peds: GU & Neuro Flashcards
medications used to treat ADHD
- methylphenidate (Ritalin)
- amphetamine/dextroamphetamine (Adderall)
how does Ritalin improve symptoms of ADHD?
- increases attention span and cognitive performance
- decreases impulsivity, restlessness, hyperactivity
side effects of Ritalin
- GI disturbance
- anorexia
- headache
- confusion
- euphoria
- tremors
- hyperhidrosis
- irritability, restlessness, anxiety
nursing considerations for Ritalin
- risk for dependence
- do not take at bedtime
- take 30-45 mins before meals
describe how prolonged use of Amphetamine/Dextroamphetamine (Adderall) can affect the heart.
- tachycardia, palpitations, dysrhythmia, HTN
- adderall=stimulant, which causes an increase in heart rate, blood pressure, and temperature
identify common side effects of Amphetamine/Dextroamphetamine (Adderall).
GI disturbance, weight loss, xerostomia (production of not enough saliva), increased alertness, euphoria, insomnia, irritability/restlessness
list important patient education for taking Methylphenidate (Ritalin).
- Possible risk for dependence
- Do not take in evening or at bedtime
- Take 30-45 mins before meals
- Drug interactions: MAOIs, psychostimulants, sympathomimetics, barbiturates, anticonvulsants, anticoagulants
- Food interactions: caffeine, ginseng
- Monitor CBC and liver enzymes
MOA for Methylphenidate (Ritalin)
- treatment for ADHD
- increases attention span and cognitive performance
- decreases impulsivity, restlessness, hyperactivity
- inhibits reuptake of dopamine and norepinephrine; augments serotonin
MOA for Amphetamine/Dextroamphetamine (Adderall)
- treats ADD/ADHD
- stimulates release of neurotransmitters, then blocks reuptake
- norepinephrine + dopamine
- triggered in brain and sympathetic nervous system
identify the side effects of Baclofen (Lioresal) and list important assessment findings for those side effects.
- Dizziness- change in gait
- Drowsiness- change in LOC
- Confusion- failed neuro assessment, wandering
- h/a- complaints of pain, request for pain medication
- GI upset- tender abdomen, loose stools, nausea, complaints of pain, hyperactive bowel sounds
discuss some important nursing considerations for patients taking Baclofen (Lioresal).
- Notable sedative effect
- Cautious use with other depressant agents (barbiturates, narcotics, alcohol)
- Risk of drug dependence
- Gradual withdrawal of medication
explain how Baclofen (Lioresal) works to produce therapeutic effects.
- Treats skeletal muscle spasticity
- MOA is unknown, depresses neuron activity on spinal cord (CNS)
i. Suppresses hyperactivity reflexivity
ii. Decreases pain and improves mobility-
- Review and know the indications, side effects, and nursing considerations for the following:
a. Aspirin – Reye’s syndrome
b. Folic acid – neural tube defects
c. Tetracycline antibiotics
first-generation antihistamines properties and medications
- Anticholinergic properties:
Useful in cold treatment
s/e: dry mouth, blurred vision
avoid with narrow angle glaucoma - CNS properties:
Sedative effect
s/e: drowsiness, dizziness, fatigue - Medications:
Diphenhydramine (Benadryl)
Chlorpheniramine (ChlorTrimeton)
second-generation antihistamines properties and medications
- Minimal anticholinergic effects
- “non-sedating” antihistamine
- Medications:
Cetirizine (Zyrtec)
Loratadine (Claritin)
identify the common side effects of anti-histamines.
- Drowsiness
- Dizziness
- Fatigue
- Ataxia (loss of muscle control)
- Hypotension
- Wheezing/SOB
identify an indication for using an anti-histamine medication.
- Allergic rhinitis
- Allergic conjunctivitis
- Allergic dermatological reaction
- Sinusitis
- Urticaria
identify 2 advantages of second-generation antihistamine medications:
- minimal anticholinergic effects
- “non-sedating”
identify 2 disadvantages of first-generation antihistamine medications:
- anticholinergic side effects
- sedative effect
list an indication for using Fluconazole (Nystatin).
yeast infection
discuss important nursing considerations for administering Fluconazole (Nystatin).
