signs, etc)
chest to establish baseline
 GI: dysphagia, status before
abdominal beginning therapy,
discomfort determine drug
effectiveness and
evaluate for any
potential adverse
effects.
 Monitor laboratory
test results (liver,
kidney function tests)
to determine need
for dose adjustment
 and identify possible
toxic effects.
 Administer drug to
relieve acute
migraines (at first sign
of headache) and not
to prevent migraine
because these are not
indicated for
prevention.
 Monitor for
complaints of
extremity numbness
and tingling to
identify effects on
vascular constriction.
 Provide comfort
measures to help
patient cope with
withdrawal
syndrome.
 Provide safety
measures (e.g.
adequate lighting,
raised side rails, etc.)
to prevent injuries.
 Educate client on
drug therapy to
promote
understanding and
compliance.
 Monitor patient
response to therapy
(relief of acute
migraine headache).
 Monitor for adverse
effects (e.g. CV
changes, arrhythmias,
hypertension, etc).
 Evaluate patient
understanding on
drug therapy by
asking patient to
name the drug, its
indication, and
adverse effects to
watch for.
 Monitor patient
 compliance to drug
therapy.

ACTIVITY 14.2.
Drugs affecting the Mechanism of Indications Adverse Effects Important Nursing
ANS Action Considerations
Nicotinic agonist Nicotine binds to Nicotine Discontinue use Nicotine is a hazardous
and activates patches are and call provider if: drug; use safe handling
nicotinic used as an aid and disposal
acetylcholine to smoking -Allergic reaction precautions. Apply one
receptors, cessation and such as difficulty new patch every 24
mimicking the for the relief of breathing or rash hours on skin that is
effect of nicotine -Irregular dry, clean, and hairless.
acetylcholine at withdrawal heartbeat or Remove backing from
these receptors. signs and palpitations patch and immediately
symptoms as -Symptoms of press onto skin. Hold for
part of a nicotine overdose 10 seconds. Wash
comprehensive such as nausea, hands after applying or
behavioral vomiting, dizziness, removing the patch.
smoking weakness, and Save pouch to use for
cessation rapid heartbeat patch disposal. Dispose
program of the used patches by
folding sticky ends
together and putting in
pouch. The used patch
should be removed and
a new one applied to a
different skin site at the
same time each day. Do
not wear more than one
patch at a time.
Discontinue use and call
provider if an allergic
reaction occurs, such as
difficulty breathing or
rash, or symptoms of
nicotine overdose
occur, such as nausea,
vomiting, dizziness,
weakness, and rapid
heartbeat.  It may also
cause vivid dreams or
sleep disturbances.  If
these occurrences
occur, patients should
 be counseled to remove
the patch at bedtime
and apply a new one in
the morning.
Pilocarpine: Used to treat Caution with night Remove contact lens
Causes the ciliary glaucoma. driving. before administration.
muscle to Apply light finger
contract, allowing pressure on lacrimal sac
for the drainage for 2 minutes after
Parasymphatho- of aqueous instilling to minimize
mimetics/ humor from the systemic absorption.
muscarinic agonists anterior chamber
of the eye and
reducing
intraocular
pressure related
to glaucoma.
Specific Varying dosages Immediately report As with all
anticholinergic are used symptoms of anticholinergics, use
responses are preoperatively overdose: with caution with the
dose-related. to diminish elderly, because elderly
Small doses of secretions, to urine retention, patients may react with
atropine inhibit stimulate the abnormal agitation or drowsiness.
salivary and heart rate in heartbeat, Heat stroke may occur
bronchial conditions dizziness, passing in the presence of high
secretions and causing out, difficulty temperatures.
sweating. bradycardia, or breathing, Immediately report
Moderate doses to treat weakness, or symptoms of overdose:
dilate the pupil, muscarinic tremors urine retention,
Anticholinergics/
inhibit symptoms of abnormal heartbeat,
muscarinic
accommodation, insecticide dizziness, passing out,
antagonists
and increase the (organophosph difficulty breathing,
heart rate orus or weakness, or tremors.
(vagolytic effect). carbamate) Physostigmine has been
Large doses poisoning or used to reverse
decrease motility mushroom anticholinergic effects.
of the poisoning.
gastrointestinal
and urinary
tracts, and very
large doses will
inhibit gastric
acid secretion.