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Pharmacology · chapter 35 · Urinary and Bladder Disorder Drugs

Urinary Stimulants

The 13 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. How urinary stimulants work

    These drugs work by activating the muscarinic receptors of the bladder, leading to increased bladder contractions and improved bladder emptying.

  2. Main uses

    They are primarily prescribed for urinary retention or to improve bladder function in individuals with certain neurologic conditions, such as a spinal cord injury.

  3. Bethanechol indications

    Bethanechol Chloride Bethanechol chloride (Duvoid) is indicated for acute postoperative and postpartum nonobstructive (functional) urinary retention and for neurogenic atony of the urinary bladder with retention (Padda Derain, 2022).

  4. Onset and peak

    The drug’s effects sometimes appear within 30 minutes, usually peak between 60 and 90 minutes, and persist for approximately 1 hour (DailyMed, Bethanechol chloride, 2022).

  5. Common adverse effects

    Adverse Effects and Contraindications Common adverse effects include malaise, urinary urgency, headache, vasomotor response, sweating, and miosis.

  6. Contraindications

    Contraindications include hyperthyroidism, peptic ulcer disease, asthma, pronounced bradycardia, hypotension, coronary artery disease, seizure, Parkinson’s disease, and hypersensitivity to the drug or any of its components.

  7. Watch for vasomotor responses

    Monitor the client closely for vasomotor responses, such as hypotension, bradycardia, and orthostatic hypotension.

  8. Bronchospasm and tachycardia

    For a client taking bethanechol chloride, monitor closely for bronchospasm, wheezing, and tachycardia because these can be serious adverse effects of the drug.

  9. Take on an empty stomach

    Take bethanechol chloride on an empty stomach, at least 1 hour before or 2 hours after a meal, for better absorption.

  10. No improvement in 90 minutes

    Notify their health care provider if symptoms do not improve within 90 minutes after taking bethanechol chloride because the treatment may need to be modified.

  11. Storage

    Store bethanechol chloride at room temperature and away from moisture and heat.

  12. Get up slowly

    Avoid getting up too fast from a sitting or lying position because this drug may cause a vasomotor response that includes dizziness.

  13. Never take doses together

    From the book’s list of what the client should not do:

    Take two or more doses at one time because this may cause a significant vasomotor response such as severe hypotension and bradycardia.

Terms to know

Urinary stimulants
Urinary stimulants stimulate the smooth muscles of the urinary bladder.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

The graded version needs JavaScript. Every question is below anyway, with the answer and why.

Every question here, with the answer

  1. A postpartum client has nonobstructive urinary retention and is prescribed bethanechol. Which finding in her history should the nurse report before giving it?

    1. Asthma
    2. Inability to void since delivery
    3. Recent vaginal delivery
    4. Mild perineal pain

    Answer: Asthma

    Asthma is a contraindication to bethanechol, and the drug can cause bronchospasm and wheezing. Postpartum nonobstructive retention is an indication, not a reason to hold it.

  2. When should the client take bethanechol?

    1. On an empty stomach, 1 hour before or 2 hours after a meal
    2. With a large meal to prevent nausea
    3. With milk
    4. Only at bedtime

    Answer: On an empty stomach, 1 hour before or 2 hours after a meal

    Bethanechol is taken on an empty stomach, at least 1 hour before or 2 hours after a meal, for better absorption. The other timing options are not supported.

  3. After a dose of bethanechol, which findings should the nurse monitor for as vasomotor or serious adverse effects? Select all that apply.

    1. Dilated pupils
    2. Hypotension
    3. Bradycardia
    4. Wheezing
    5. Orthostatic hypotension

    Answer: Hypotension, Bradycardia, Wheezing, Orthostatic hypotension

    The nurse monitors for vasomotor responses such as hypotension, bradycardia and orthostatic hypotension, and for bronchospasm, wheezing and tachycardia. Bethanechol causes miosis, which is pupil constriction, not dilation.

  4. A client took bethanechol 2 hours ago and still cannot void. What should the nurse teach the client to do in this situation at home?

    1. Notify the health care provider.
    2. Take a second dose right away.
    3. Drink a large amount of fluid quickly.
    4. Wait another 24 hours.

    Answer: Notify the health care provider.

    Clients notify the provider if symptoms do not improve within 90 minutes because treatment may need to change. Taking doses together can cause severe hypotension and bradycardia.

  5. Which conditions are contraindications to bethanechol? Select all that apply.

    1. Hyperthyroidism
    2. Parkinson's disease
    3. Postoperative functional urinary retention
    4. Peptic ulcer disease
    5. Coronary artery disease

    Answer: Hyperthyroidism, Parkinson's disease, Peptic ulcer disease, Coronary artery disease

    Contraindications include hyperthyroidism, peptic ulcer disease, asthma, bradycardia, hypotension, coronary artery disease, seizures and Parkinson's disease. Postoperative functional retention is an indication.

  6. A client on bethanechol feels dizzy when standing up. What teaching is most appropriate?

    1. Stop drinking fluids.
    2. Get up slowly from sitting or lying down.
    3. Stand up quickly to raise the blood pressure.
    4. Take two doses together to finish faster.

    Answer: Get up slowly from sitting or lying down.

    Bethanechol can cause a vasomotor response with dizziness, so clients avoid getting up too fast. Taking doses together can cause severe hypotension and bradycardia.

Where every quote comes from

Section 35.4 Urinary Stimulants of Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris, Dorie Weaver, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.