Nurses Compass
Drug Guide
Pentolinium Tartrate
Classification
Therapeutic: To be specified as it's an older agent, likely used as an antihypertensive or in anesthesia practice.
Pharmacological: Nicotinic acetylcholine receptor antagonist, ganglionic blocking agent.
FDA Approved Indications
- Historical uses include control of hypertension during surgery, but largely discontinued due to adverse effects and availability of safer agents.
Mechanism of Action
Pentolinium Tartrate blocks nicotinic receptors at autonomic ganglia, leading to blockade of sympathetic and parasympathetic ganglia, resulting in decreased autonomic reflexes and lowering blood pressure.
Dosage and Administration
Adult: Dosing varies; typically administered intravenously under medical supervision. Precise dosing should follow specific clinical protocols.
Pediatric: Limited data; usage generally not recommended due to safety concerns.
Geriatric: Careful monitoring required due to increased sensitivity and risk of adverse effects.
Renal Impairment: Adjustments not well-established; caution advised.
Hepatic Impairment: No specific adjustments; caution due to altered drug metabolism.
Pharmacokinetics
Absorption: Not applicable; administered parenterally.
Distribution: Widely distributed after IV administration.
Metabolism: Metabolized in the liver.
Excretion: Excreted primarily via the kidneys.
Half Life: Short, typically around 15-30 minutes; effects are rapid and transient.
Contraindications
- Known hypersensitivity to pentolinium or other ganglionic blockers.
- Severe aortic stenosis.
Precautions
- Use with caution in patients with cardiovascular disease, cerebral vascular disease, or prostate hypertrophy. Monitor blood pressure closely during administration.
Adverse Reactions - Common
- Orthostatic hypotension (Common)
- Reflex tachycardia (Common)
- Dry mouth, blurred vision, urinary retention (Less common)
Adverse Reactions - Serious
- Severe hypotension leading to shock (Rare)
- Arrhythmias (Rare)
- Gastrointestinal bleeding or colitis (rare) (Rare)
Drug-Drug Interactions
- Other antihypertensives may cause additive effects.
- Caution with agents affecting cardiac conduction.
Drug-Food Interactions
- Less relevant due to parenteral use.
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood pressure and heart rate regularly. Watch for signs of hypotension or excessive vagal blockade.
Diagnoses:
- Risk for hypotension
- Impaired cardiovascular function
Implementation: Administer under strict medical supervision. Prepare for potential emergency intervention if severe adverse reactions occur.
Evaluation: Assess blood pressure response and adverse effects; adjust dosage accordingly.
Patient/Family Teaching
- Inform about potential side effects such as dizziness, orthostatic hypotension.
- Advise to change positions slowly.
- Report symptoms like dizziness, fainting, or irregular heartbeats immediately.
Special Considerations
Black Box Warnings:
- No current black box warnings; however, caution is advised due to dangerous hypotension and reactions.
Genetic Factors: None known.
Lab Test Interference: May alter blood pressure readings; monitor closely.
Overdose Management
Signs/Symptoms: Severe hypotension, bradycardia, shock, arrhythmias.
Treatment: Supportive care, intravenous fluids, vasopressors if needed, atropine for bradycardia, and immediate emergency intervention.
Storage and Handling
Storage: Store at room temperature, protected from light and moisture.
Stability: Stable when stored properly, but consult product specifics.