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atc 19-22 pharm
| Question | Answer |
|---|---|
| CNS Stimulants? NAME 4 | Amphetamines Analeptics, caffeine Anorexiants |
| Attention Deficit/Hyperactivity Disorder ADD OR ADHD ..PATHOLOGY? EPIDEMIOLOGY?CHARACTERISTICS? | Disregulation of transmitters Serotonin, norepinephrine, dopamine Usually occurs in children before age 7 boys Characteristics Inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks, impulsivity |
| Narcolepsy CHARACTERISTICS | Narcolepsy Characteristics Recurrent attacks of drowsiness and sleep during daytime Unable to control sleep |
| Amphetamine (Adderall) Dextroamphetamine (Dexedrine ACTIONS? | Stimulate release of norepinephrine and dopamine Uses Increase wakefulness in narcolepsy Increase attention span, cognition Decrease hyperactivity, impulsiveness, restlessness of ADHD |
| Amphetamines SIDE EFFECTS | Tachycardia, palpitations, dizziness, hypertension Sleeplessness, restlessness, nervousness, tremors, irritability Increased hyperactivity Anorexia, dry mouth, vomiting, diarrhea, weight loss Thrombocytopenia |
| Amphetamine-Like Drugs | ADHD Methylphenidate (Ritalin) Methamphetamine (Desoxyn) Narcolepsy Modafinil (Provigil) Pemoline (Cylert |
| Methylphenidate (Ritalin)ACTION ) | Acts on cerebral cortex, reticular activity system Uses: ADHD, fatigue, narcolepsy Interactions Caffeine may increase effects Decrease effects of decongestants, antihypertensives, barbiturates May alter insulin effects |
| Migraine and Cluster Headaches PREVENTION | Prevention Beta-adrenergic blockers Propranolol (Inderal) Anticonvulsants Valproic acid (Depakote) Gabapentin (Neurontin) Tricyclic antidepressants Amitriptyline (Elavil) |
| Migraine and Cluster Headaches MANAGEMENT OF | Management Analgesics Aspirin, acetaminophen NSAIDs: ibuprofen, naproxen (Aleve) Opioid analgesics Meperidine (Demerol) Butorphanol nasal spray (Stadol NS) Ergot alkaloids Ergotamine tartrate (Ergostat) Selective serotonin1 receptor |
| Migraine and Cluster Headaches MEDS FOR | Agonists Sumatriptan (Imitrex) Zolmitriptan (Zomig) |
| Sumatriptan ACTION | Action Causes vasoconstriction of cranial arteries Use Treat migraine or cluster headaches |
| Sumatriptan SIDE EFFECT | Side effects Dizziness, tingling, numbness, warm sensation, drowsiness, seizures Muscle cramps, nausea, vomiting, diarrhea Dysrhythmias, thromboembolus, heart attack, stroke |
| Sleep Disorders EXAMPLE | Insomnia More common in females Treatment: sedative-hypnotics Nonpharmacologic management No daytime naps, drink warm fluids Avoid caffeine 6 hrs before bedtime Avoid heavy meals/exercise before bedtime Warm bath, read, listen to music |
| Sedative-Hypnotics | Sedatives Mildest form of CNS depression Sedative-hypnotics Barbiturates Benzodiazepiness Nonbenzodiazepines Piperidinediones OTC Nytol, Sleep-Eze, Tylenol PM Diphenhydramine (Benadryl |
| Sedative-Hypnotics SIDE EFFECTS | General side effects Residual drowsiness (hangover) Drug dependence Drug tolerance Excessive depression Respiratory depression Withdrawal symptoms |
| Barbiturates ULTRA SHORT ACTING | Ultrashort-acting Used as a general anesthetic Example: thiopental sodium (Pentothal) |
| Barbiturates SHORT ACTING | Short-acting Induce sleep No residual drowsiness Examples: pentobarbital (Nembutal), secobarbital (Seconal) |
| BARBITURATES INTERMEDIATE ACTING | Intermediate-acting Induce and sustain sleep Residual drowsiness (hangover effect) Examples: amobarbital (Amytal), butabarbital (Butisol |
