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38 Cards in this Set

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TCA
amitriptyline ( Elavil)
imipramine (Tofranil)
anticonvulsant
carbamazepine (Tegretol), gabapentin (Neurontin)
phenytoin (Dilantin)
CNS stimulants
methylphenidate (Ritalin)
dextroamphetamine
antihistamine
hydroxyzine (Vistaril)
glucocorticoids
dexamethasone (Decadron)
bisphosphonates
etidronate (Didronel)
pamidronate (Aredia)- IV
NSAIDS
ibuprofen (Motrin)
ketorolac (Sprix)
adjuvant meds MOA
enhance effects of opioids
adjuvant meds use
these meds are used in combination with opioids and cannot be used as a substitute for opioids
NSAIDS Use
treat inflammation
TCA use
depression and neuropathic pain
anticonvulsant use
relieve neuropathic pain
CNS stimulant use
augment analgesia and decrease sedation
antihistamines use
decrease anxiety, prevent insomnia, and relieve nausea
glucocorticoids use
decrease pain from spinal cord compression and intracranial pressure
bisphophosphates use
manage hypercalcemia and bone pain
TCA adverse amitriptyline
orthostatic hypotension
sedation
anticholinergic effects
anticonvulsant adverse
bone marrow suppression
GI distress
methylphenidate adverse
weight loss
insomnia
antihistamine adverse
sedation
dry mouth
glucocorticoid adverse
adrenal insufficiency
osteoporosis
hypokalemia
glucose intolerance
PUD
bisphophosphates adverse
transient flu like symptoms
venous irritation at injection site
hypocalcemia
NSAIDS adverse
bone marrow suppression
GI distress
nausea, vomiting, diarrhea, or ulceration
TCA contraindciations
recovering from MI and within 14 days of taking MAOI
seizure disorder
urinary retention
hyperplasia
angle-closure glaucoma
hyperthyroidism
liver or kidney disease
anticonvulsant contraindications
bone marrow suppression and within 14 days of taking MAOI
seizure disorder
CNS stimulant contraindications
hyperthyroidism
within 14 days of MAOI
caution to those with agitation or tics
antihistamine contraindications
hydroxyzine is contraindicated in clients who are hypersensitive to this med
caution to older adults
glucocorticoids contraindications
fungal infection
seizure disorder
PUD
hypertension
hyperthyroidism
DM
liver disease
bisphosphonate contraindications
kidney disease
hypersensitivity
NSAIDS contraindications
history of bronchospasms with aspirin or NSAIDS
clients who have peptic ulcers, hypertension, liver or kidney disease
TCA interactions
barbiturates, CNS depressants, and alcohol may cause additive CNS depression- do not use together
anticonvulsant interactions
carbamazepine casues a decrease in effects of oral contraceptives and warfarin because of the stimulation of hepatic drug-metabolizing enzymes- monitor for therapeutic effects of warfarin with PT and INR
grapefruit juice inhibits metabolism and increases carbamazepine levels
phenytoin and phenobarbital decrease effects of carbamazepine
CNS stimulants adverse
alkalizing meds- may increase reabsorption
acidyfing meds may increase excretion of amphetamine
insulin and oral antidiabetic meds may increase excretion of amphetamine
insulin and oral antidiabetic meds may decrease glucose level
MAOIs may cause severe hypertension
Caffeine may increase stimulant effect
OTC meds with sympathomimetic action may ead to increased CNS stimulation
antihistamines adverse
barbiturates, CNS depression, and alcohol may cause additive CNS depression
glucocorticoids adverse
promote hyperglycemia, thereby counteracting the effects of insulin and oral hypoglycemics
concurrent use of salicylates and NSAIDS may increase the risk for GI bleed
digoxin- increased risk of dysrhythmias
diuretics- promote potassium loss and increase risk of hypokalemia
bisphosphonates adverse
decreased absorption with calcium or iron supplements and high calcium foods
NSAIDS adverse
reduce effectiveness of antihypertensives
furosemide
thiazide diuretics
aspirin and corticosteroids may increase GI effects
increase levels of oral anticoagulants and lithium
adjunct meds effectiveness
relief of depression, seizures, dysrhythmias, and othe rsymptoms that aggravate the client's pain level
decreased opioid adverse effects
relief of neuropathic pain
decreased bone cancer pain