Nervous System Medications Flashcards
1
Q
Anti-anxiety medication action
A
Increase the efficacy of GABA to reduce anxiety
2
Q
Anti-anxiety medications (3)
A
- Benzodiazepines
- Buspirone
- Antidepressants
3
Q
Antidepressant medications (4)
A
- Venlafaxine
- Duloxetine
- Paroxetine
- Escitalopram
4
Q
Anti-anxiety uses (4)
A
- Generalized anxiety disorder, panic disorder
- Insomnia
- Alcohol withdrawal
- Anesthesia induction
5
Q
Anti-anxiety precautions (2)
A
- Use caution when giving benzos to patients with substance use disorder and liver disease
- Venlaxafine contraindicated in patients on MAOIs
6
Q
Anti-anxiety side/adverse effects (4)
A
- CNS depression
- Paradoxical response (insomnia, excitation, euphoria)
- Withdrawal symptoms (not buspirone)
- Risk of abuse/overdose (benzodiazepines)
7
Q
Anti-anxiety nursing interventions (4)
A
- Monitor vitals
- Never stop abruptly
- Monitor for side/adverse effects
- Avoid alcohol
8
Q
SSRI antidepressants action
A
Block serotonin reuptake
9
Q
SNRI antidepressants action
A
Block reuptake of norepinephrine and serotonin
10
Q
Tricyclic antidepressants action
A
Block reuptake of norepinephrine and serotonin
11
Q
MAOI antidepressants action
A
Increase norepinephrine, dopamine, serotonin by blocking MAO-A
12
Q
SSRI medications (4)
A
- Citalopram
- Fluoxetine
- Paroxetine
- Sertraline
13
Q
SNRI medications (2)
A
- Duloxetine
- Venlafaxine
14
Q
SSRI/SNRI precautions (3)
A
- Avoid alcohol
- Don’t stop abruptly
- Monitor for serotonin syndrome (agitation, confusion, hallucinations) within first 72 hours
15
Q
SSRI/SNRI side/adverse effects (4)
A
- Weight gain
- Sexual dysfunction
- Fatigue
- Drowsiness
16
Q
Tricyclic medications (2)
A
- Amitriptyline
- Imipramine
17
Q
Tricyclic precautions (3)
A
- Don’t use with MAOIs, St. John’s wort
- Avoid alcohol
- Contraindicated in patients with seizure disorders
18
Q
Tricyclic side/adverse effects (4)
A
- Anticholinergic effects
- Orthostatic hypotension
- Cardiac dysrhythmias
- Decreased seizure withhold
19
Q
MAOI medications (3)
A
- Isocarboxazid
- Tranylcypromine
- Phenelzine
20
Q
MAOI precautions (3)
A
- Avoid foods with tyramine
- Antihypertensives have additive hypotensive effect
- Contraindicated with SSRIs, tricyclics, heart failure, CVA, renal insufficiency
21
Q
MAOI side/adverse effects (3)
A
- CNS stimulation
- Orthostatic hypotension
- Hypertensive crisis in patients taking tyramine, SSRIs, tricyclics
22
Q
Antidepressant nursing interventions (7)
A
- Assess for suicide risk
- Take daily and don’t miss doses
- Teach client about therapeutic effects and time of onset
- Avoid stopping abruptly
- Take SSRIs in the morning to minimize sleep disturbances
- Give patients list of tyramine containing foods if taking MAOIs
- Avoid taking other medications without consulting with provider
23
Q
Bipolar disorder medications action
A
Produce neurochemical changes in the brain to control acute mania, depression, and incidence of suicide
24
Q
Bipolar disorder medication
A
Lithium carbonate
25
Bipolar medication uses (4)
- Bipolar
- Alcohol use disorder
- Bulimia
- Schizophrenia
26
Bipolar medication precautions (3)
- Use caution in patients with renal dysfunction, heart disease, hyponatremia, dehydration
- NSAIDS increase lithium levels
- Monitor serum sodium levels
27
Bipolar medication side/adverse effects (5)
- GI distress
- Fine hand tremors
- Polyuria
- Hypothyroidism
- Renal toxicity
28
Bipolar medication nursing interventions (6)
- Monitor therapeutic levels
- Monitor serum sodium levels
- Therapeutic effects appear 7-14 days
- Dosing is 1-3 times daily
- Nutritional counseling for food sources with sodium
- Give with food to decrease GI distress
29
Antipsychotic medication action
Block dopamine, acetylcholine, histamine, norepinephrine receptors in the brain and periphery
30
Typical antipsychotic medications (4)
- Chlorpromazine
- Fluphenazine
- Thiothixene
- Haloperidol
31
Atypical antipsychotic medications (6)
- Aripiprazole
- Clozapine
- Olanzapine
- Paliperidone
- Quetiapine
- Ziprasidone
32
Antipsychotic medication uses (6)
- Acute/chronic psychosis
- Schizophrenia
- Manic phase of bipolar
- Tourette syndrome
- Delusional/schizoaffective disorders
- Dementia
33
Antipsychotic medication precautions (2)
