The nurse is reviewing a medication history of a client with BPH. Which medication should be recognized as likely to aggravate BPH?
A. metformin (Glucophage)
B. buspirone (BuSpar)
C. inhaled ipratropium (Atrovent)
D. ophthalmic timolol (Timoptic)
Correct Answer: C. inhaled ipratropium (Atrovent)
Atrovent is a bronchodilator, and its anticholinergic effects can aggravate urinary retention. Caution is necessary for the use of intranasal/inhaled ipratropium in patients with hypertrophic prostate. Ipratropium is an acetylcholine antagonist via blockade of muscarinic cholinergic receptors. Blocking cholinergic receptors decreases the production of cyclic guanosine monophosphate (cGMP). This decrease in the lung airways will lead to decreased contraction of the smooth muscles.
Option A: Metformin does not affect the urinary system. Metformin is a biguanide drug that reduces blood glucose levels by decreasing the production of glucose in the liver, decreasing intestinal absorption, and increasing insulin sensitivity. Metformin decreases both the basal and postprandial blood glucose.
Option B: BuSpar does not affect the urinary system. Buspirone’s use is primarily for the treatment of generalized anxiety disorder (GAD). Typically, it is used as a second-line agent behind selective serotonin reuptake inhibitors (SSRIs) when a patient does not respond to or cannot tolerate the side effects of SSRIs.
Option D: Timolol does not have a systemic effect. Timolol is a medication used in the treatment and management of open-angle glaucoma and ocular hypertension. It is in the beta-blocker class of drugs. Timolol can also be used in some instances to treat infantile hemangiomas, hypertension, myocardial infarction, migraine prophylaxis, and atrial fibrillation.
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