Nursing Implications for Sanctura Trospium Chloride

Trospium Chloride (tro-spi′um)

Sanctura, Sanctura XR

Classifications: ANTICHOLINERGIC; ANTIMUSCARINIC; ANTISPASMODIC

Therapeutic: URINARY SMOOTH MUSCLE RELAXANT

Prototype: Oxybutynin

Pregnancy Category: C

AVAILABILITY

Tablet; capsule

ACTION & THERAPEUTIC EFFECT

Antagonizes the effect of acetylcholine on muscarinic receptors in smooth muscle. Its parasympatholytic action reduces tonus of the smooth muscle of the bladder. Decreases urinary frequency, urgency, and urge incontinence in patients with overactive bladders.

USES

Treatment of overactive (neurogenic) bladder, urinary incontinence.

CONTRAINDICATIONS

Hypersensitivity to trospium; patients with or at risk for urinary retention; uncontrolled narrow-angle glaucoma; gastric retension, GI obstruction, ileus, pyloric stenosis, toxic megacolon, severe ulcerative colitis.

CAUTIOUS USE

Significant bladder obstruction, closed-angle glaucoma; BPH; ulcerative colitis, GERD, intestinal atony; myasthenia gravis, autonomic neuropathy; moderate or severe hepatic dysfunction; severe renal insufficiency, renal failure; older adults; pregnancy (category C), lactation. Safety in children has not been established.

ROUTE & DOSAGE

Overactive Bladder

Adult: PO 20 mg twice daily OR Extended release: 60 mg daily

Geriatric (75 y or older): PO 20 mg once daily at bedtime if anti-cholinergic adverse effects are intolerable

Renal Impairment Dosage Adjustment

CrCl less than 30 mL/min:

Immediate release: 20 mg once daily at bedtime

Nursing Implications for Sanctura Trospium Chloride

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ADMINISTRATION

Oral

• Give at least 1 h before meals or on an empty stomach.
• Store at 20°–25° C (66°–77° F).

ADVERSE EFFECTS (≥1%)

Body as a Whole: Fatigue, dry skin. CNS: Headache. GI: Dry mouth, constipation, abdominal pain, dyspepsia, flatulence, vomiting. Special Senses: Dry eyes, blurred vision. Urogenital: Urinary retention, urinary tract infection.

INTERACTIONS

Drug: Increased anticholinergic adverse effects with ANTICHOLINERGIC AGENTS.

PHARMACOKINETICS

Absorption: Less than 10% absorbed orally. Peak: 5–6 h. Elimination: Primarily in feces. Half-Life: 20 h.

Nursing Implications

Assessment & Drug Effects

• Monitor bowel and bladder function. Report urinary hesitancy or significant constipation.
• Withhold drug and notify prescriber if urinary retention develops.
• Monitor for and report worsening of GI symptoms in those with GERD.

Patient & Family Education

• Report promptly any of the following: Signs of an allergic reaction, (e.g., itching or hives), blurred vision or difficulty focusing, confusion, dizziness, difficulty passing urine.
• Moderate intake of tea, coffee, caffeinated sodas, and alcohol to minimize side effects of this drug.
• Avoid situations in which overheating is likely, as drug may impair sweating, which is a normal cooling mechanism. Do not engage in hazardous activities until response to the drug is known.

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Ditulis oleh Unknown pada tanggal Saturday, August 29, 2015