- Contraindicated in patients with severe depression, Parkinson's disease, prolactin dependent cancer, severe hypotension
- Use caution in patients with glaucoma, paralytic ileus, prostate enlargement, seizure disorder
34
Typical antipsychotic medication side/adverse effects (7)
- Sedation
- Extrapyramidal effects
- Anticholinergic effects
- Tardive dyskinesia
- Agranulocytosis
- Neuroleptic malignant syndrome
- Seizures
35
Atypical antipsychotic medication side/adverse effects (6)
- Agranulocytosis
- Weight gain
- Diabetes
- Dyslipidemia
- Orthostatic hypotension
- Extrapyramidal effects
36
Antipsychotic medication nursing interventions (5)
- Monitor for side effects within 5 hours- 5 days of giving
- Inform patient of potential side effects
- Monitor CBC
- Encourage fluids
- Stop medication if experiencing signs of neuroleptic malignant syndrome
37
ADHD medication action
- Increase attention span, reduce impulsiveness/hyperactivity
38
ADHD stimulant medication action
Increase levels of norepinephrine, serotonin, dopamine into CNS
39
ADHD non stimulant medication action
Increase levels of norepinephrine into CNS
40
ADHD stimulant medications (3)
- Dextroamphetamine
- Amphetamine
- Methylphenidate
41
ADHD stimulant medication side/adverse effects (4)
- Insomnia
- Headache
- Suppressed appetite
- Abdominal pain
42
ADHD stimulant medication nursing interventions (3)
- Give early in the morning with/without food
- Don't stop abruptly
- Monitor for signs of abuse, agitation
43
ADHD non-stimulant medications (2)
- Atomoxetine
- Guanfacine for Asperger's syndrome
44
ADHD non-stimulant medication side/adverse effects (3)
- GI upset
- Insomnia
- Mood swings
45
ADHD non-stimulant medication nursing interventions (4)
- Take medication daily
- Don't crush/chew
- Report immediately if worsening anxiety, agitation
- Don't take with MAOIs
46
Sedative/hypnotic medication action
Slow neuronal activity in brain to induce sedation/sleep
47
Sedative/hypnotic medications (2)
- Benzodiazepines
- Benzodiazepine like medications
48
Benzodiazepine like medications (2)
- Zolpidem
- Eszopiclone
49
Sedative/hypnotic medication uses (2)
- Short term insomnia
- Difficulty falling/staying asleep
50
Sedative/hypnotic medication precautions (2)
- Use caution in patients with severe mental depression
- Avoid combining with alcohol and medications that depress CNS function
51
Sedative/hypnotic medication side/adverse effects (3)
- Amnesia
- Respiratory depression
- Daytime drowsiness, dizziness
52
Sedative/hypnotic medication nursing interventions (3)
- Take before bedtime because has abrupt onset of sleep
- Avoid alcohol
- Potential for sleep activities without recall, report to provider immediately
53
Abstinence maintenance medications (2)
- Disulfiram
- Methadone
54
Disulfiram action
Interferes with hepatic oxidation of alcohol resulting in elevation of blood acetaldehyde levels
55
Disulfiram use
- Maintain sobriety in treatment for alcohol use disorder
56
Disulfiram precautions (3)
- INH increases risk of adverse CNS effects
- Ingestion of large amounts of alcohol may cause respiratory depression, dysrhythmias, cardiac arrest
- Adjust doses of warfarin, phenytoin
57
Disulfiram side/adverse effects (4)
- Drowsiness
- Headache
- Metallic taste
- Hepatotoxicity
58
Disulfiram nursing interventions (5)
- Start medication 12 hours of last ingestion of alcohol
- Inform patient that if they consume alcohol while taking disulfiram they can experience flushing, throbbing headache/neck pain, dyspnea, n/v, sweating ,thirst, chest pain
- Effects last 30 minutes-several hours when alcohol is consumed
- Effects of disulfiram can stay in the body for weeks after medication is stopped
- Therapy can last weeks-years
59
Methadone action
Binds with opiate receptors in CNS to produce analgesic and euphoric effects
60
Methadone use
Prevent withdrawal symptoms in patients addicted to opioids
61
Methadone precautions (2)
- Don't use in patients with severe asthma, chronic respiratory disease, history of a head injury
- Avoid in patients with QT syndrome
62
Methadone side/adverse effects (3)
- Sedation
- Respiratory depression
- Paradoxical CNS excitation
63
Methadone nursing interventions (4)
- Monitor for drug tolerance, psychological dependence
- Monitor for respiratory depression
