Chronic Neurologic Disorder Medication: neostigmine (Prostigmin)
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| What is the prototype drug for this class? | neostimine (Prostigmin)
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| What conditions is this medication used to treat? (2) | Myasthenia Gravis & Parkinson's Disease
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| How does this medication help those with Myasthenia Gravis & Parkinson's Disease? (2) | To manage symptoms & improve quality of life
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| How does this medication work? | Prevents the enzyme cholinesterase from inactivating acetylchoine
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| What results come from the inactivation of acetylcholine? | An increase in the amount of acetycholine available to receptor sites
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| What is this drug used to treat? (2) | 1.) myasthenia gravis
2.) reversal of neuromuscular blocking agents
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| What is the main adverse effect caused by this drug & what symptoms arise (3)? | Parasympathetic NS effects (diarrhea, bradycardia, urinary urgency)
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| Cholinergic crisis (2) | Parasympathetic effects & respiratory depression
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| What can respiratory depression lead to? (2) | Respiratory arrest OR cardiac failure
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| What pregnancy category is this drug? | C
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| What is the antidote used to treat neostigmine adverse effects (SNS)? | Atropine
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| What would be present if the patient were going into respiratory depression? (3) | 1.) Respiratory rate below 12
2.) Cyanotic
3.) SpO2 below 94%
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| When should you use this medication cautiously? (5) | 1.) Seizures
2.) PUD
3.) Asthma (causes bronchoconstriction)
4.) bradycardia
5.) hypotension
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| When would you NOT give this medication? | If the patient had obstructive disorders
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| What do you monitor when giving Atropine? (3) | 1.) BP
2.) pulse
3.) Respirations (before & AFTER administration)
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| Instruct patient to take this medication ______ | As prescribed
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| What is a usual dose routine for this medication? | Start with a LOW dose & then TITRATE
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| When titrating this medication, how will you know when you have reached therapeutic levels? | When the desired muscle function is achieved
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| When should you take this medication? (2) | 1.) At the SAME time each day
2.) In the morning
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| What should you suggest your patient do while taking this medication? | Advise them to KEEP A JOURNAL.
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| What should you educate your patient to record in the journal? (5) | 1.) How it's making them feel
2.) How are they able to do their ADLs?
3.) Any adverse effects?
4.) Difficulty swallowing?
5.) Urinary urgency
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| The patients' journal should let the nurse know... | If the medication is working
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| How would the nurse know if the medication is working? | The patients' ability to do their ADLs should improve. If not, slowly increase dose
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| What should the nurse educate the patient to wear? | A medic alert bracelet
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| How would the nurse evaluate improvement with this medication? | 1.) Strength in chewing
2.) Swallowing
3.) Performing ADLs
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