Which organ is primarily responsible for excretion of a medication?

Choice A reason: "If my breathing begins to feel tight, I will use the cromolyn immediately." is an incorrect statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. Cromolyn is a medication that prevents the release of inflammatory substances from the mast cells in the airways, which can cause bronchospasm and asthma symptoms¹. Cromolyn is not a rescue medication, but a maintenance medication that should be used regularly to prevent asthma attacks. The client should use Albuterol, a short acting beta agonist, to relieve acute bronchospasm and wheezing.

Choice B reason: "I will be sure to take the albuterol before taking the Atrovent." is a correct statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma. Atrovent is a medication that blocks the action of acetylcholine, a neurotransmitter that causes bronchoconstriction and mucus secretion, which can worsen the asthma symptoms. The client should take the Albuterol before the Atrovent, as this will allow the Albuterol to open the airways and enhance the absorption and effectiveness of the Atrovent.

Choice C reason: "I will administer the medications 10 minutes apart." is an unnecessary statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. The client does not need to wait 10 minutes between the administration of the two medications, as they can be given together in the same nebulizer chamber. This will save time and simplify the treatment regimen for the client. The client should follow the instructions on the medication label or the prescriber's order regarding the dosage and frequency of the nebulizer treatments.

Choice D reason: "I will use both medications immediately after exercising." is an inappropriate statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. The client should not use both medications immediately after exercising, as this may not prevent or relieve exercise induced bronchospasm, a condition that causes the airways to narrow during or after physical activity. The client should use Albuterol, a short acting beta agonist, before exercising, as this will prevent the bronchospasm and allow the client to exercise safely and comfortably. The client should use Atrovent, an anticholinergic, as prescribed, usually twice a day, to control the chronic symptoms of asthma.

Choice A reason: This is correct. Dry mouth is a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and other fluids in the body. Dry mouth can cause discomfort, bad breath, and increased risk of dental problems¹.

Choice B reason: This is incorrect. Constricted bronchioles are not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: dilated bronchioles. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that causes the smooth muscles of the airways to contract. Dilated bronchioles can improve breathing and reduce wheezing in people with respiratory disorders, such as asthma or COPD.

Choice C reason: This is incorrect. Increased heart rate is not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: decreased heart rate. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that slows down the heart rate and lowers the blood pressure. Decreased heart rate can be beneficial for people with certain heart conditions, such as atrial fibrillation or tachycardia.

Choice D reason: This is correct. Dilated pupils are a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that controls the muscles of the iris, which regulate the size of the pupils. Dilated pupils can cause blurred vision, sensitivity to light, and difficulty focusing.