Week 7 Flashcards
What are the adverse reaction of phenobarbital
Nausea and drowsiness
What are the uses of phenobarbital ( barbiturates )
Control epilepsy
Sedation
Insomnia
Short acting can be used as anesthetics
What are the nursing interventions of phenobarbital
Toxicity, pulmonary constriction, cold, clammy skin, insomnia, n/v
Physical dependency may occur
Do not stop abruptly-withdrawals
Initiated when neurotransmitters withdraw from a reticular formation in the brain
Non REM
Occurs in cycles about every 90 min starting 1-2 hrs after falling asleep. With more in the morning . Has memorable dreams
REM sleep
What are the effects of sleep deprivation
Fatigue irritably poor concentration, poor relationships, feelings of persecution, decreased motor coordination, increased stress level
Sleep for elderly?
More time to fall asleep, tend to wake up more at night , tend to awaken earlier, tolerate sleep deprivation poorly, require less sleep but. Eyed to stay in bed longer to get the same quality of sleep.
What are the non medication ways to promote sleep
Standard bedtime to encourage circadian rhythm
No alcohol or caffeine for several hr before bed
Bed only for sleep and sex
Unwind before sleep
Warm bath, soft music, message
What is benzodiazepines diazepam
Long half life so sleep hangover is common
Deep and refreshing sleep
Less REM
After chronic use REM sleep increase as tolerance develops
When discontinued rebound increase in REM sleep ( bizarre dreams)
What is benzodiazepines used for
Sedation
Treatment of insomnia
Reduction of pre operative anxiety
Problem dependency if used for periods longer then 45-99 days
Nursing consideration for benzo
Cns depressant increase with ETOH or narcotics
Reduce the amount of time spent in REM sleep
Give at 2200 n later 0100
Do not stop abruptly
What are the uses for lorazepam
Anti anxiety drug
Relieves anxiety in phobic disorders
Treat potential delirium tremendous in acute ETOH withdraw
Properties relaxation
What are the adverse reactions of lorazepam
Dizziness, drowsiness, blurred vision, orthostatic hypotension n/v/d, incontinence, visual disturbance
Most adverse reactions are seen in higher doses
What are the nursing interventions or larazepam
Monitor vs, if b/p drops by 20 mmHg hold and notify RN
Moniter liver and renal studies
Give with food or milk if hi symptoms present
What is the most common of the psychiatric disorders
Depression
Major depression is characterized by at least five of the following
Loss of energy , fatigue insomnia obsession with death , suicidal ideation , feeling of worthlessness
Hallucination and delusions
Block the reputable of norepinephrine and serotonin which result in stimulation of the CNS
Tricyclics antidepressant
How do neurotransmitter a normally work
Neurotransmitter a can be returned to axon terminals for reuse or transported into Gaul cells
Neurotransmitter —-
Enzymes inactivated them
Can diffuse out of synaptic cleft
Inhibits the activity of the Mao which results in crease of epi and norepinephrine and serotonin
Reduces depression by stimulating the CNS
Monoamine oxidase inhibitors MAO
Selective serotonin rep take inhibitor does what
Block the reputable of serotonin
What are the adverse reactions if antidepressants
Paralytic ileus
Acute renal failure ARF
Some brands will cause HTN
What are the common side affects of antidepressant
Drowsiness dizziness Dry mouth diarrhea orthostatic hypotension
Tonic clinic type of seizure characterized by contractions of involuntary muscle
Convulsions
What are the causes for seizures
Hypoglycemia fever electrolyte imbalance overdose withdrawal of alcohol withdrawal of sedative hypnotic drugs head trauma
Anticonvulsant medication work in two main ways
Block the movement of sodium ions into nerve cells
Inhibit glutamate, the major excitatory neurotransmitter in the brain
What are the uses for anti convulsants medication
Prevent seizures stop acute sir urea stop status epilepticus, tonic clinic convulsions
Medication for seizing patient
Rectal Valium is common
IMValium or Ativan
IV ^
IV Dilantin
What are the causes of parkinson disease
Primary cause reduction of dopamine producing cells
Head trauma intracranial infection rumors drug exposure
Medication that will treat Parkinson’s disease is
Levodopa
