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Pharmacology Exam #1 > Neurological Medications > Flashcards

Neurological Medications Flashcards

1
Q

baclofen (Lioresal): class

A

centrally acting muscle relaxants

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2
Q

baclofen (Lioresal): use

A

drugs for muscle spams, spinal cord injuries, MS, CP

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3
Q

baclofen (Lioresal): ADRs

A

drowsiness/dizziness, weakness/fatigue is common, N/V, constipation and urinary retention is possible

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4
Q

baclofen (Lioresal): contraindications

A

ETOH, MAOIs, SSRI, caution in older adults, children, severe mental disorders, and CVAs

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5
Q

baclofen (Lioresal): RN interventions

A

Must be tapered to prevent withdrawal (seizures, spasticity/fever and muscle damage)
- take with food, fiber + hydration to decrease constipation, caution with things that need mental alertness, change position slowly

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6
Q

Dantrolene (dantrium): class

A

peripherally acting muscle relaxants/ direct-acting skeletal muscle relaxers

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7
Q

Dantrolene (dantrium): use

A

malignant hyperthermia, muscle spasms, spinal cord injuries

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8
Q

Dantrolene (dantrium): ADR

A

muscle weakness, drowsiness, dizzy, diarrhea, higher dose may lead to liver toxicity

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9
Q

Dantrolene (dantrium): contraindications

A

avoid w/ liver disease, older women on estrogen higher risk, ETOH, calcium channel blockers -> cardiac dysrhythmias

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10
Q

Dantrolene (dantrium): RN Interventions

A

call provider if prolonged diarrhea and muscle weakness, report abdominal pain or jaundice (liver failure)

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11
Q

phenytoin (Dilantin): class

A

traditional AEDs - hydantoins

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12
Q

phenytoin (Dilantin): use

A

tonic-clonic &partial seizures

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13
Q

baclofen (Lioresal): EPA

A

increases effects of GABA in spinal cord, suppression of hyperactive reflexes

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14
Q

dantrolene (Dantrium): EPA

A

acts directly on skeletal muscle by inhibiting calcium releases

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15
Q

phenytoin (Dilantin): EPA

A

suppress sodium uptake in neurons which reduces neuronal activity in seizure-generating cells of the brain

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16
Q

phenytoin (Dilantin): ADR

A

CNS depression, downiness, gingival hyperplasia, skin rash

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17
Q

phenytoin (Dilantin): contraindications

A

teratogenic, bradycardia/heart block, MANY drug interactions, oral contraceptives

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18
Q

phenytoin (Dilantin): RN interventions

A

Narrow therapeutic window (10-20), too much will lead to nystagmus, ataxia, sedation, blurred vision, Give slowly, educate on good dental hygiene, don’t stop abruptly

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19
Q

carbamazepine (Tegretol): class

A

Traditional AEDs: Iminostilbenes

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20
Q

carbamazepine (Tegretol): use

A

tonic-clonic & partial seizures, bipolar, trigeminal neuralgia pain

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21
Q

carbamazepine (Tegretol): EPA

A

inhibits sodium influx through sodium channels to decrease neuronal activity

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22
Q

carbamazepine (Tegretol): ADR

A

neurological effects - visual disturbances, HA, ataxia, nystagmus, blurred vision. Fluid retention. Skin rash (SJS). Photosensitivity. Bone marrow suppression = decreased blood counts

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23
Q

carbamazepine (Tegretol): contraindication

A

teratogenic, avoid in absence/myoclonic seizures, people with hematologic disorders or heart failure, MANY drug interactions

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24
Q

carbamazepine (Tegretol): RN interventions

A

give with food, monitor CBC, call provider about rash, decreased urine output or edema, avoid grapefruit juice, use condoms also if using oral contraceptives

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25
Q

valproic acid (Depakote, Depacon, Depakene): class

A

Traditional AEDs: Histone Deacetylase Inhibitor

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26
Q

valproic acid (Depakote, Depacon, Depakene): use

A

ALL seizure types, mania of bipolar

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27
Q

valproic acid (Depakote, Depacon, Depakene): EPA

A

effect influx of calcium and enhance inhibitory effects of GABA

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28
Q

valproic acid (Depakote, Depacon, Depakene): ADR

A

GI upset/indigestion, bone marrow suppression (blood stuff), skin rash, live toxicity

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29
Q

valproic acid (Depakote, Depacon, Depakene): contraindications

A

teratogenic, avoid if with liver disorder, thrombocytopenia, hyperammonemia, caution with other anticonvulsants

30
Q

valproic acid (Depakote, Depacon, Depakene): RN Intervention

A

give with food, monitor lab values (blood and liver), call provider if rash, N/V, jaundice, confusion, bleeding, avoid getting pregnant

31
Q

lidocaine (Xylocaine) - “amide” type: class

A

local anesthetics

32
Q

lidocaine (Xylocaine): uses

A

anesthesia to direct body area, suturing, dental procedure, nerve blocks, epidural/spinal anesthesia

33
Q

lidocaine (Xylocaine): EPA

A

blocks influx of sodium, prevents depolarization = no action potential activated

34
Q

lidocaine (Xylocaine): ADR

A

only occur in high systemic absorption, stimulation or depression of CHS, most severe: respiratory depression, hypotension, cardiac dysrhythmias

35
Q

lidocaine (Xylocaine): RN Intervention

A

monitor vital signs and respiratory rate, do not administer in eyes or broken skin

