Neuro: Therapeutic Uses Flashcards
epinephrine
(Adrenalin) stimulated alpha 1+2 and beta 1+2, chatecholamine (does not cross BBB)
- elevates BP, anaphylactic (epipen), bronchodilation, overcome heart block
Adverse effects: dysrythmias, hypertension, necrosis, high sugars, psych meds interactions
albuterol
(Proventil, Ventolin) noncatecholamines, more able to cross BBB, longer half life
bethanechol
(Urecholine) make wetness FLUID EVERYWHERE
- used for urinary retention in postpartum or postop (not for blockages)
Adverse: hypotension (low) brady cardia, excessive salivation, increased gastric acid (bad for ava) abdominal cramps (not absorbing as much water), more bronchoconstriction, dysrhythmias
-stigmine
(Prostigmin) used to treat muscles issues (myasthenia gravis) will get things moving
- will get liquid everywhere
Adverse: SLUD
atropine
(AtroPen) dries everything up
natural found in nature, bright red berries (deadly nightshade)
- mimics fight or flight response, increases HR, dilates pupil, relaxes bronchi
Adverse: BUDCAT, bad for asthma or covid (want stuff in fluid to stay wet so that it doesnt become a blockage)
benzotropine
(Cogentin) a parkinsons med (EXAM)
helps dry up the synapse gap and allows the transfers of action potential
Adverse: BUDCAT
tolterodine tartrate
(Detrol) for an overactive bladder, selective for the bladder!
- “generic” would be benadryl if you don’t want to pay and don’t have other options
diazepam
(Valium) benzo
calms everything down, can cause amnesia, can cause excitability (1/20)
can be a rescue med for seizures
alprazolam
tremazepam
triazolam
(Xanax)
(Restoril)
(Halcion)
more examples of benzos, treat anxiety
zolpidem
(ambien) benzo - similar
short term only 2-4.5 hours, gets people to sleep may wake people up
effects: daytime drowsiness, NO ETOH
ketamine hydrochloride
(ketalar) works quick and you need a lot of it
midazolam
(versed) minor surgery or intubation, patient can still respond to commands
propofol
(Diprivan) minor surgery or intubations, so that patient can respond to commands
procaine hydrochloride
(Novocain) local anesthetic
lidocane hydrochloride
(Xylocaine) local anestetic
comes in patches, can go fishing for IVs
phenytoin
(Dilantin) treats sezuries (10-20)
DOES not play nice #4, never stop abruptly
not for use in pregnancy’s, and decreases effect of oral contraception’s
adverse above 20: ataxia (stumbling gait) sedation, double vision, gingival hyperplasia (grown gum)
adverse below 10: seziures
adverse normal IV: iv necrosis (purple glove syndrome), constipation, trouble sleeping, headache, high BS
pentothal
induction of anestesia
phenobarbital
(Luminal) barbituate
NURSING: shake for 5 minutes
Lab value: 20-40
treatment of seizures
clonazepam
(Klonopin) treats absent seizures (petit mal)
- tolerance occurs after 6 months
carbamazepine
(Tegretol) seizure control
- grapefruit effect
Adverse: headaches, gait change and unsteadiness
LAB: CBC monitoring
Steven Johnson syndrome, ask all people if they are of Asian descent for genetic testing (deadly skin rash)
valproate
(Depakote) seizure control, slow release for younger kids (not for below 2)
1/500 have LIVER issues: right side tenderness, appetite off, doesn’t want to do anything
gabapentin
(Neurontin)
80% scripts for off-label use (migraines, fibromyalgia, hot flashes)
Can be used for seizures, works on nerves, after shingles outbreaks
Very well tolerated , often combined with other AEDs
levetiracetam
(Keppra)
PREVENT and TREAT seizures
Unknown how it works
Works well most other medication
Adverse: fatigue, weakness
Should consider if should be driving
KEPPRA Rage is real! Large reports of
personality changes
Does NOT impair cognitive functions
MAJOR RED FLAGS:
Steven Johnson syndrome
Suicidal thoughts (mood changes, new anxiety, new agitation)
