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CHAPTER 18 Gastrointestinal System

Anticholinergic
Use

Prevention and treatment of

nausea, vomiting, vertigo due to
motion sickness. Treatment of
vertigo associated with diseases
affective vestibular system.

Example

Meclizine
(Antivert)

How it works

Route:
PO

Half-life:
6h

Pregnancy
category: B

Onset:
3060 min

Peaks:
10 h

Duration:
1224 h

Pharmacokinetic:
Well absorbed from GI tract; widely
distributed; metabolized in liver.

Reduces labyrinth excitability, diminishes vestibular stimulation

of labyrinth, affecting chemoreceptor trigger zone (CTZ),
reducing nausea, vomiting, vertigo. Anticholinergic activity.

Adult dose

Motion sickness: PO: 2550 mg 1 hour before travel.

Before administration

Assess medical and drug history.

Assess vital signs.

Administration

Give without regard to meals.

Scored tablets may be crushed; do not break or crush capsule
form.

After administration

Contraindications

Monitor B/P especially in elderly (increased risk for hypotension).

Monitor children closely for paradoxical response.
Monitor serum electrolytes in those with severe vomiting.
Assess skin turgor, mucous membranes to evaluate hydration
status.

None significant.
Cautions: Narrow-angle glaucoma, prostatic hypertrophy,
pyloroduodenal or bladder neck obstruction, asthma, COPD,
increased intraocular pressure, cardiovascular disease,
hyperthyroidism, hypertension, seizure disorders.

Side effects/
adverse reaction

Note: Elderly (>60 years) tend to develop sedation, dizziness,

hypotension, mental confusion, disorientation, agitation,
psychotic-like symptoms.

Frequent: drowsiness.
Occasional: Blurred vision, dry mouth, nose or throat.

CHAPTER 18 Gastrointestinal System

Anticholinergic (continued)
Side effects/
adverse reaction
(continued)

Children may experience dominant paradoxical reaction

(restlessness, insomnia, euphoria, nervousness, tremors).
Overdosage in children may result in hallucinations,
convulsions, death.

Hypersensitivity reaction (eczema, pruritus, rash,

cardiac disturbances, photosensitivity) may occur.

Overdose may vary from CNS depression (sedation, apnea,

cardiovascular collapse, death) to severe paradoxical reaction
(hallucinations, tremor, seizures).
Patient education

Tolerance to sedative effect may occur.

Avoid tasks that require alertness, motor skills until response to
drug is established.

Dry mouth, drowsiness, dizziness may be an expected response

of drug.

Avoid alcoholic beverages during therapy.

Sugarless gum, sips of tepid water may relieve dry mouth.
Coffee or tea may help reduce drowsiness.