Drugs for Neurologic Disorders Flashcards
drugs used for epileptic seizures; “antiepileptic drugs (AEDs)”
Anticonvulsants
seizure characterized by sustained muscle contraction
Tonic Seizure
seizure characterized by dysrythmic muscle contraction
Clonic Seizure
a diagnostic test used to diagnose epilepsy; records abnormal electric discharges of the cerebral cortex
electroencephalogram (EEG)
overgrowth of the gum tissues or reddened gums that bleed easily
gingival hyperplasia
the most common form of seizure in which the muscles contract or tighten in a spasm lasting 3-5 seconds then start dysrythmic contractions or jerkiness of limbs for 2-4 minutes
Grand Mal Seizure
a rapid succession of epileptic seizures
Status Epilepticus
brief loss of consciousness lasting less than 10 seconds with fewer than 3 spikes on the EEG ; usually occurs in children
Petit Mal Seizure
medication used to treat Alzheimer’s disease symptoms: tacrine, donezepril, rivastigmine, & galantamine
Acetylcholinesterase (AChe) Inhibitor
slow movement
Bradykinesia
drugs that stimulate dopamine receptors
Dopamine Agonists
impaired voluntary movement
Dyskinesia
involuntary abnormal movement
Dystonic Movement
disease marked by involuntary tremors of the limbs, rigidity of the muscles & slowness of movement; gradual onset generally affecting persons over 50 years of age
Parkinsonism
disease frequently occurring as an adverse reaction to antipsychotic drugs mimicking parkinsonism
Pseudoparkinsonism
acute exacerbation of symptoms of myasthenia gravis
Cholinergic Crisis
neuromuscular disorder that attacks the myelin sheath of nerve fibers, causing lesions known as plaques
Multiple Sclerosis
drugs that reduce the spasticity of muscles
Muscle Relaxants
a chronic autoimmune neuromuscular disease that affects approximately 14 in 100,000 persons…muscular weakness & fatigue, respiratory muscle paralysis, ptosis, difficultly chewing/swallowing…lack of ACh reaching cholinergic receptors…treated w/ AChE Inhibitors
Myasthenia Gravis (MG)
severe generalized muscle weakness that may involve the muscles of respiration
Myasthenia Crisis
anticonvulsant (AED) that inhibits sodium inlfux (phenytoin)
Hydantoins
G.U.M.S.= Nursing Interventions for Anticonvulsants
nursing interventions for anticonvulsants…G= gingival hyperplasia, U= use alternate birth control, M= mouth care, S= don’t stop abruptly
Nursing Interventions for Dopaminergic Agent Administration
monitor vital signs & EEG, monitor orthostatic hypotension, observe for weakness, dizziness or syncope; administer with low protein foods, observe for symptoms of parkinsonism
Patient Teaching for Dopaminergic Agent Administration
urge pt. not to stop abruptly, advise urine may be discolored, advise not to crush or chew ER tablets, encourage pt. to report side effects, advise that food will slow absorption rate, urge pt. who takes selegiline to avoid foods high in tyramine (hypertension), urge pt. taking amantadine to report skin lesions, seizures or depression; advise pt. taking bromocriptine to report lightheadedness, warn pt. to avoid alcohol when taking bromocriptine, teach pt. to check HR
Nursing Interventions for Anticholinergic Agents Administration
monitor vital signs, urine output & bowel sounds; observe for involuntary movements
Patient Teaching for Anticholinergic Agents Administration
advise pt. to avoid alcohol, cigarettes, caffeine & aspirin; encourage pt. to relieve dry mouth; suggest sunglasses & sunscreen; advise pt. to void before taking the drug; encourage pt. to have routine eye exams, encourage pt. to eat high fiber foods & increase fluid intake
Nursing Interventions for Rivastigmine Administration
maintain consistency in care, assist pt. in ambulation, monitor for side effects, record vital signs, observe for behavioral changes
Patient Teaching for Rivastigmine Administration
explain purpose of drug, clarify time for dosing, teach family about safety techniques, inform family of support groups, advise pt. to rise slowly, monitor LFTs, inform family about food preparation for tolerance
to relieve muscular spasms & pain associated with traumatic injuries & spasticity from chronic debilitating disorders (MS, stroke, cerebral palsy, head & spinal cord injuries)
Indications for Muscle Relaxants
Nursing Interventions for Muscle Relaxant Administration
monitor serum liver enzyme levels of pt. taking dantolene & carisoprodol, record vital signs, observe for CNS effects,
Patient Teaching for Muscle Relaxant Administration
teach pt. not to stop abruptly, advise pt. not to drive/operate machinery, inform pt. that drugs are usually not taken longer than 3 weeks, teach pt. to avoid alcohol, advise pt. to use cautiously with pregnancy, encourage pt. to report side effects: N&V, dizziness, fainting, headache, diplopia; advise pt. to take with food
Three Ways Anticonvulsants Work
(1) suppressing Na+ influx= Hydantoins (2) suppressing Ca+ influx= Succinamides (3) increasing action of GABA= Barbituates
Nonpharmcological Treatments for Parkinsonism
exercise, nutritional diet, support groups
Parkinsonism Medications
Anticholinergics, Dopaminergics, Dopamine Agonists, MAO-B inhibitor, COMT inhibitor
1st group of drugs for Parkinson’s (drug induced)…inhibits release of ACh…decreases tremors…start w/ low dosages then gradually increase…contraindicated in pt. w/ memory loss/dementia, glaucoma, GU obstruction, BPH
Anticholinergics as Parkinson’s Drug (benztropine, biperiden, trihexyphenidyl, Benadryl)
drugs that decreases symptoms of Parkinson’s…carbidopa, a decarboxylase inhibitor, permits more levodopa to reach striatum nerve terminals where it’s converted to dopamine
Dopaminergics
drugs for Parkinson’s…selegiline- inhibits catabolic enzymes of dopamine to extend action of dopamine (early treatment of Parkinson’s)…rasagiline- inhibits breakdown of dopamine at synapses in brain, allows neurons to reabsorb more dopamine for use later
MAO-B Inhibitor
drug that inhibits COMT enzyme increasing concentration of levodopa (used in combo w/ carbidopa-levodopa)
COMT Inhibitor
Side Effects of Anticholinergics
red as a beet, dry as a bone, mad as a hatter, hot as a hare, can’t see can’t pee, can’t spit can’t shit, N&V, postural hypotension
Side Effects of Dopaminergics
GI upset, dyskinesias, orthostatic hypotension, cardiac dysrythmias, psychosis, agranulocytosis (low WBC)
tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), memantine (Namenda XR)
ACh Inhibitors for Alzheimer’s Disease
Drugs for Myasthenia Gravis (MG)
ultrashort-acting= Tensilon, short-acting= Prostigmin, intermediate-acting= Mestinon, long-acting= Mytelase
Side Effect of AChE Inhibitors for MG
GI disturbances, increased salivation, increased tearing, miosis, blurred vision, bradycardia & hypotension
disease characterized by weakness or spasticity in extremeties & double vision (diplopia)
Multiple Sclerosis
