Cognition 1 Flashcards by Rudy McLean

Benzodiazepines - drugs, action, side effects, nursing interventions?

Drugs: Alprazolam
Action: Bind with GABA, intensify effects of GABA
Side effects: Drowsiness, respiratory depression, sedation, lethargy, sleep hangover, dependence
Nursing interventions: Antidote - flumazenil, tolerance, avoid alcohol, safety (driving), take 30-60 minutes before bedtime.

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Barbiturates - action, side effects, nursing interventions?

Action: Depress CNS function @ all levels
Side effects: Resp. depression, hypotension, sedation, drowsiness, somnolence.
Nursing interventions: Rarely used - dependence high, W/D can be fatal, overdose – death

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Non-benzodiazepines, non-barbiturates - drugs, action, side effects, nursing interventions?

Drugs: Zolpidem
Action: Various
Side effects: Drowsiness, dizziness, headache, fatigue, dry mouth, diarrhea, hypotension, N&V
Nursing interventions: Buspirone - take several weeks before effective - accumulates, non-addicting

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Anti-seizure side effects?

Sedation, drowsiness, N&V, prolonged bleeding time.

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Beta blockers action, side effects?

Action: Suppress sympathetic system for anxiety
Side effects: Bradycardia, hypotension, confusion, fatigue

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Melatonin action, side effects?

Action: Melatonin receptor agonists
Side effects: Somnolence, dizziness, nausea

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Alprazolam (Xanax) classification?

Benzodiazepine

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Alprazolam (xanax) contraindications?

Acute narrow angle glaucoma
pulmonary disease
alone in primary depression or psychotic disorders
Bipolar disorders
Organic brain disorders

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Alprazolam (xanax) uses/action?

CNS depressant - acts on limbic, thalamic, hypothalamic levels of CNS
Uses: Anxiety, sedative, panic disorders, alcohol withdrawal

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Alprazolam (xanax) interactions?

Alcohol
CNS depressants
Anticonvulsants
Antihistamines
Barbiturates
Narcotics
St. John’s wort
Cigarettes < serum level by 50%

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Alprazolam (xanax) side effects?

Drowsiness
sedation

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Alprazolam (xanax) nursing interventions?

Safety - sedation
No alcohol, CNS depressants, OTC antihistamines
Do not drive until response known
Taper dose to D/C
Withdrawal: N&V, abdominal/muscle cramps, sweating, confusion, tremors, convulsions.

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Zolpidem (ambien) classification?

Sedative-hypnotic, non-barbiturate

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Zolpidem (ambien) contraindications?

Angioedema, suicidal ideation, depression

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Zolpidem (ambien) uses/action?

Uses: short-term treatment of insomnia
Action: Binds with GABA-A - inhibiting action potential in cortical region of the brain

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Before giving zolpidem (ambien)?

Assess respiratory rate - do not give if <12/min

Zolpidem (ambien) interactions?

CNS depressants
alcohol
phenothiazines
food < absorption

Zolpidem (ambien) side effects?

headache on awakening
drowsiness
fatigue
lethargy
sleepwalking

Zolpidem (ambien) nursing interventions?

Give immediately before bedtime
Give on an empty stomach
Monitor for S/S of depression
Avoid alcohol, other CNS depressants
Do not drive until drug response is known
Report vision changes to prescriber

Rivastigmine (exelon) classification?

Cholinesterase inhibitor, antidementia

Rivastigmine (exelon) contraindications?

None

Rivastigmine (exelon) uses/action?

Uses: Mild to moderate dementia of Alzheimer’s, Parkinsons disease related dementia.

Rivastigmine (exelon) interactions?

Attenuate effects of anticholinergic agents

Rivastigmine (exelon) side effects?

N&V
Anorexia
Diarrhea
abdominal pain
Dizziness
Headache
Insomnia

Rivastigmine (exelon) nursing interventions?

Give with food Monitor cognitive function & ability to perform ADLs Withhold drug & notify HCP if N&V, anorexia, wt. loss occurs Monitor ambulation - safety (dizziness) Monitor diabetics for loss of glycemic control. Weigh pt. weekly Overdose: severe N&V, sweating, salivation, hypotension, bradycardia, convulsions, > muscle weakness.

Memantine (Namenda) classification?

N-methyl-D-aspartate (NMDA) receptor antagonist; antidementia

Memantine (Namenda) contraindications?

Renal failure

Memantine (Namenda) Uses/action?

Uses: Moderate to severe Alzheimer's Action: Block NMDA receptors slowing intracellular calcium accumulation, preventing nerve damage without interfering w/ glutamate.

Memantine (Namenda) interactions?

Carbonic anhydrase inhibitors sodium bicarbonate < effects of levodopa containing drugs

Memantine (Namenda) side effects?

None

Memantine (Namenda) nursing interventions?

Assess for & report S/S of focal neurologic deficits Monitor diabetics for loss of glycemic control Monitor LFTs, renal function, urine pH Report to HCP: vision problems, skin rash, SOB, swelling of throat/tongue, agitation/restlessness, confusion, dizziness, incontinence. Do not drive until reaction to drug is known.