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DRUG STUDY

GENERIC NAME: benztropine TRADE NAME: Cogentin CLASSSIFICATION: Antiparkenson agent ACTION: Blocks cholinergic activity in the CNS, which is partially responsible for the symptoms of Parkinson's disease. Restores the natural balance of neurotransmitters in the CNS. Therapeutic Effects- Reduction of rigidity and tremors. PHARMACOKENETICS Absorption: well absorbed. Distribution: unknown Metabolism and Excretion: unknown Half-life: unknown CONTRAINDICATIONS\PRECAUTIONS Contraindicated in: Hypersensitivity. Narrow-angle glaucoma. Tardive dyskinesia. Use Cautiously in: Geriatric patients. Prostatic Hypertension, Seizure disorder. ADVERSE REACTIONS\SIDE EFFECTS CNS: confusion,depression, dizziness, headache sedation, weakness,EENT: blurred vision,dry eyes, mydriasis CV: arrhythmias, hupotension, palpitations, GI: cconsitpation, dry mouth, nausea. GU: urinary hesitancy, urinary retention. MISC: decreased sweating. INTERACTIONS Drug-drug: additive anticholinergic effects with drugs sharing same properties, such as antihistamines, phenothiazines, quinidine, disopyramid, and tricyclic antidepressants. Antacides and antidiarrheals may decrease absorption. Drug-natural Products: increased anticholinergic effect with angel's trumpet and scopolia. NURSING IMPLICATIONS OF DRUG ADMINISTRATION

Prior to administration of Medication: Assessment •Obtain complete health history including allergies, drug history and possible drug interactions. •Obtain baseline of severity of Parkenson's symptoms to determine effectivness of medication (restlessness, rigidity, tremor, mask like face, shuffling gait, muscle spasms, loss of balance control) •Assess for use of other medications. •Obtain labwork to include a complete blood count, liver and real funtion studies. •Obtain baseline vital signs, especially pulse. •Monitor intake and output ratio and assess patient for urinary retention. •Assess bowel function daily. Monitor for constipation. •Assess for behavioral changes. Potential nursing Diagnosis •risk for Constipation related to side effects of drug •risk for injury, related to effects of drug •risk for Imbalanced Body Temperature •risk for Urinary Retention side effect of drug Planning Patient will •Demonstrate and understanding of the drug's action by accurately decribing drug side effects and precautions, and measures to take to decrease side effects. •Maintain compliance with drug regimem. •Maintain normal bowel pattern. •Immediately report and occurrence of adverse reactions.
Implementation

•Administer with food or immediately after meals to minimize gastric irritation. •Monitor patients ability to void. (Benztropine can cause urinary retention) •Monitor environmental temperature. ( Patient will have decreased tolerence to heat and could develop heat stroke). Patient Teaching •to take benztropine as ordered, unless side effects occur, then notify health care provider •advise patient to avoid strenuous activity in hot weather, to plan rest periods, to decrease risk of heat stroke •instruct patient to report infrequent voiding and to keep a record in intake and output if voiding pattern off. •Instruct patient to disclose any history of psychiatric problems. •may cause drowsiness or dizziness, advise patient to avoid driving until alert. •instruct patient to use good dental hygiene as this med.may causes dry mouth. •Caution patient to change positions slowly to minimize orthostatic hypotension. •advise patient to avoid taking antacids or anti diarrheals with 1-2 hr of this medication. •caution patient concerning the use of OTC and to check with the a professional before taking, especially cold medications or sleep aids. •caution patient this medication decreases perspiration. Overheating is to be avoided. Evaluation •decreased in tremors and rigidity and an improvement in gait and balance. Therapeutic effects are usually seen 2-3 days after the initiation of theraphy.