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23 Cards in this Set
- Front
- Back
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BENZODIAZEPINES (BZ)
ACTION (13) |
-Widely used
-MOA: receptor agonists of GABA ---BZ binds with GABA at receptor ---BZ potentiates action of GABA ---Stabilizes cell membrane ---Decreases brain hyperactivity |
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BENZODIAZEPINES (BZ)
PHARMACOKINETICS (13) |
-Well absorbed, most given orally
-Highly lipid soluble -Highly bound to protein -Affected by low protein levels -Half-life varies with drug ---Diazepam (Valium) 20-80 hrs ---Lorazepam (Ativen 10-20 hrs ---Alprazolam (Xanax) 7-15 hrs -Long half-life not so good for elderly bc of decreased organ function, esp. liver and kidneys |
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BENZODIAZEPINES (BZ)
INDICATIONS FOR USE (13) |
-Anxiety disorders
-Sedation -Balanced anesthesia -Alcohol withdrawal ---chlordiazepoxide (librium) ---diazepam (Valium) -Seizure disorder ---chlordiazepoxide (librium) -Acute sizure activity (IVP) ---diazepam (Valium) -Status epilepticus |
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BENZODIAZEPINES (BZ)
SIDE EFFECTS (13) |
-Sedation
-Tolerance -HTN (drop 20 mm Hg) -Withdrawal (if given on regular basis and stopped abruptly) ---increased anxiety ---agitatin, irritability ---insomnia -Dry mouth -May cause physical dependency -Drug tolerance with extended use |
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BENZODIAZEPINES (BZ)
NURSING IMPLICATIONS (13) |
-Start low, go slow
-Usually administered at hs -Use short term -Administer deep IM (vastus lateralus, ventral gluteal) -Use short half-life drugs with older adults -Give IVP slo (over 1 minute) -Dilute lorazepam (Ativen) -Do not mix IV -Discontinue gradually to prevent withdrawal -Drug Interactions ---Alcohol ---CNS depressants -Contraindicated in pregnancy |
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BENZODIAZEPINES (BZ)
TOXICITY (13) |
-S/S
---excessive sedation ---respiratory depression ---coma -Treatment ---flumazenil (Romazicon) ---antidote ---competes at receptor sites ---IVP in large vein |
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SEDATIVE HYPNOTICS
ACTION (13) |
CNS depression by binding to GABA
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SEDATIVE HYPNOTICS
PHARMACOKINETICS (13) |
-Rapidly absorbed
-Administered orally -Short half-life |
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SEDATIVE HYPNOTICS
INDICATIONS FOR USE (13) |
Insomnia
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SEDATIVE HYPNOTICS
SIDE EFFECTS/PATIENT TEACHING (13) |
-SE
---Daytime drowsiness ---NVD ---Dizziness -Patient Teaching ---Avoid alcohol & CNS depressants ---Withdraw slowly |
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ANTISEIZURE DRUGS
ACTION (15) |
-Suppression of Na or Ca influx across cell - make neurons fire more slowly
-GABA drugs - raise brain level of inhibitory neurotransmitter GABA -Combination of both -Work to raise seizure threshhold |
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ANTISEIZURE DRUGS
INDICATIONS FOR USE (15) |
-Acute Seizure
---lorazepam (Ativan) ---diazepam (Valium) |
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ANTISEIZURE DRUGS
SIDE EFFECTS (15) |
-Drowsiness
-Double vision -NVD -Lymphadenopathy, orange urine, gingival hyperplasia (phenytoin [Dilantin]) -Teratogenicity -Blood dyscrasias -Stevens Johnson Syndrome |
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ANTISEIZURE DRUGS
NURSING IMPLICATIONS (15) |
-Assess seizure activity
-Instruct SE -Implement safety measures -Seizure precautions -Monitor WBC, platelets for blood dyscrasias _Administer w/food to decrease GI upset -Soft toothbrush -Do not stop abruptly -Do not switch generic brands |
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ANTISEIZURE DRUGS
DRUG INTERACTIONS (15) |
-Multiple drug interactions for many drugs in this drug classification
-Alcohol -Tricyclic antidepressants |
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ANTIPARKINSON DRUGS
DRUG THERAPY (15) |
-Control symptoms, not cure
-Lose effect over time -Symptom control requires multiple drugs -Goal ---Increase levels ofdopamine ---Inhibit action of ACH |
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ANTIPARKINSON DRUGS
MAO-B INHIBITORS (15) |
-selegiline (Eldepryl)
-Selective inhibitor of MAO-B to increase dopamine levels -Adjunct therapy with levadopa therapy -Helps reduce levadopa dose |
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ANTIPARKINSON DRUGS
PRESYNAPTIC DOPAMINE RELEASE ENHANCER (15) |
-amantadine (Symmetrel)
-Increases dopamine levels in brain -Helps to control dyskensia associated with levadopa |
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ANTIPARKINSON DRUGS
CATECHOL ORTHO-METHYLTRANSFERASE INHIBITORS (15) |
-entacapone (Comtan)
-Block COMT which breaks down dopamine -Adjunct therapy with levadopa -Works peripherally to prolong duration of levadopa -May cause discoloraiton of urine works by enzyme theory |
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ANTIPARKINSON DRUGS
NONDOPAMINE DOPAMINE RECEPTOR AGONIST (15) |
-bromocriptine (Parlodel)
-ropinirole hydrochloride (Requip) -Activates presynaptic dopamine receptors to produce more dopamine -Used as monotherapy or as adjunct with low dose levadopa -works by receptor theory |
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ANTIPARKINSON DRUGS
DOPAMINERGIC (15) |
-levadopa/carbidopa (Sinemet)
-Stimulates presynaptic dopamine receptors to increase brain levels of dopamine |
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ANTIPARKINSON DRUGS
ANTICHOLINERGIC DRUGS (15) |
-benztroine mesylate (Congentin)
-Decreases ACH and overstimulation of cholinergic excitatory pathways -Used for antidyskinetic properties |
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ANTIPARKINSON DRUGS
SIDE EFFECTS (15) |
-segeline: dizziness, dyskinesia, nausea, syncope
-amantadine: dizziness, insomnia, nausea -entacapone: GI upset, dyskinesia, urine discoloration -bromocriptine: ataxia, confusion, dizziness, depression, sedation,GI upset -levodopa/carbidopa: heart palpitation, hypotension, urinary retention, psychosis, depression, dyskinesia |
