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EXAM 4 - MED SURG

Medications to Know

QuestionAnswer
Levodopa-Carbidopa (Sinemet) Levodopa-Carbidopa -- carbidopa delays the conversion of levodopa into dopamine. Nerve cells use levodopa to make dopamine replenish the brain.
Entacapone (Comtan) Decreases the breakdown of dopamine. Increases the duration of action of carbidopa and levodopa. Possible side effects include abdominal pain, back pain, constipation, nausea, diarrhea, blood in urine
Amantadine Hydrochloride (Symmetrel) Increases dopamine release and blocks reuptake of dopamine into presynaptic neurons. Reduces rigidity, tremors, bradykinesia, and postural changes in early Parkinson's Disease. Possible psychiatric disturbances (mood changes, depression, hallucinations), edema, nausea, urinary retention, headaches, and visual impairments
Donepezil (Aricept), Rivastigmine (Exelon) increases acetylcholine in the brain by inhibiting its metabolism, leading to elevated acetylcholine levels in the cortex. Slows the neuronal degradation that occurs in the AD. Cognitive ability may improve within 6-12 months of therapy. Side effects include headache, dizziness, depression, insomnia. Also GI upset may occur, asthma, COPD, fainting, heart disease, sinus sick syndrome, dyspnea. Patient education is to take exactly as prescribed, at bedtime.
Memantine (Namenda) Uncompetitive low-to-moderate affinity N-methyl-D-asparate receptor antagonist. Appears to work by regulating the activity of glutamate, one of the brain's chemicals involved in information processing, storing, and retrieval.
Sumatriptan (Imitrex) First-Line for moderate to severe migraine pain. Best results are achieved with early use of triptans within 20-60 minutes of taking the drug and if needed may be repeated in 2-4 hours. Contradicted in ischemic heart disease.
Saturated Solution of Potassiium Iodide (SSKI) Suppresses the release of thyroid hormone. Mix with juice or milk. Give by straw to prevent staining of teeth
Propranolol (Inderal) Beta-Adrenergic Blocking Agent. Monitor cardiac status, hold for bradycardia or decreased output. Use with caution in HF
Propylthiouracil (PTU) Blocks synthesis of hormones (conversion of T4 to T3). Monitor cardiac parameters. Observe for hypothyroidism. Must be given by mouth. Watch for rash, nausea, vomiting, and agranulocytosis
Levothyroxine a synthetic preparation of T4, is the drug of choice for long-term treatment of hypothyroidism.
Phenobarbital this will control seizures (NOW BLACK BOX WARNINGS) -- Do not take in pregnancy - Use 2 contraceptives -- given later with status epilepticus. monitor closely for suicidal ideation
Diazepam (Valium) given first in status epilepticus - stop having seizures - BLACK BOX WARNING - not with other opioids, or CNS depressants.
Gamma-Aminobutyric Acid gabapentin (Neurontin) used with partial seizures and off label uses such as alcohol withdrawal, fibromyalgia
Hydantoins - Phenytoin (Dilantin) a traditional antiepileptic drug, is most widely used first line to treat seizures by selective inhibition of sodium channels. Side effects include nystagmus, gingival hyperplasia, and rash. Phenytoin is teratogenic and should only be used in pregnant women when no other safe therapy is available. History of tonic clonic or psychomotor seizures - monitor for hyperplasia of gum tissue (See dentist), - increase calcium (osteoporosis)
Iminostilbenes (Carbamazepine - Tegretol) Toxic effects: severe skin rash, blood dyscrasias, hepatitis. monitor for aplastic anemia and agranulocytosis
Histone Deacetylase Inhibitor Valproate (Depakote) BLACK BOX WARNING - Monitor for signs of pancreatitis and wean off. This med is teratogenic. Check for signs of bleeding and bruising as altered bleeding times may occur
Sulfamate-Substitute Monosaccharides Topiramate (Topamax) Toxic effects: nephrolithiasis
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