bethanechol chloride

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bethanechol chloride

Duvoid (CA), Myotonachol (CA), Myotonine (UK), PMS-Bethanecol Chloride (CA), Urecholine

Pharmacologic class: Cholinergic

Therapeutic class: Urinary and GI tract stimulant

Pregnancy risk category C

Action

Stimulates parasympathetic nervous system and cholinergic receptors, leading to increased muscle tone in bladder and increased frequency of ureteral peristaltic waves. Also stimulates gastric motility, increases gastric tone, and restores rhythmic GI peristalsis.

Availability

Tablets: 5 mg, 10 mg, 25 mg, 50 mg

Indications and dosages

Postpartal and postoperative non-obstructive urinary retention; urinary retention caused by neurogenic bladder

Adults: 10 to 50 mg P.O. three to four times daily; dosage may be determined by giving 5 or 10 mg q hour until response occurs or a total of 50 mg has been given.

Contraindications

• Hypersensitivity to drug

• GI or GU tract obstruction

• Hyperthyroidism

• Active or latent asthma

• Bradycardia

• Hypotension

• Atrioventricular conduction defects

• Coronary artery disease

• Seizure disorders

• Parkinsonism

• Peptic ulcer disease

Precautions

Use cautiously in:

• sensitivity to cholinergics or their effects and tartrazine (some products)

• pregnant or breastfeeding patients

• children.

Administration

• Give drug on empty stomach 1 hour before or 2 hours after a meal to help prevent nausea and vomiting.

Adverse reactions

CNS: headache, malaise, seizures

CV: bradycardia, hypotension, heart block, syncope with cardiac arrest

EENT: excessive lacrimation, miosis

GI: nausea, vomiting, diarrhea, abdominal discomfort, belching

GU: urinary urgency

Respiratory: increased bronchial secretions, bronchospasm

Skin: diaphoresis, flushing

Other: hypothermia

Interactions

Drug-drug. Anticholinergics: decreased bethanechol efficacy

Cholinesterase inhibitors: additive cholinergic effects

Depolarizing neuromuscular blockers: decreased blood pressure

Ganglionic blockers: severe hypotension

Procainamide, quinidine: antagonism of cholinergic effects

Drug-herbs. Angel's trumpet, jimson-weed, scopolia: antagonism of cholinergic effects

Patient monitoring

• Monitor blood pressure. Be aware that hypertensive patients may experience sudden blood pressure drop.

• Stay alert for orthostatic hypotension, a common adverse effect.

• Monitor fluid intake and output and residual urine volume.

Patient teaching

• Tell patient that drug is usually effective within 90 minutes of administration.

• Advise patient to take drug on empty stomach 1 hour before or 2 hours after a meal to avoid GI upset.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from blood pressure decrease.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

bethanechol chloride

(bĕ-thăn′ĭ-kôl′)
n.
A cholinergic drug that acts principally by stimulating the parasympathetic nervous system and is used in the form of its chloride to treat urinary retention.

bethanechol chloride

A cholinergic agent with muscarinic effects, which stimulates the parasympathetic system, increasing smooth muscle activity of the gastrointestinal (GI) and genitourinary (GU) tracts.
 
Indications
GI and GU atony—e.g., neurogenic bladder, atony of stomach after vagotomy, postoperative gastric retention, acute postoperative and postpartum urinary retention, reflux esophagitis, GERD/GORD.

Adverse effects
Dizziness, lightheadedness, nausea, vomiting, abdominal pain, diarrhoea, increased saliva, urinary urgency, sweating, flushing, watery eyes, or headache.

bethanechol chloride

Urecholine A cholinergic agent with muscarinic effects, which stimulates smooth muscle activity of the GI and GU tracts Indications Gi and GU atony–eg, neurogenic bladder, atony of stomach after vagotomy, postoperative gastric retention, acute postoperative and postpartum urinary retention, reflux esophagitis, GERD

pilocarpine 

An alkaloid obtained from the leaves of Pilocarpus microphyllus and other species of Pilocarpus. It is a parasympathomimetic (direct-acting cholinergic) drug, which mimics the effect of acetylcholine causing miosis and accommodation. It counteracts sympathomimetic mydriatics. It is used in the treatment of glaucoma. Pilocarpine hydrochloride is most commonly applied to the eye as a 1% solution. Carbachol and bethanechol chloride are other parasympathomimetic drugs with similar effects to pilocarpine. See parasympathomimetic drug; physostigmine.