Action, Uses, Caution, Side effect
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| SSRI Action | Decrease the reuptake of serotonion at select nerve terminals in CNS.
Also have weak uptake on Norepienpherine and Dopamine
Increase availability of serotonin at receptors = mood elevation, reduced anxiety
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| SSRI Uses | Mild to Moderate Depression,
Obsessive-compulsive disorder,
Panic Disorder
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| SSRI Contra | Hypersensitivity to SSRIs,
Concurrent use of MAO inhibitors
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| SSRI Caution | Zoloft may cause delusional and aggressive behavior
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| SSRI Side effects | Insomnia, anxiety,
Palpitations, h/a
Dyspepsia,
Diarrhea, tremor, excessive sweating
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| Nursing Implications | 1. Monitor Liver function while taking drug
2. Check the client's history for possible seizure disorders due to lower seizure threshold
3. Don't give with MAO inhibitors
4. Do not abruptly stop med, must be gradual.
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| MAO Inhibitor Action | Inhibits monoamine oxidase, enzyme involved in metabolism of amines, ie, epineperine, noreprineprine, tryamine, seratonin. MAO increase these transmitter = reduce depression
For depression thought to be due to low noreprineprine and dopamine
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| MAO Inhibitor Uses | Relieves s/s of manic depression, clinical depression and psychosis.
For severe depression in patients who don't respond to other treatment.
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| MAO Inhibitor Contras | Impaired renal of hepatic function
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| MAO Inhibitor Side effect | Orthostatic hypo-tension, seizures, hypertensive crisis
Weight gain, sexual dysfunction, edema, blurry vision, diarhea
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| Tricyclic Antidepressants Action | Decrease the reabsorption of norepinepherine, & seratonin, which allows more of neurotransmitters to be available at postsynaptic receptors.
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| Tricyclic Antidepressants Uses | Endogenous, reactive depression
Depression related to alcohol or cocaine withdrawal
Reserved for patients who don't respond well to other antibiotics
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| Tricyclic Antidepressants Contras | Acute recovery of Myocardial ischemia or Severe CAD
Hyperthyroidism
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| Tricyclic Antidepressants Side effects | Sedation, orthostatic hypotension, arrhythmias
Cholinergic effects: dry moth, h/a, urinary retention
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| Tricyclic Antidepressants Nursing Implications | 1. Older patients are more susceptible to morning orthostatic hypotension.
2. Adminster at bedtime
3. Advise client to stop smoking
4. Teach client to avoid alcohol
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| Antihistamines Action | Competitively block H1-receptor sites on effector cells and impede histamine regulate response.
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| Antihistamines Uses | Prevent and treat allergic reaction
Allergic transfusion reaction
Motion sickness and insomnia
Used with epinephrine in the management of aniphalxis
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| Antihistamines Contra | Sensitivity to antihistamines
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| Antihistamines Precautions | History of acute asthmatic problems, pregnancy and lactation, Urinary obstruction, Glaucoma
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| Antihistamines Side Effects | Benadryl: Sedation, disturbed coordination, epigastric distress, thickening of bronchial secretions, dry mouth, drowsy, oral use only
Vistaril: Drowsiness, dry mouth, hypotension, potentiates narcotics & barbituates
Antivert: Drowsy, dry mouth, oral onl
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| Broncodialators Action | Beta2-Selective adrenergic agonists.
Sympathomimetic agents relax the beta2-receptors to relax smooth muscle in bronchials, producing dilation
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| Broncodialators Uses | Short acting, preparations to treat exacerbation of asthma.
Short term relief of bronchoconstriction due to bronchitis or emphysema
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| Broncodialators Contras | Cardiovascular disease, thyroid disease, DM
Lactation, sensitivity, seizure disorders
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| Broncodialators Precautions | Sensitivity to sympathomemtics
Terbualine: Not given to kids under 12 y.o.
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| Diuretics Action | Loop Diuretics: Inhibit Na and Cl reabsorption through direct action primarily in the ascending loop of Henle but also in proximal and distal tubules.
Thiazide Diuretics: Act primarily on the distal tubules, inhibit Na and Cl
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| Diuretics Uses | Treat edema that involves fluid volume excess resulting from a number of disorders of the heart, liver and kidney
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| Diuretics Contras | Hypersensitivity to sulfonmides
Severe adrenocortical impairment, anuria, progressive oliguria
Fluid and electrolyte depletion
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| Diuretics Precautions | Hepatic cirrhosis and coma
Renal dysfunction
Bronchial Asthma
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| Diuretics Side effects | Unusual Tiredness, weakness and dizziness
Irregular Heart Beat, weak pulse, orthostatic hypotension
Tinnitus, hearing loss (lasix)
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| Hypertension Classifications | Blood Pressure is regulated by cardiac output and peripheral vascular resistance.
