Artane

trihexyphenidyl

Artane

Indications

Action

Pharmacokinetics

Time/action profile (antiparkinson effects)

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• dizziness (most frequent)
• nervousness (most frequent)
• confusion
• drowsiness
• headache
• psychoses
• weakness

Ear, Eye, Nose, Throat

• blurred vision (most frequent)
• mydriasis (most frequent)

Cardiovascular

• orthostatic hypotension
• tachycardia

Gastrointestinal

• dry mouth (most frequent)
• nausea (most frequent)
• constipation
• vomiting

Genitourinary

• urinary hesitancy
• urinary retention

Dermatologic

• decreased sweating

Interactions

Drug-Drug interaction

Route/Dosage

Availability (generic available)

Nursing implications

Nursing assessment

• Assess parkinsonian and extrapyramidal symptoms (restlessness or desire to keep moving, rigidity, tremors, pill rolling, mask-like face, shuffling gait, muscle spasms, twisting motions, difficulty speaking or swallowing, loss of balance control) prior to and throughout therapy.
• Monitor intake and output ratios and assess patient for urinary retention (dysuria, distended abdomen, infrequent voiding of small amounts, overflow incontinence).
• Patients with mental illness are at risk of developing exaggerated symptoms of their disorder during early therapy with this medication. Withhold drug and report significant behavioral changes.

Potential Nursing Diagnoses

Implementation

• Oral: Usually administered after meals. May be administered before meals if patient suffers from dry mouth or with meals if gastric distress is a problem. Use calibrated measuring device to ensure accurate dose of elixir.

Patient/Family Teaching

• Instruct patient to take this drug exactly as directed. If a dose is missed, take as soon as remembered, unless next scheduled dose is within 2 hr; do not double doses.
• Medication should be tapered gradually when discontinuing or a withdrawal reaction may occur (anxiety, tachycardia, insomnia, return of parkinsonian or extrapyramidal symptoms).
• May cause drowsiness or dizziness. Advise patient to avoid driving or other activities that require alertness until response to medication is known.
• Caution patient to change positions slowly to minimize orthostatic hypotension.
• Instruct patient that frequent rinsing of mouth, good oral hygiene, and sugarless gum or candy may decrease dry mouth. Patient should notify health care professional if dryness persists (saliva substitutes may be used). Also, notify the dentist if dryness interferes with use of dentures.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially cold remedies, or drinking alcoholic beverages.
• Caution patient that this medication decreases perspiration. Overheating may occur during hot weather. Patient should remain indoors, in an air-conditioned environment, during hot weather.
• Advise patient to increase activity and bulk and fluid in diet to minimize constipating effects of medication.
• Advise patient to avoid taking antacids or antidiarrheals within 1–2 hr of this medication.
• Advise patient to notify health care professional if confusion, rash, urinary retention, severe constipation, or visual changes occur.
• Emphasize the importance of routine follow-up exams.

Evaluation/Desired Outcomes

• Decrease in tremors and rigidity and an improvement in gait and balance. Therapeutic effects are usually seen 2–3 days after the initiation of therapy.
• Resolution of drug-induced extrapyramidal symptoms.