Cogentin


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Cogentin

 [ko-jen´tin]
trademark for preparations of benztropine mesylate, an antidyskinetic.

benztropine mesylate

Apo-Benztropine (CA), Cogentin, PMS Benztropine (CA)

Pharmacologic class: Anticholinergic

Therapeutic class: Antiparkinsonian

Pregnancy risk category C

Action

Inhibits cholinergic excitatory pathways and restores balance of dopamine and acetylcholine in CNS, thereby decreasing excess salivation, rigidity, and tremors (parkinsonian symptoms)

Availability

Injection: 1 mg/ml in 2-ml ampules

Tablets: 0.5 mg, 1 mg, 2 mg

Indications and dosages

Parkinsonism

Adults: Initially, 1 to 2 mg/day P.O. or I.M. at bedtime or in two or four divided doses. Dosage range is 0.5 to 6 mg/day.

Acute dystonic reactions

Adults: Initially, 1 to 2 mg I.M. or I.V., then 1 to 2 mg P.O. b.i.d.

Drug-induced extrapyramidal reactions (except tardive dyskinesia)

Adults: 1 to 4 mg P.O. or I.M. once or twice daily

Dosage adjustment

• Elderly patients

Off-label uses

• Excessive salivation

Contraindications

• Hypersensitivity to drug
• Angle-closure glaucoma
• Tardive dyskinesia
• Children younger than age 3

Precautions

Use cautiously in:
• seizure disorders, arrhythmias, tachycardia, hypertension, hypotension, hepatic or renal dysfunction, alcoholism, prostatic hypertrophy
• elderly patients
• pregnant or breastfeeding patients.

Administration

• Give after meals to prevent GI upset.
• Crush tablets if patient has difficulty swallowing them.
• Know that I.V. route is seldom used.
• Be aware that entire dose may be given at bedtime. (Drug has long duration of action.)

Adverse reactions

CNS: confusion, depression, dizziness, hallucinations, headache, weakness, memory impairment, nervousness, delusions, euphoria, paresthesia, sensation of heaviness in limbs, toxic psychosis

CV: hypotension, palpitations, tachycardia, arrhythmias

EENT: blurred vision, diplopia, mydriasis, angle-closure glaucoma

GI: nausea, constipation, dry mouth, ileus

GU: urinary hesitancy or retention, dysuria, difficulty maintaining erection

Musculoskeletal: paratonia, muscle weakness and cramps

Skin: rash, urticaria, decreased sweating, dermatoses

Interactions

Drug-drug.Antacids, antidiarrheals: decreased benztropine absorption

Antihistamines, bethanechol, disopyramide, phenothiazines, quinidine, tricyclic antidepressants: additive anticholinergic effects

Drug-herbs.Angel's trumpet, jimsonweed, scopolia: increased anticholinergic effects

Drug-behaviors.Alcohol use: increased sedation

Patient monitoring

• Monitor blood pressure closely, especially in elderly patients.
• Monitor fluid intake and output; check for urinary retention.
• Assess for signs and symptoms of ileus, including constipation and abdominal distention.

Patient teaching

• Advise patient to use caution during activities that require physical or mental alertness, because drug causes sedation.
• Tell patient to avoid increased heat exposure.

Caution patient not to stop therapy abruptly.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

Cogentin

a trademark for an antiparkinson drug (benztropine mesylate).

benztropine

An anticholinergic used to manage parkinsonism, Parkinson’s disease and dystonia.
 
Adverse effects
In high doses can cause nervousness, impaired memory, numbness, listlessness, depression, confusion, excitement, and hallucinations; GI symptoms include dry mouth, constipation, nausea, vomiting, blurred vision, mydriasis, hyperthermia, anhidrosis, urinary retention, dysuria, weakness, rash and tachycardia.

Cogentin

A brand name for BENZTROPINE (benzatropine).
References in periodicals archive ?
Upon discharge, Andrea has prescriptions for 150 mg of Wellbutrin twice daily, 75 mg of Effexor twice daily, 2 mg of Cogentin once daily, and 5 mg of Haldol once daily.
Two were prescribed both Haldol and Cogentin (along with either Prozac or clonidine).
Antiparkinsonism Agents -- L-DOPA, Sinemet, Symmetrel, Cogentin, Artane, Kemadrin, Benadryl, Akineton, Parlodel, Permax, Eldepryl
These patients truly like Cogentin and the other anticholinergics, and they will abuse them.
Benzodiazepines, for example, may have higher anticholinergic activity than Cogentin [benztropine mesylate]," he said.