36
Q

lidocaine (Xylocaine): contraindication

A

allergy, avoid viscous solution in children under 3 years, caution in clients with bradycardia

37
Q

methohexital sodium (Brevital): class

A

general anesthetics: barbiturates

38
Q

methohexital sodium (Brevital): EPA

A

enhances inhibitory effects of GABA and causes significant CNS depression

39
Q

methohexital sodium (Brevital): Use

A

rapid induction of anesthesia and hypnosis

40
Q

methohexital sodium (Brevital): ADR

A

respiratory depression & hypotension

41
Q

methohexital sodium (Brevital): RN intervention

A

resuscitation and emergency equipment close by, airway maintenance supplies, IV fluids, vasopressors, monitor IV site for extravasation

42
Q

midazolam (Versed): class

A

adjuncts to anesthesia/ conscious sedation: Benzodiazepines

43
Q

midazolam (Versed): EPA

A

enhance inhibitory effects of GABA = CNA depression, hypnosis and amnesia

44
Q

midazolam (Versed): use

A

conscious sedation, sedation prior to general anesthesia, supplement inhaled anesthesia

45
Q

midazolam (Versed): ADR

A

amnesia, large dosages have potential for cardiac and respiratory areest

46
Q

midazolam (Versed): RN intervention

A

educate on amnesia effects, monitor vital signs and respiratory signs, have resuscitation equipment nearby

47
Q

midazolam (Versed): contraindications

A

teratogenic, greater CNS depression when given with others, Herbal products may increase or decrease effects

48
Q

fentanyl (Duragesic): class

A

adjuncts to anesthesia/ conscious sedation: opioids

49
Q

fentanyl (Duragesic): EPA

A

pain receptor agonists that cause analgesia and sedation, Narcotic

50
Q

fentanyl (Duragesic): ADR

A

sedation, respiratory depression, hypotension, nausea

51
Q

fentanyl (Duragesic): contraindication

A

history substance abuse, teratogenic, caution with intracranial pressure, older adults, young children, caution with liver, respiratory, or kidney disorders, do not give with MAOIs, given with other CNS depressants = excessive respiratory depression

52
Q

fentanyl (Duragesic): RN Interventions

A

monitor vital signs, have resuscitation equipment on hand, educate to report nausea, schedule II controlled substance, have reversal! NALOXONE

53
Q

amphetamine/ dextroamphetamine sulfate (Adderall): class

A

CHS stimulant: Amphetamines

54
Q

amphetamine/ dextroamphetamine sulfate (Adderall): EPA

A

increases norepinephrine and dopamine in brain and PNS = more alert, energy, improved mood, increased ability to focus/attention span

55
Q

amphetamine/ dextroamphetamine sulfate (Adderall): use

A

ADHA, Narcolepsy

56
Q

amphetamine/ dextroamphetamine sulfate (Adderall): ADRs

A

insomnia, nervousness, hypertension, tachycardia, palpitations, weight loss, appetite suppressant effect, large doses may show paranoid schizophrenia

57
Q

amphetamine/ dextroamphetamine sulfate (Adderall): RN Interventions

A

give in the AM, monitor weight in children, drug “holidays,” schedule II - high risk for abuse, can lead to dependence, taper, monitor vitals, educate to avoid caffeine, report severe symptoms

58
Q

amphetamine/ dextroamphetamine sulfate (Adderall): contraindications

A

avoid in clients with cardio problems, severe hypertension, hyperthyroidism, never take with MAOIs

59
Q

methylphenidate (Ritalin, Concerta): class

A

CNS Stimulant: Amphetamine-related

60
Q

methylphenidate (Ritalin, Concerta): EPA

A

same as amphetamines, increase norepinephrine and dopamine in brain and PNS = more alert, improved mood, attention

61
Q

methylphenidate (Ritalin, Concerta): Use

A

ADHD, Narcolepsy

62
Q

methylphenidate (Ritalin, Concerta): ADR

A

insomnia, nervousness, hypertension, tachycardia, palpitations, weight loss, appetite suppressant effect, large doses may show paranoid schizophrenia, Toxicity: psychosis, dysrhythmias, seizures

63
Q

methylphenidate (Ritalin, Concerta): RN Interventions

A

same as amphetamines, applying patch: press in place for 30 seconds, remove after 9 hours, do not touch drug side with fingers

64
Q

methylphenidate (Ritalin, Concerta): Contraindications

A

same as amphetamines, do not use with history of psychosis/depression, not in children under 6 years

65
Q

modafinil (Provigil): class

A

CNS Stimulant: Non-amphetamine

66
Q

modafinil (Provigil): EPA

A

precise mechanism unknown. Thought to block reuptake of norepinephrine

67
Q

modafinil (Provigil): Use

A

ADHD, narcolepsy, shift-work sleepiness, obstructive sleep apnea

68
Q

modafinil (Provigil): ADR

A

common= nausea and diarrhea, headache, tachycardia, hypertension, rare = SJS

69
Q

modafinil (Provigil): RN Intervention

A
  • administer in AM or 1 hour before work
  • take with food to minimize GI effects
  • monitor for CNS effects
  • report rash immediately
  • use other contraception
  • lower abuse potential but can lead to psychological dependence
70
Q

modafinil (Provigil): contraindications

A
  • avoid in clients with valvular heart disease
  • caution with cardio problems, hypertension, renal or hepatic failure
  • No with methylphenidate
  • interacts with oral contraceptives

Pharmacology Exam #1 (4 decks)

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