Which symptom is an adverse effect of anticholinergic agents used to treat overactive bladder syndrome (OAB)?

Nitroglycerin is a medication that dilates the blood vessels and improves blood flow to the heart. It is used to treat angina, a condition that causes chest pain due to reduced oxygen supply to the heart. However, nitroglycerin can lose its effectiveness over time if it is used continuously. This is called tolerance, and it means that the patient will need higher doses of the medication to achieve the same relief. To avoid tolerance, patients who use transdermal nitroglycerin patches are instructed to remove the patch at bedtime and apply a new one in the morning. This creates a nitrate-free interval of about 8 to 12 hours, which allows the body to restore its sensitivity to nitroglycerin.

Choice A is wrong because an allergic response is not a common side effect of nitroglycerin. Some patients may experience skin irritation or rash at the site of application, but this is usually mild and does not require discontinuation of the medication.

Choice C is wrong because overdosage is unlikely with transdermal nitroglycerin patches. The patches deliver a controlled amount of nitroglycerin through the skin over a period of time. The risk of overdosage is higher with other forms of nitroglycerin, such as tablets or sprays, which are taken as needed for acute angina attacks.

Choice D is wrong because forgetting to remove the patch in the morning is not a serious problem. The patch will continue to deliver nitroglycerin until it is removed, but it will not cause harm to the patient. However, it may reduce the effectiveness of the next patch if there is no nitrate-free interval between them.

HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from other parts of the body back to the liver, where it can be removed.HDL cholesterol is often called the “good” cholesterol because it helps protect against heart disease by lowering the amount of plaque buildup in the arteries.Increasing HDL cholesterol levels can reduce the risk of cardiovascular disease in patients.

Choice A is wrong because increasing LDL cholesterol levels would have the opposite effect.

LDL stands for low-density lipoprotein, which is a type of cholesterol that carries cholesterol from the liver to other parts of the body, where it can accumulate in the walls of the arteries and form plaque.

LDL cholesterol is often called the “bad” cholesterol because it increases the risk of heart disease by narrowing and hardening the arteries.Decreasing LDL cholesterol levels can reduce the risk of cardiovascular disease in patients.

Choice C is wrong because increasing triglyceride levels would also increase the risk of cardiovascular disease.

Triglycerides are a type of fat (lipid) that circulates in the blood and provides energy for the body.

However, when triglycerides are too high, they can contribute to plaque formation in the arteries and inflammation of the pancreas.

High triglycerides are often associated with obesity, diabetes, metabolic syndrome, and low thyroid levels.Lowering triglyceride levels can reduce the risk of cardiovascular disease in patients.

Choice D is wrong because increasing intake of saturated fats would also increase the risk of cardiovascular disease.

Saturated fats are a type of fat that are solid at room temperature and are found mostly in animal products, such as meat, butter, cheese, and cream.

Saturated fats can raise both LDL and HDL cholesterol levels, but they also increase inflammation and oxidative stress in the body, which can damage the blood vessels and increase the risk of heart disease.Reducing intake of saturated fats and replacing them with unsaturated fats, such as olive oil, nuts, seeds, and fish, can reduce the risk of cardiovascular disease in patients.

The normal ranges for blood lipid levels are as follows:

• Total cholesterol: less than 200 mg/dL (5.2 mmol/L)

• LDL cholesterol: less than 100 mg/dL (2.6 mmol/L)

• HDL cholesterol: 40 mg/dL (1.0 mmol/L) or higher for men; 50 mg/dL (1.3 mmol/L) or higher for women

• Triglycerides: less than 150 mg/dL (1.7 mmol/L)