| BARBITURATES LONG ACTING | Long-acting Used to control seizures Example: phenobarbital |
| BARBITUATES | Secobarbital (Seconal) Act:depression of CNS Use: shortacting to treat insomnia S. effects Hangover, dizziness, paradoxical excitement in elderly, respiratory distress, laryngospasm Interact. Decreased respirations with alcohol, CNS depressants |
| Benzodiazepines | as hypnotics Temazepam (Restoril) Action: Interacts with neurotransmitter GABA to reduce neuron excitability Use: reduce anxiety, treat insomnia Nonbenzodiazepines as hypnotics Zolpidem (Ambien), eszopiclone (Lunesta) Action: neurotransmitter |
| Sedative-Hypnotics | Drug interactions Alcohol, CNS depressants Nursing interventions First use nonpharmacologic methods Take 15-45 min before bedtime Report hangover effect Be attentive to safety Avoid alcohol, other CNS depressants Monitor BP, R, withdrawal sympt |
| Anesthetics TYPES | Types General Purpose: analgesia, muscle relaxation, loss of consciousness, amnesia Local Purpose: analgesia in limited area |
| Anesthetics ROUTES | Routes Inhalation IV Topical Local Spinal |
| Anesthetics | Balanced anesthesia Hypnotic Zolpidem (Ambien) Narcotic analgesic or benzodiazepine Morphine or Midazolam (Versed) Anticholinergic Atropine Barbiturate Thiopental sodium (Pentothal) Muscle relaxant Succinylcholine (Anectine |
| Anesthetics SIDE EFFECTS | Side effects/adverse reactions Respiratory depression Hypotension Dysrhythmias Hepatic dysfunction |
| Anesthetics NURSING INTERVENTIONS | Nursing interventions Monitor patient’s level of consciousness Monitor vital signs (respirations, P, BP) Respiratory status Cardiovascular status Monitor urine output Administer analgesics as necessary |
| Epilepsy | Seizure disorder Abnormal elec. discharges from cerebral neurons Characteristics Loss of consciousness Convulsive movements Cause Unknown Secondary to trauma, anoxia, infection, stroke Isolated seizures due to fever, electrolyte, or acid-base |
| International Classification of Seizures | Generalized Grand mal (tonic-clonic) Most common Generalized alternating muscle spasms and jerkiness Petit mal (absence) Brief loss of consciousness (10 seconds or less) Usually occurs in children |
| International Classification of Seizures CONT... | Partial Psychomotor Repetitive behavior Chewing or swallowing motions Behavioral changes Motor seizures |
| Anticonvulsants Hydantoins | Phenytoin (Dilantin) |
| Phenytoin (Dilantin)SIDE EFFECTS AND CONTRI. | Contraindications Pregnancy (teratogenic) Therapeutic serum level 10-20 mcg/ml Side effect/adverse reactions Gingivitis, gingival hyperplasia, diplopia, dizziness, slurred speech, decreased coordination, alopecia Thrombocytopenia, Stevens-Johnson |
| Phenytoin (Dilantin) Drug interactions | Increased eff. w/ cimetidine (Tagamet),INH, sulfonamides DEeff. w/ folic acid, antacids, calcium, sucralfate, antineoplastics, antipsychotics, primrose, ginkgo Decreased eff. of anticoagulants, oral contraceptives, antihistamines, dopamine, theophylline |
| Hydantoins (PHENYTOIN) NUSING INTERVENTIONS | Shake suspension well (5 min) Monitor serum drug levels Safety: Protect from environmental hazards, driving Warn females taking oral contraceptives to use additional contraception |
