A client is taking cyclobenzaprine (Flexeril) for acute muscle spasms of the back. The nurse educates the client on which possible anticholinergic side effects associated with this medication? (Select all that apply)
Decreased Urination
Diarrhea
Dry Mouth
Tachycardia
Excessive Lacrimation
Excessive Sweating
Correct Answer : A,C,D
A. Decreased urination is an anticholinergic side effect due to the medication's action on the bladder.
B. Diarrhea is not an anticholinergic side effect; in fact, anticholinergics typically cause constipation.
C. Dry mouth is a common anticholinergic side effect, resulting from reduced saliva production.
D. Tachycardia can occur as an anticholinergic effect due to decreased vagal tone.
E. Excessive lacrimation is not associated with anticholinergic effects; it is the opposite, as anticholinergics usually lead to dry eyes.
F. Excessive sweating is contrary to anticholinergic effects, which often result in decreased sweating.
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Correct Answer is C
Explanation
A. Anaphylaxis is not a common side effect of montelukast.
B. Regular blood monitoring is not required with montelukast.
C. Montelukast is a leukotriene receptor antagonist, used for long-term management of asthma and to prevent exercise-induced bronchoconstriction.
D. Montelukast is not intended for immediate relief or repeated dosing in acute situations.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.