- Slowly taper dose to produce detoxication
- Patient must be monitored through treatment center
64
Cholinesterase inhibitor action
Prevent cholinesterase from inactivating acetylcholine resulting in improved transmission of nerve impulses
65
Cholinesterase inhibitor medications (3)
- Neostigmine
- Ambenonium
- Edrophonium
66
Cholinesterase inhibitor use
Myasthenia gravis
67
Cholinesterase inhibitor precaution
- Don't give if heart rate is less than 60/min
68
Cholinesterase inhibitor side/adverse effects (11)
- Slow heart rate
- Chest pain
- Weak pulse
- Increased sweating
- Dizziness
- Feeling faint
- Weak/shallow breathing
- Urinating more than usual
- Seizures
- Trouble swallowing
69
Cholinesterase inhibitor nursing interventions (4)
- Dose individualized
- Keep diary to record side effects
- Wear medical alert bracelet
- Monitor for cholinergic crisis
70
Anti-parkinson's medication action
Increase dopamine to minimize tremors and rigidity
71
Anti-parkinson's medications (3)
- Benztropine
- Carbidopa/levodopa
- Levodopa
72
Anti-parkinson's medication precautions (4)
- Don't use levodopa within 2 weeks of using MAOIs
- Pyridoxine (vitamin B6) decreases effects of levodopa
- Benztropine contraindicated in patients with narrow angle glaucoma
- Stop 6-8 hours before anesthesia
73
Anti-parkinson's medication side/adverse effects (5)
- Muscle twitching (especially in eyelids)
- Headaches
- Dizziness
- Dark urine
- Orthostatic hypotension
74
Anti-parkinson's medication nursing interventions (6)
- Family members should help with medication regimen
- Notify provider if sudden loss of medication effects
- Maximum therapeutic effects can take up to 4-6 weeks
- Monitor for signs of adverse reactions
- Avoid high protein meals and snacks
- Keep medication away from heat, light, moisture, dark pills means they lost their potency and should be thrown away
75
Anti-seizure medication action
Slow rates of neuronal activity in the brain by blocking specific channels responsible for neuron firing resulting in elevated seizure thresholds
76
Anti-seizure medications (5)
- Carbamazepine
- Gabapentin
- Phenobarbital
- Phenytoin
- Valproic acid
77
Anti-seizure medication use
Prevent and/or control seizure activity
78
Carbamazepine precautions (2)
- Contraindicated in patients with bone marrow suppression, bleeding disorders
- Decreases effectiveness of oral contraceptives and warfarin
79
Carbamazepine side/adverse effects (3)
- Anemia
- Leukopenia
- Stevens-Johnson syndrome
80
Gabapentin precaution
Don't stop abruptly
81
Gabapentin side/adverse effects (4)
- Headaches
- Weight gain
- Nausea
- Report CNS depression, seizures, visual changes, unusual bruising
82
Phenobarbital precautions
Contraindicated in history of substance use disorder
83
Phenobarbital side/adverse effects (3)
- Drowsiness
- Hypotension
- Respiratory depression
84
Phenytoin precautions
- Increased excretion of digoxin, warfarin, oral contraceptives
85
Phenytoin side/adverse effects (4)
- Gingival hypertrophy
- Diplopia
- Drowsiness
- Hirsutism
86
Valproic acid precautions
- Contraindicated in liver disease, pregnancy
87
Valproic acid side/adverse effects (3)
- Hepatotoxicity
- Teratogenic effects
- Pancreatitis
88
Nursing interventions for anti-seizure medications (6)
- Monitor for therapeutic effects
- Monitor patients taking phenytoin for toxic effects and serum levels
- Compliance important
- Treatment regimen is individualized
- Inform patients of side/adverse effects
- Status epilepticus: IV diazepam/lorazepam then IV phenytoin/fosphenytoin
89
Anti-glaucoma medication action
Reduce aqueous humor
90
Anti-glaucoma medications (4)
- Levobunolol
- Timolol
- Pilocarpine
- Latanoprost
91
Anti-glaucoma medication precautions
- Caution in patients taking oral beta blocker, calcium channel blocker
92
Anti-glaucoma medication side/adverse effects (3)
- Systemic effect of beta blockers: bradycardia, heart failure, bronchospasm
- Brown discoloration of iris (latanoprost)
- Retinal detachment (pilocarpine)
93
Anti-glaucoma medication nursing interventions (3)
- Use sterile technique when handling applicator portion of container
- Hold gentle pressure on nasolacrimal duct for 30-60 seconds immediately after instilling drops
- Monitor pulse rate/rhythm for patients taking beta/calcium channel blockers
