Question

Anticholinergics Drugs (atropine)., Jane Clark a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets "very seasick" whenever she is on a boat. She calls her doctor's office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm Scop) 1. Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch? The nurse provides patient education, and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship 2. That evening, J. and L. go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first night-of-the-cruise celebration. How should J. respond? 3. The next morning, while out on the deck, L. and J. are taking pictures of the bright, snow-covered shoreline views L. looks at J. and exclaims, "Look at your eyes! Is that a side effect of that patch?" What has L. noticed about J.'s blue eyes? What would you suggest for J. because of what L. has noticed? 4. Later that day, J. tells L., "T'm feeling great! I don't think I need this patch. I'm going to take it off, but I'll save it for later in case I get nauseated." Is this a good idea? Explain your answer

Answer 1

1. Contraindication to scopolamine patch:

• Allergic to Belladonna alkaloids.
• patient with open-angle or wide angle glaucoma
• patient with a mental disorder
• Pregnancy with hypertension
• Liver disorder
• Reduced kidney function
• seizures.

2. J should avoid taking champagne because she is on scopolamine patch. Intake of alcohol-related products interfere with this drug and produce a serious effect on the central nervous system. So she should respond as No.

3. MR. L may notice redness on J's eye. This is one of the side effects of the scopolamine patch which happens due to the long acting effect of the drug on the eye. This will be back to normal. She can consult with an ophthalmologist if needed.

4. No. this is not the right idea. Sudden discontinuation of this medication may produce drug withdrawal symptoms such as nausea, dizziness, vomiting, mental confusion, abdominal cramps, hypotension, and disequilibrium in balance. So she should follow the physician order and advice before discontinuing this medication.