Chronic Neurologic Disorders 13 Flashcards
Anti-Parkinson’s medications
Levodopa
Mirapex Cogentin Symmetrel
They do not halt the progression, but they offer symptomatic relief.
Family members assist with medication. There may be a sudden loss of effects of the medication. Effects may take several weeks to several months. Holidays maybe indicated, but must be monitored in the hospital setting. Avoid high-protein snacks and meals.
Cholinesterase inhibitors
Neostigmine(prostigmin)
Mytelase/ambenonium: Trt myasthenia gravis
mestinon/ pyridostigmine: Trt myasthenia gravis, reverse neuromuscular blockade
tensilon/edrophonium: dx myasthenia, reverse neuromuscular blockade
Prostigmin/neostigmine: Trt myasthenia gravis, reverse neuromuscular blockade
Existence muscarine stimulation as evidenced by increased GI motility, increased secretions, bradycardia, urinary urgency. Treat with atropine. Cholinergic crisis include respiratory depression and neuromuscular blockade. Treat with atropine. Contraindicated with obstruction of GI and GU.
Atropine counteracts and treats toxicity.
Can reverse neuromuscular blocking agents after anesthesia. Succinylcholine increases neuromuscular blockade.
Encourage clients to participate in self dosage adjustments by keeping a record of medication administration, signs of inadequate dosing such as difficulty swallowing and signs of overmedication such as urinary urgency. Where a medical alert bracelet.
Levodopa
First-line meds for Parkinson’s disease. Side effects include nausea and vomiting, gassiness. Dyskinesias such as head bobbing in trimmers may require a decrease in dosage. Orthostatic hypotension. Cardiovascular effects including tachycardia, palpitations, irregular heartbeat. Psychosis including visual hallucinations and nightmares may need an antipsychotic medication. Discolored sweat and urine. Activation of malignant melanoma, do not use if suspected.
Do not use look into weeks of MAOIs. Proteins decreased the therapeutic effect. Vitamin B6 decreases effect.
Pramipexole (mirapex)
Notify the doctor if you have a sudden inability to stay awake. Daytime sleepiness. Avoid other CNS depressants such as alcohol. Orthostatic hypotension. Psychosis. Dyskinesias. Nausea: take with food.
If used with levodopa it can cause increased hypotension and dyskinesias
Benztropine/cogentin
Side effects include nausea and vomiting: take with food but not high-protein. Atropine like effects such as dry mouth, blurred vision, mydriasis, urinary retention, constipation. Notify the doctor, chew sugarless gum, eat high fiber, increase fluids. Antihistamine effects such as Sedation and drowsiness. Avoid activities. Contraindicated with narrow angle glaucoma. Used with caution in the older and very young, and clients that have an enlarged prostate and urinary retention.
Amantadine/Symmetrel
Is antiviral. May cause CNS effects such as confusion, dizziness, and restlessness. It has atropine like effects such as dry mouth, blurred vision, urinary hesitancy, retention, constipation, and mydriasis. It can discolor the skin which is called livido reticularis and will subside when the medicine discontinued
Phenobarbital/luminal
AED, barbiturate
Partial seizures and generalized tonic clonic. It is not for absence. CNS such as drowsiness, sedation, confusion, and anxiety. In children they may be irritable or hyperactive.
Toxicity includes nystagmus, ataxia, respiratory depression, coma, pinpoint pupils,hypotension, death. Stop medication, give oxygen and ventilation, monitor vitals.
Phenytoin/Dilantin
Hydantoin/AED
Is effective against all major forms of epilepsy except absence seizures. IV for status epileptic. Can be used as antidysrhythmic. CNS include nystagmus, sedation, ataxia, double vision, cognitive impairment. Gingival hyperplasia occurs and should have good oral hygiene. Stop if a skin rash. The boy in pregnancy. Can cause dysrhythmias and hypertension: give slow IVN dilute. It can cause a coarsening of facial features, hirsutism, and interfere with vitamin D metabolism.
Causes a decrease in contraceptives, warfarin, and glucocorticoids. Alcohol, valium, Tagamet, and valproic acids increase levels. Tegrotol decreases levels.
Carbamazepine/tegretol
AED
Used for simple and complex seizures, tonic clonic seizures, bipolar disorder, trigeminal and glossopharyngeal neuralgia. Side effects include a slight decrease in cognitive function. CNS effects such as nystagmus, double vision, vertigo, staggering gait, headache. Blood dyscrasias such as leukopenia, anemia, and thrombocytopenia. It is hypo osmolarity increases risk for fluid overload. Can cause a skin disorder. Decreases world contraceptives and warfarin. Not take with grapefruit juice.
General antiepileptic instructions
Monitor Plasma levels and know the therapeutic range. It controls does not cure. Keep a seizure diary. Do not stop suddenly. avoid hazardous activities until seizures are controlled. Carry extra medications when traveling. Avoid pregnancy.