| Hydantoins (PHENYTOIN) NUSING INTERVENTIONS CONT. | Avoid certain herbs, alcohol, and other CNS depressants not to discontinue abruptly frequent oral hygiene and dental check-ups Monitor glucose level in diabetics take drug at same time every day Warn of harmless pinkish red or brown urine |
| Parkinsonism Pathophysiology | Chronic neurologic disorder Degeneration of dopaminergic neurons Imbalance of the neurotransmitters Less dopamine |
| Parkinsonism (cont’d) Characteristics | Tremors of head and neck Rigidity (increased muscle tone) Bradykinesia (slow movement) Postural changes Head and chest thrown forward Shuffling walk Lack of facial expression Pill-rolling motion of hands |
| Parkinsonism (cont’d) Treatment regimen | Anticholinergics Block cholinergic receptors Dopaminergics Convert to dopamine Dopamine agonists Stim. dopamine receptors MAO-B inhibiT Inhibit MAO-B enzyme that interferes w/ dopamine COMT inhibitors Inhibit COMT enzyme that inactivate dopamine |
| Antiparkinsonism Drugs | Dopaminergics,Anticholinergics |
| Anticholinergics ACTION | Parasympatholytic Benztropine (Cogentin) Trihexyphenidyl HCl (Artane) inhibit release of acetylcholine Decrease tremors and rigidity |
| Dopaminergics ACTION AND SIDE EFFECT | Carbidopa-levodopa (Sinemet) converted to dopamine Increases mobility S.E.Fatigue, insomnia, dry mouth, blurred vision Orthostatic hypotension, palpitations, dysrhythmias Urinary retention, nausea, vomiting Dyskinesia, psychosis, severe depression |
| Dopaminergics | Carbidopa-levodopa (Sinemet |
| Carbidopa-levodopa (Sinemet DRUG INTERACTIONS) | Decrease levodopa effect with: Anticholinergics Phenytoin Tricyclic antidepressants MAO inhibitors Benzodiazepines Phenothiazines Vitamin B6 |
| Dopamine Agonists | Amantadine (Symmetrel) |
| Amantadine (Symmetrel) ACTIONS AND USE | Also antiviral drug for influenza A Action Stimulates dopamine receptors Taken alone or in combination with levodopa or anticholinergic Use Early treatment as drug tolerance develops Improvement of symptoms |
| Antiparkinsonism Drugs NURSING INTERVENTIONS | Monitor for orthostatic hypotension Admin. drug w/ low-protein Avoid vitamin B6, alcohol,depressants Do not abruptly STOP Warn of urine/sweat getting harmless brown discolor Assess for suicidal tendencY Monitor blood cell counts,liver& kidney func |
| Alzheimer’s Disease Pathophysiology | Progressive, degenerative disease Neuritic plaques form Neurofibrillary tangles are in neurons Cholinergic neurotransmitter abnormality |
| Alzheimer’s Disease (cont’d) Characteristics | Loss of memory, logical thinking, judgment Time disorientation Personality changes Hyperactivity Tendency to wander Inability to express oneself |
| Acetylcholinesterase Inhibitors USES FOR | Alzheimer’s Disease |
| Acetylcholinesterase Inhibitors EXAMPLES | Donepril (Aricept) Rivastigmine (Exelon |
| Acetylcholinesterase Inhibitors ACTIONS AND USES | Action Allow more acetylcholine in neuron receptors Increase cognitive function Use Mild to moderate alzheimer’s diseas |
| Acetylcholinesterase Inhibitors (cont’d) Side effects | Headache, dizziness Depression GI distress Dehydration, dry mouth Blurred vision Insomnia Hypertension, hypotension, dysrhythmias Hepatotoxicity |
| Acetylcholinesterase Inhibitors (cont’d) Nursing interventions | Monitor vital signs Maintain consistency in care Monitor behavioral changes Provide safety when wandering Arise slowly to avoid dizziness Monitor for GI bleeding |
Created by:
lisav803
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