Pharmacology
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| What are the adverse reactions for dopaminergic drugs | nervousness,anxiety,HA,blurred vision, arrhthymias
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| Dopaminergic drugs increase levels of______ in _____? | Increase levels of Dopamine in substantia nigra
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| Dopaminergic drugs directly ______ ______ _______ | stimulate dopamine receptors
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| Dopaminergic drugs help restore? | balance between inhibitory and stimulation neurons
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| Levodopa does not cross the blood brain barrier. T/F | False, levodopa does cross the blood brain barrier. Dopaminergic drugs do not cross the blood brain barrier.
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| Contraindications for Dopaminergic Drugs | Angle Closure glaucoma and GI obstruction
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| Cautions for dopaminergic drugs | Cardiovascular disease, bronchial asthma, peptic ulcer, UT obstruction
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| Dopaminergic drug-drugs | MAOIs,Vitamin B6, Phenytoin
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| Dopaminergic drugs and MAOIs cause? | risk of hypertension, so stop 14 days prior to use(MAOIs)
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| Dopaminergic drugs and Vitamin B6 cause? | decrease effectiveness of levodopa
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| Dopaminergic drugs and phenytoin cause? | decrease effectiveness of levodopa
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| precursor of dopamine | levodopa
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| Levodopa is converted into? | dopamine
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| Levodopa is usually given with _____ as ____ | carbidopa as Sinemet
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| Carbidopa reduces amount of _____ ____ to do what? | Reduces amount of levodopa needed to reach therapeutic level in brain
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| With less levodopa, what happens? | there are reduced side effects
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| Adverse reactions of Levodopa | adentitious movements, hand tremors, anorexia, dry mouth, dysphagia, urinary retention, cardiac irregularities
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| Nursing considerations for Levodopa are? | observe for balance(decline levels of dopamine), assess use of vitamin B6(increase dominance of cholinergic neurons), watch EKG changes(prolonged QT), empty bladder before taking drug, if constipation, implement bowel program
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| types of dopaminergic drugs | parlodel, symmetrol, Requip, Dermax, Mirapex
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| Anticholinergic drugs block ______ in _____ | block action of ACh in CNS
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| Anticholinergic drugs help normalize ___________ | ACh-dopamine imbalance
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| Anticholinergic drugs are used for? | -treat parkinsonism
-relief of extrapyramidal symptoms
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| Contraindications for anticholingeric drugs | -narrow angle glaucoma
-GI obstruction
-GU obstruction
-prostatic hypertrophy
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| Cautions for anticholinergic drugs | -dysrhythmias
-hypertension
-hypotension
-hepatic dysfunction
-pregnancy
-lactation
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| Adverse reactions for anticholinergic drugs | disorientation, confusion, agitation, delirium, NV, paralytic ileus
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| Drug-Drug for Anticholinergic Drugs | Tricyclic antidepressants and phenothiazines
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| Example of a Anticholinergic Drug | Biperiden(Akineton)
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| Nursing Considerations for Anticholinergic Drugs | -Assess for tachycardia and dysrhythmias
-watch for constipation and paralytic ileus
-sugarless candy or lozenges if dry mouth
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| Most skeletal muscle relaxants work in? | Most work in brain and spinal cord
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| Skeletal muscle relaxants interfere with? | Interfere with cycle of muscle spasm/pain and with reflex arc in upper level CNS that cause spasm
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| Skeletal muscle relaxants ___ or ___ spasm. | lyse or destroy spasm(spasmolytics)
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| Skeletal muscle relaxants that enter muscle fibers directly are? | Botulinum toxins and Dantrolene
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| Muscle spasm is often from? | injury to musculoskeletal system
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| Muscle spasm caused by? | flood sensory impulses coming to spinal cord from injured area
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| Muscle spasticity is a result of? | damage to neurons within CNS
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| Muscle spasticity may result from? | increase in excitatory influences within CNS or a decrease in inhibitory influences within CNS
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| Centrally acting skeletal muscle relaxants action | exact mechanism of action unknown
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| Centrally acting skeletal muscle relaxants contraindication | rheumatic disorders
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| Caution- Centrally actng skeletal muscle realaxants | -epilepsy(seizures worsen)
-cardiac dysfunction(decreased muscle function)
-muscle weakness conditions
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| Adverse reactions of Centrally Acting Skeletal Muscle Relaxants | drowsiness,fatigue,weakness, hypotension, confusion, HA,N, dry mouth
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| Drug to drug for Centrally Acting Skeletal Muscle Relaxants | CNS depressants
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| Example of a Centrally Acting Skeletal Muscle Relaxant | Baciofen(Lioresal)
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| Indication of Lioresal | alleviation of signs and symptoms of spasticity, may be used in spinal cord injuries or spinal cord diseases
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| Lioresal metabolized? | not metabolized
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| Nursing Considerations for Lioresal | -Warn about driving, operating equipment
-no alcohol use
-warn about CNS depressants
-taper drug over 1-2weeks (to prevent psychoses)
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| Direct Acting Skeletal Muscle Relaxants interfere with? | release of calcium from muscle tubules
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| D.A.S.M.R.- Interfere with release of calcium from muscle tubules prevents? | prevents fibers from contracting
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| D.A.S.M.R.- Interfere with release of calcium from muscle tubules don't interfere with? | Don't interfere with neuromuscular transmission
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| Direct acting skeletal muscle relaxants treat ____ directly affecting what? | treat spasticity directly affecting peripheral muscle contraction
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| Direct acting skeletal muscle relaxants manage? associated with? | Manage spasticity associated with neuromuscular disease
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| Contraindications for Direct acting skeletal muscle relaxants | spasticity related to locomotion, hepatic disease, lactation
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| Adverse reactions of Direct acting skeletal muscle relaxants | fatigue,weakness,confusion,GI irritation, enuresis(bed wetting), urinary frequency and urgency
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| Drug-Drug for Direct acting skeletal muscle relaxants | Estrogen(risk of liver toxicity), neuromuscular junction blockers(added effect)
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| Example of Direct acting skeletal muscle relaxants | Dantrium
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| Nursing Implications for Direct acting skeletal muscle relaxants | Assess for muscle weakness, respiratory depression, liver damage(NV,anorexia, fatigue), extravasation(alkaline solution), diarrhea(lower dose)
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mhruska
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