Medications that influence CO or PVR lead to contol of BP
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| What systems regulate cardiac output and peripheral vascular resistance and blood pressure? | Vascular, Cardiac, and Renal and the Sympathetic Nervous System
Antihypertensive drugs that influence these systems to lower the BP are ACE inhibitors, beta-adrenergic blockers and calcium channel blockers
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| Diuretics Uses | Treat edema that involves fluid volume excess resulting from a number of disorders of the heart, liver and kidney
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| Diuretics Contras | Hypersensitivity to sulfonmides
Severe adrenocortical impairment, anuiria, progressive oliguria
Fluid and electrolyte depletion
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| Diuretics Precautions | Hepatic cirrhosis and coma
Renal dysfunction
Bronchial Asthma
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| Diuretics Side effects | Unusual Tiredness, weakness and dizziness
Irregular Heart Beat, weak pulse, orthostatic hypotension
Tinnitus, hearing loss (lasix)
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| Hypertension Classifications | Blood Pressure is regulated by cardiac output and peripheral vascular resistance.
Medications that influence CO or PVR lead to contol of BP
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| What systems regulate cardiac output and peripheral vascular resistance and blood pressure? | Vascular, Cardiac, and Renal and the Sympathetic Nervous System
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| ACE inhibitors (Antihypertensive) Actions | Block the conversion of angiotensis 1 to angiotensin 11, a vasoconstrictor. This block causes vasodialation and therefore decreases PVR, resulting in a decrease in BP. Aldosterone is also blocked, causing decrease in sodium and water retention.
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| Beta blockers (Antihypertensive) Actions | Prevent sympathetic stimulation of the heart, thereby reducing heart rate contractility.
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| Calcium Channel Blockers (Antihypertensive) Actions | Block calcium influx into the beta-receptors, decrease the force of the myocardial contraction, reduce the heart rate, and decrease PVR
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| Antihypertensive Uses | Mild to Moderate essential hypertension
Frequently in combination either as separate drugs or in combination with other drugs
Beta-adrenergic Blockers are among the most widely used
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| Examples of Beta Blockers | Inderal
Tenormin
Lopressor
Corgard
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| Actions of Beta Blockers | Blocks the sympathetic nervous system catecholamines, resulting from reduced renin and aldosterone release and fluid balance.
Vasodialation of arterioles leads to decrease in pulmonary vascular resistance and BP
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| Uses of Beta Blockers | Hypertension, antianginal agents in long-term treatment of angina
Dysrhythmias-suppress sinus and atrial tachydysrythmias
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| Beta Blockers Contras | Preganacy and Lactation
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| Beta Blockers Precautions | Can Cause Brachioconstriction, use caution with DM, thyrotoxicosis, cerrebrovascular insufficency, renal and hepatic dysfunction
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| Beta Blockers Side effects | Hypothension, bradycardia, drowsiness, depression, symptoms of CHF
Insomnia, wheezing, dyspnea, malaise, lethargy
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| Nitroglycerin classification | Nitrate vasodialtor
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| Nitroglycerin Action | Relaxes vascular (arterial and venous) with more prominent effects on veins, which decrease preload.
Arteriolar relaxation reduces systematic vascular resistance, which decreases afterload
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| Nitroglycerin Uses | Relief of anginal pain
In conjunction with beta blockers or calcium channel blockers suppress tachycardia
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| Nitroglycerin Contraindications | Hypersensitive clients
Severe anemia
Acute myocardial infaraction, cardiomyopathy
Head trauma, cerebral hemorrhage
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| Nitroglycerin Precations | Severe hepatic or Renal disease
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| Nitroglycerin Side Effects | Orthostatic hypotension
Dry Mouth, blurred vision
Tachycardia, headaches
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| Digitalis Classification | Cardiac Glycoside
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| Digitalis Action | Affects mechanical & electrial action of the heart which increase myocardial contractility. Alters the electrical activity of the noncontractile tissues & ventricular muscle (eg automatically, refractoriness, and impulse conduction) Inhibits Na-K ATPase
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| Digitalis Uses | Heart Failure--Improve Cardiac Output
Atrial Fibrillation and Flutter
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| Digitalis Contras | Hypersensitivity
Ventricular tachycardia
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| Digitalis Precautions | Renal insuffinecy, hypokalemia, advanced heart disease, acute MI, incomplete AV block, pregancy
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| Digitalis Side effects | Dizziness, H/A, malaise, fatigue, muscle weakness, visual disturbance, anorexia, Hypokalemia, arrhythmas, bradycardia
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| NSAIDs Action | Suppress inflammation by inhibition of cyclooxygenase, an enzyme responsible for synthesis of prostaglandins. ie inhibits formation and release of prostaglandins.
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| NSAIDs Uses | Mild to Moderate pain relief, Reduces inflammation
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| NSAIDs Contras | Hypersensitivity to asprin, Clients with Viral illness
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| NSAIDs Precautions | Upper GI disorders
Renal & Hepatic impairment
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| NSAIDs Side Effects | Dyspepsia, anorexia, nausea, vomiting, rash, dizziness, heart burn, GI bleeding
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