Question

Which of these doses would the nurse question?

		Bethanechol 20mg orally T.I.D. for urine retention
		Atropine 0.5mg Intravenous, PRN bradycardia (may repeat x 1)
		Adrenalin 0.2mg (0.2 mL of 1:1000 solution) subcutaneously PRN allergic wheezing (may repeat x 1)
		Atenolol 100mg Q.I.D. orally for angina

Answer 1

bethanechol is a drug used to stimulate bladder to empty and to treat urinary infection occur postoperatively, postnatally and in other situation.

a normal adult can take 10 to 50 mg 3 to 4 times per day.

side effects:

• shortness of breath, wheezing or chest tightness.
• nausea and vomiting
• headache
• increased watering of mouth or sweating

so, it is justifiable to administer 20 mg TID for urinary retention

Atropine is a life-saving drug which completely inhibits the action of acetylcholine on autonomic effectors innervated by postganglionic nerves; inhibits bradycardia.

its peak plasma time is 3 minutes and has rapid action.

for, sinus bradycardia it is advisable 0.5 -1 mg intravenously every 5 minutes, but no more than 3 mg.

Adrenaline elicits agonistic action on alpha,beta-2 and beta-2 receptors resulting in bronchial smooth muscle relaxation.

it has a sudden onset of action and route of administration for wheezing is only through inhalation or nebulizer. and doses would be 11.25mg/0.5ml for adults.

it is questionable about the dose and route of action.

Atenolol is a beta-blocker that affects the heart and circulation. it is mainly used to reduce the risk of death after a heart attack.

atenolol can take up to 200 mg per day

so, the route of administration and dose of adrenaline for wheezing should be questioned.