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38 Cards in this Set
- Front
- Back
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TCA
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amitriptyline ( Elavil)
imipramine (Tofranil) |
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anticonvulsant
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carbamazepine (Tegretol), gabapentin (Neurontin)
phenytoin (Dilantin) |
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CNS stimulants
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methylphenidate (Ritalin)
dextroamphetamine |
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antihistamine
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hydroxyzine (Vistaril)
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glucocorticoids
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dexamethasone (Decadron)
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bisphosphonates
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etidronate (Didronel)
pamidronate (Aredia)- IV |
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NSAIDS
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ibuprofen (Motrin)
ketorolac (Sprix) |
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adjuvant meds MOA
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enhance effects of opioids
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adjuvant meds use
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these meds are used in combination with opioids and cannot be used as a substitute for opioids
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NSAIDS Use
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treat inflammation
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TCA use
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depression and neuropathic pain
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anticonvulsant use
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relieve neuropathic pain
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CNS stimulant use
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augment analgesia and decrease sedation
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antihistamines use
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decrease anxiety, prevent insomnia, and relieve nausea
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glucocorticoids use
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decrease pain from spinal cord compression and intracranial pressure
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bisphophosphates use
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manage hypercalcemia and bone pain
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TCA adverse amitriptyline
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orthostatic hypotension
sedation anticholinergic effects |
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anticonvulsant adverse
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bone marrow suppression
GI distress |
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methylphenidate adverse
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weight loss
insomnia |
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antihistamine adverse
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sedation
dry mouth |
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glucocorticoid adverse
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adrenal insufficiency
osteoporosis hypokalemia glucose intolerance PUD |
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bisphophosphates adverse
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transient flu like symptoms
venous irritation at injection site hypocalcemia |
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NSAIDS adverse
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bone marrow suppression
GI distress nausea, vomiting, diarrhea, or ulceration |
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TCA contraindciations
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recovering from MI and within 14 days of taking MAOI
seizure disorder urinary retention hyperplasia angle-closure glaucoma hyperthyroidism liver or kidney disease |
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anticonvulsant contraindications
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bone marrow suppression and within 14 days of taking MAOI
seizure disorder |
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CNS stimulant contraindications
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hyperthyroidism
within 14 days of MAOI caution to those with agitation or tics |
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antihistamine contraindications
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hydroxyzine is contraindicated in clients who are hypersensitive to this med
caution to older adults |
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glucocorticoids contraindications
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fungal infection
seizure disorder PUD hypertension hyperthyroidism DM liver disease |
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bisphosphonate contraindications
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kidney disease
hypersensitivity |
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NSAIDS contraindications
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history of bronchospasms with aspirin or NSAIDS
clients who have peptic ulcers, hypertension, liver or kidney disease |
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TCA interactions
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barbiturates, CNS depressants, and alcohol may cause additive CNS depression- do not use together
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anticonvulsant interactions
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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 |
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CNS stimulants adverse
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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 |
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antihistamines adverse
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barbiturates, CNS depression, and alcohol may cause additive CNS depression
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glucocorticoids adverse
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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 |
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bisphosphonates adverse
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decreased absorption with calcium or iron supplements and high calcium foods
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NSAIDS adverse
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reduce effectiveness of antihypertensives
furosemide thiazide diuretics aspirin and corticosteroids may increase GI effects increase levels of oral anticoagulants and lithium |
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adjunct meds effectiveness
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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 |
