Oxybutynin chloride is prescribed for a client with a neurogenic bladder. What sign indicates a possible toxic effect?

Oxybutynin chloride is an anticholinergic medication used primarily to treat urinary incontinence associated with neurogenic bladder. One of the important considerations when monitoring a patient on this medication is the potential for anticholinergic side effects, which can indicate toxicity.

Restlessness can be a sign of central nervous system (CNS) effects associated with anticholinergic toxicity. When overdose or adverse effects occur, the CNS may react with symptoms such as confusion, agitation, or restlessness. This is particularly relevant with oxybutynin, as it can cross the blood-brain barrier, leading to CNS side effects.

Monitoring for restlessness is crucial, as it may suggest that the patient is experiencing an adverse reaction or toxicity from the medication. Other symptoms that could accompany such a reaction might include confusion, hallucinations, or increased agitation.

In contrast, while pallor, drowsiness, and bradycardia might be associated with various medical conditions or medication effects, they are not typically the hallmark signs of oxybutynin toxicity. Thus, restlessness stands out as a more direct indicator of a possible toxic effect from oxybutynin chloride in this context.