Medication Name: Tolterodine Tartrate Pharmacologic Class: Anticholinergic, muscartinic receptor antagonist, bladder antispasmodic Mechanism of Action: Reduces urinary incontinence, urgency, and frequency. Therapeutic Action: Controls urinary bladder incontinence by controlling contractions. 3 Reasons ordered for patients: 1. Overactive bladder 2. rinary incontinence !. rinary urgency 3 ide effects: 1. "ry mouth 2. Constipation !. "ry eyes 3 Medication!food interactions: 1. Antibiotics including clarithromycin, cyclosporine, erythromycin, itracona#ole, and $etoconan#ole increase the effects of "etrol. 2. Additive cholinergic effects %ith amantadine, amo&apine, bupropion, clo#apine, cycloben#aprine, di'sopyramide, maprotilline, olan#apine, orphenadrine, ('1 bloc$ers, phenothia#ine, trycyclic antidepressants. !. )rapefruit *uice increases "etrol levels in some patients. 3 Nursing actions!administration: 1. Assess for voiding pattern and report to physician if the patient e&periences urinary retention. +ou %ould suspect retention if the patient,s urinary output is less than !- ml.hr. 2. Assess vital signs, especially (R /0-'12-1 and 23 /12-.4-1 every 2 hours especially in those %ith cardiovascular disease. Ta$ing this drug can cause chest pain and hypertension. These are also symptoms of urinary retention. 5otify physician. !. 6erify safe dosage, doses greater than 1 mg bid are not recommended for those %ith significantly reduced liver or $idney function or if the patient is currently receiving macrolide antibiotics, a#ole antifungal agents, or other cytochrome 378- !A7 inhibitors. 3 Client education needs 1. 5otify physician if you have a rapid heartbeat, difficulty breathing, or decreased urine as these may be signs of urinary retention. 2. Report blurred physician, sensitivity to light, and dry mouth. To combat dry mouth and dry eyes be sure to drin$ almost 2--- m9 of fluids preferably %ater per day. !. 2e sure to let your doctor $no% if there are any changes to your voiding patterns to determine the effectiveness of the medication and to monitor for adverse effects. +our urine output should be equal to !- m9.hr. :t should also almost equal the amount of fluids you ta$e in per day. " Nursing Diagnoses 1. ;luid and electrolyte imbalance 2. <&cess fluid volume Reference (#ritten in APA $ormat): =ilson, 2. A., >hannon, ?. T., >hields, @., =ilson, ;., )eoff, ;., A )eoff, ;. /2-111. Pearson nurse's drug guide 2012. /2-12 ed.1. pper >addle River, 5BC 3rentice (all.