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pathopharm II
Drugs for Test 4
| Question | Answer |
|---|---|
| Dantrolene | Givein IV or Oral; Peripherally acting spasmolytic that relaxes uscles thru direct action on skeletal muscle fibers. HAS NO NEUROMUSCULAR COMMUNICANTION NOR CNS EFFECTS. |
| Dantrolene | for acute treatment of malignant hyperthermia (life threating complication of general anesthesia) |
| Dantrolene | manages spasticity resutling from spinal cord and crebral injuries, MS, cerbral palsy, and possibly CVA; NOT effective in treating acute muscle weakness of local origin or muscel weakness resulting from rheumatoid spondylitis, arthritis, or bursitis |
| How long does it take for a Pt to see theraputic effects of Dantrolene? | Pt will not see theraputic effects 1 week. |
| Dantrolene works by... | reducing the force of contraction of skeletal muscle thru a direct effect on muscle cells, reduces the amount of Calcium released from the sarcoplasmic reticulum, relaxing the muscle contraction from excitation. |
| Dantrolene | has little or no effect on contraction of CARDIAC OR INTESTINAL SMOOTH MUSCLE. It may decrease hyperreflexia, muscle stiffness, and spasticity in pt w/ upper motor neuron disorders. |
| DO NOT GIVE DANTROLENE TO Pts with... | COPD, Cardiac Disease, Pregnant and lactating, |
| Dantrolene is GIVEN CAUTIOUSLY TO... | pts who rely on spasticity to maintain an upright posture and balance, EX: those w/ Cerebral palsy |
| Dantrolene Drug Interactions | CNS depressants, clofibite, estrogens, verapamil, and warfarin |
| Drug closely related to Dantarolene | Botox=neurotoxin used for muscle-relaxing properties; it is a protien that is produced by the anaerobic bacterium Clostridum botulinum. It is produced under controlled laboratory conditions and given in extremely small doses (0.05-0.1) mL per injection |
| Botox | Gradual relaxation occurs 1-2 weeks after the injection, reduction of muscle spasm lasts for 3-4 months and pain relief can last even longer. |
| Botox Adverse effects | temporay increase in pain, weakness in the muscle injected, body aches, dry mouth, hoarsness, and flu-like symptoms |
| Baclofen is a... | Centrally acting spasmolytic; relieves some componets of spinal spasticity-- involuntary flexor and extensor spasms and resistance to passive movements |
| Baclofen is absorbed how? | rapidly absorbed orally and peaks in 2-3 hrs. It crosses blood-brain barrier and placenta into breast milk!!! half-life ranges from 2-4 hrs and metabolized in liver |
| Baclofen Contraindications | Contraindicated for spasticity of cerebral origin or for reducing the rigitidy of parkinsonism or Huntington chorea; and pregnant and lactating women |
| Baclofen Adverse Effects | drowsiness, weakness, dizziness, headache, N&V, hypotension, increased urinary frequency; CNS: excitement, depression, adn hallucinations; may cause paresthesias and tinnitus; GI: anorexia and diarrhea |
| Baclofen what should you assess for? | Assess for relief of spasm! |
| Give Baclofen causiously to these pts.. | Pts who have CNS disorders, cerebral hemorrhoage or prior CVA because it may increase risk for developing CNA, respiratory, or cardiovascular depresion or ataxia; may increase glucose concentration in pts w/ diabetes |
| Baclofen Pt teaching | Teach pt to avoid sudden cessation of durg; they will need to be taperred off of drug for 2 weeks |
| Drug closely related to Baclofen | Zanaflex=oral agent used to treat spasticity related to spinal cord pathology and MS |
| Zanaflex is used cautiously in pts w/... | hypotension, hepatic disease (make sure they have a liver function test first), psychosis, or renal impairment |
| Drug significantly different from Baclofen | Gabapentin (Neurotin)=miscellaneous antiepileptic drug used for the management of neuropathic pain and spasticity; useful in manageing spasticity associated w/ MS and this is an off label indication. |
| NSAIDs (prostiglandin synthetase inhibitors) | work by inhibiting COX and decreasing prostaglandins and thromboxane |
| Ibuprofen (protoype NSAID) | Used for rhematoid arthritis, juvenile rhemutoid arthritis, oseoartheritis, mild to moderate pain, primary dysmenorrhea, migranine headache, and fever. |
| Ibuprofen (protoype NSAID) absorbed how? | 80% is absorebed from the GI system after oral administration. ABSORPTION IS SLOWER IF TAKEN W/ FOOD. Peak serum concentration occurs in 1-2hrs. |
| Ibuprofen (protoype NSAID) analgesic and antipyretic effect takes place in... | 2-4hrs |
| Ibuprofen (protoype NSAID)inflammatory response takes place in... | a few days to 2 weeks |
| What is the main difference between Ibuprofen and Asprin? | Ibprofen DOES NOT have an anticoagualnt effect |
| What does and Ibuprofen and Aspirn have in commin?? Think: I have "ringin" in my ears! | Tinnitus |
| Ibuprofen common side effects mainly (GI) | N&V, diarrhea, constipation, flatulence, and abdominal pain |
| Ibuprofen Contraindications (same as asprin) | pt's w/ history of active GI disease (peptic ulcer disease, ulceratigve colitis, or GI bleeding) |
| Ibuprofen use caustiously in Pt's w/... | prexisting hepatic, renal, or hemopoietic dysfunction and those over the age of 60; those w/ coagulopathy, or hemophilia |
| Drugs that interact w/ Ibuprofen | Probenicid increases risk of toxicity from Ibuprofen; increases nephrotoxcity w/ cyclosporin |
| Drugs closely related to Ibuprofen Propionic acids: ketoprofen (orudis), naproxen, oxyprozin (daypro) | These drugs are chemically similar, patients may have relief os symptoms from one drug in this group but not another; Naproxen is tolerated better than any other NSAIDs |
| Acetic Acids (closely related to Ibuprofen) | Voltaren and Flector (patch placed on most painful part twice daily) are associated w/ high incidence of GI distress and should be given w/ meals or milk and my increase BP |
| Acetic Acids (closely related to Ibuprofen) | may aggrevate depression, other psychiatric distrubances, epilepsy, and parkinsonism; advantage long-half life, once or twice daily dosing; diadvantage high cost |
| Fenamates (closely related to Ibuprofen) Ponstel | used to treat mild to moderate pain and dysmenorrhea |
| Sumatriptan | for actte migraines or cluster headache; most common advers: feelings of tingleing, heat, weakness; |
Created by:
prettydee1908
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