Unit 4 Flashcards
1
Q
Carbidopa-levodopa (Sinemet)*
A
- Dopamine Agonists r/t Parkinsons disease (decrease tremors/muscle rigidity)
- Increase dopamine in CNS (levodopa convert to dopamine in CNS + carbidopa prevents breadkown of levodopa)
- SE: HA, anxiety, arrhythmias, halucinations (too much/little dopamine)
- CI: narrow-angle glaucoma (rare), malignant melanoma
- Adjusted periodically, given on strict schedule (spaced out 5-6 xD)
2
Q
Benztropine mesylate (Cogentin)*
A
- Anticholinergics drug therapy r/t parkinsons disease (decrease tremor, muscle rigidity, EPS), decrease drool
- Decreases ACh in CNS to balance w/ dopamine.
- SE: anticholinergic effects, hyperthermia, confusion, disorientation, psychosis, Tardive disconisia, sedation, hallucination, agitation
- Avoid taking other CNS depressants/ETOH
3
Q
Donepezil (Aricept)
A
- cholinesterase inhibitor r/t mild-moderate Alzheimer’s disease, slows disease progress
- Inhibit ACh breadown, improving memory, cognition, + ability to perform ADLs.
- SE: GI upset, drowsiness, bradycardia, hyotension.
- Take at bedtime, interacts with anticholinergics + NSAIDs
4
Q
Phenobarbitol (Luminal)*
A
- Barbiturates, Antileptic drugs (AED) r/t seizures, occasionally anxiety
- increase GABA to depresse CNS (affect breathing, HR, LOC)
- SE: CNS depression (drowsiness), cognitive impairment (thought processes), Stevens-Johnson syndrome (rare/life-threatening - skin peals off in large pieces), (BBW) ^ risk for suicidal ideation
- abuse potential (IV) + tolerance can develop, may be fatal w/ ETOH, older drug interactions.
5
Q
Diazepam (Valium), lorazepam
A
- Benzodiazepines, Antileptic drugs (AED) r/t anxiety, ETOH withdrawl, muscle spasms, sleep aid, antidepressant
- Enhances GABA effect in CNS (calmer, suppressed nerves)
- SE: depression, disorientation, resltessness, confusion, CV collapse, hypotension, bradycardia/tachycardia
- CI: narrow angle glaucoma, alchohol intoxication, pregnancy, CNS depression as it multiplies sedation affect
6
Q
Gabapentin (Neurotin)*
A
- GABA analogues r/t neuropathic pain primarily, surgical pain, acute pain, seizures, anticonvulsant
- Acts like GABA in CNS, inhibit potentiation of impulses of nerve for neuropathy.
- SE: CNS depression, sedation, cognition impairment, respiratory depression
- Antacids inhibit absorption
7
Q
Phenytoin (Dilantin)
A
- Hydantoins r/t epilepsy, seizure disorders, partial + tonic-clonic seizures
- Inhibit Na influx into neurons (K + Na create electrical impulse)
- SE: CNS depression, GI upset, gingival hyperplasia (over growth on gum tissue)
- Monitor serum levels in therapeutic range
- PO abut also IV
8
Q
Valproic acid (Depakote)
A
- Carboxylic Acid Derivatives r/t seizures (general/partial), mood disorders (bipolar/mood stablizer), neuropathic pains (calming impulses in CNS),
- Increases effect of GABA to decrease overall electrical activity
- SE: bleeding time, GI effects, CNS effects, teratogenic
- Check lab values, don’t take when pregnant, delayed release (PO solution)
9
Q
Morphine sulfate (MSo4)*, oxycodone, fentanyl, hydromorphone, naloxone
A
- Opioids/Narcotic r/t pain, sedation promotion
- Bind w/ opioid receptors in CNS to change perceived pain.
- SE: CNS Depression (RR, cough suppression, sedation), constipation, N/V, hypotension
- Can be used w/ non-opioid analgesics like APAP (Hydrocodone *,oxycodone), rapid onset, high potential for abuse - controlled substances (2-3)
- Concerns: tolerance, dependence, addiction
- Withdrawl, taper to minimize S/S: Anxiety, chills, joint pain, crying/runny nose, diaphoresis, N/V/D
- Avoid tasks requiring mental alertness
- CI: asthma, addiction, head injury, increased intracranial pressure.
- ER lasts for base line pain controle, SA for PRN for breakthrough pain, IR (do not chew PO due to significant issues)
- Opioid antagonist: naloxone (Narcan) w/ no opiod effects (IV) is antidote causing temporary alert and pain.
10
Q
Amitriptyline (elavil)
A
- Tricyclic Antidepressants r/t depression, schizophrenia, eating disorders, personality disorders, sleep
- non-selective inhibit the enzyme that breakdown neurotransmitters.
- SE: sedation, impotence, hypotension
11
Q
Fluoxetine (prozac)*, bupropion (wellbutrin)
A
- Second generation & SSRI r/t anxiety, depression, OCD, PTSD
- Inhibits serotonin reuptake (i.e. increases serotonin), inhibits reuptake of noreepinephrine + serotonin w/ bupropion
- Fluoxetine is selective reuptake inhibitors (SSRI’s)
- SE: insomnia, anxiety, decreased appetite, interact w/ warfarin, fatal if taken w/ MAOI (dangerouse elevation of Serotonin)
- Monitor for Suicide thinking when just starting/dose change at risk for trying to reach therapeutic level
12
Q
Lithium (Lithobid)
A
- (AK tranquilizers/neuroleptics) Antipsychotics r/t mania, bipolar disorders
- Block dopamine receptors in the brain, influence reuptake of neurotransmitters
- SE: supress GI function, extrapyramidal effects (EPS), dardive dyskinesia (facial movements)
13
Q
Chlopromazine (Thorazine)
A
- Phenothiazines r/t antiemetic (schizophrenia, hallucinations), hiccups
- Alters action of dopamin in CNS
- SE: high amount, including EPS, tadive dyskinesia
14
Q
Haloperidol (haldol)
A
- Butyrophines r/t agitation w/ high risk in non-psych clients
- For those that are non-compliant (4 wks long acting)
- blocks dopamine effectively
- SE: High potency, low CV, anticholinergic, sedative, high risk for EPS
15
Q
Risperidone (Risperdal), olanzapine
A
- atypical antipsychotoc r/t s/s of schizophrenia (postive is added so voices, delusions + negative is taken so flat affect (facial expresisons to depict unemotional), psychotic behavior from Alzheimers (dementia)
- Acts on serotonin receptors
- SE: minimal risk for EPS
- Ensure swallowing, monitor labs, educate w/ ETOH sedation, educate/monitor for EPS/neuroleptic malignant syndrom
- Good oral care r/t dry mouth