- monitor liver, kidney, and cardiac function
- evaluate for medication/food interactions:
o Warfarin- increased INR
o Phenytoin- potentiation of effect
o Sulfonylureas- increased hypoglycemia
o Caffeine- increased serum levels
identify the route of administration for Fluconazole (Nystatin) and some important lab test the nurse should monitor.
- PO, IV, topical
- monitor liver, kidney, cardiac function
explain how Permethrin (Eliminate, Nix) works in the treatment of scabies and head lice.
- damages the nerve cell membrane, which causes paralysis of parasite
identify and discuss important patient teaching for administering topical Permethrin (Eliminate, Nix).
- all areas of body from neck down
- avoid contact with eyes
- apply to clean, cool, dry skin
- remain on for 8-14 hours
- thoroughly wash off
identify an important drug-drug interaction that can occur when using Ivermectin.
warfarin- may slow clotting time when taken concurrently
identify and discuss the contraindications for using Ivermectin.
- breastfeeding
- immunosuppression
- liver disease
- asthma
antihistamine class
h1 blocker
antihistamine indication
treatment of allergic rhinits, n/v
fluconazole indication
treatment of yeast infections
fluconazole s/e
- GI upset
- h/a
- rash
fluconazole nursing considerations
- monitor liver, kidney, cardiac function
- contraindicated w pregnancy
permethrin s/e
- skin rxn (burning, itching, stinging)
- numbness/tingling
ivermectin class
broad-spectrum anthelmintic (antiparasitic)
ivermectin s/e
- pruritus/urticaria
- n/v/d
- arthralgia
- vertigo
- drowsiness
- ocular irritation
palivizumab (synagis) indication
prevention of RSV
palivizumab s/e
- hypersensitivity: urticaria/angioedema, dyspnea, respiratory failure, hypotonia, hypotension
palivizumab nursing considerations
- indicated for infants born <29 weeks gestation
-infants >29 weeks may qualify if: CLD, CHD, CF, neuromuscular disorders - contraindicated w thrombocytopenia
- not indicated for treatment of active RSV
acetylcysteine class
mucolytic agent
acetylcysteine indication
copious, thick, or tenacious respiratory secretions
acetylcysteine s/e
- runny nose
- n/v
- rash
- wheezing
- chest tightness
- respiratory distress
acetylcysteine is the antidote for. . .
acetaminophen
indomethacin indication
treatment of PDA, pain, fever, inflammation
indomethacin s/e
- bleeding
- decreased urine output
- tachycardia/arrhythmia
prostaglandin-E1 s/e
- apnea
- fever
- flushing
prostaglandin-E1 nursing considerations
- life-saving intervention
- evaluate ABGs
- monitor RR, BP, temp
surgery req to correct
immunoglobulin class
antibody
immunoglobulin indication
management of Kawasaki Disease
immunoglobulin s/e
- flushing
- h/a
- fever
- chills
- malaise
- muscle cramps
- injection site rxn
methylphenidate indication
treatment of ADHD
methylphenidate s/e
- GI upset
- anorexia/weight loss
- h/a
- confusion
- euphoria
- tremors
- hyperhidrosis
- irritability, restlessness, anxiety
methylphenidate nursing considerations
- controlled substance
II - do not take at bedtime
- take 30-45 mins before meals
- avoid caffeine
- monitor CBC and liver enzymes
amphetamine indication
treatment of ADD/ADHD
amphetamine s/e
- GI upset
- weight loss
- xerostomia
- increased alertness
- euphoria
- insomnia
- irritability/restlessness
baclofen s/e
- dizziness
- drowsiness
- confusion
- h/a
- GI upset
baclofen nursing considerations
- do not take with other CNS deoressants
- cautious use with other depressants
