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67 Cards in this Set

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What are Iminostilbenes used for
generalized and partial seizures and bipolar disorder (mental disorder)
How do valproic acids exert their pharmacological effect
by suppressing sodium and calcium influx and by potentiating GABA
Valporic Acids are used to treat
generalized, partial, and abscence seizures
Bipolar disorder and prophylaxis of migraine HA's
Valporic Acid toxicity
moderately hepatoxic
Succinides pharmacological effect
used to treat absence seizures by reducing the synaptic nerve response to low-frequency repetitive stimulation
What settings are Succinides used
clinics only
Anti-Seizure agents nursing considerations
monitor seizure activity, watch for drowsiness when giving sedating agents, monitor therapeutic blood levels, monitor liver enzymes and assess weakness, fatigue and muscle pain
(Anti-Depressants) What is the basis of depression
thought to be a depletion of the neurotransmitters serotonin, dopamine, and norepinephrine
How does depletion of neurotransmitters during Anti-Depressants occur
due to excessive reuptake or by excessive breakdown by monoamine oxidase (MAO)
Why do clients get discouraged when taking anti-depressants
symptoms does not improve for about 4 weeks
What kind of response does anti-depressants have
therapeutic responses vary
How does anti-seizure meds exert a therapertic effects
Anti-seizure agents raise the seizure threshold by inhibiting excitatory activity in the motor cortex of the brain
(3) Mechanism Anti-seizure drugs exert a therapeutic effect
1) suppression of sodium influx,
2) suppression of calcium influx or
3) potentiation of gamma aminobutyric acid (GABA) in the brain
Classificiations of Anti-Seizure Agents
Hydantoins
Iminostilbenes
Barbituates
Benzodiazepines
Valporic Acids
Succinides
Barbituates agents exert their pharmacological effect by
potentiating GABA and decreasing the conduction of impulses
Barbituates are used for.....and are....
seizures and are sedating
Barbituates use with other drugs
may be used in conjunction with other anti-convulsants
What Benzodiazepines will be used during coma or respiratory depression and how long does it take to work
(Romazicon) may be given IV, will work within 2 min.
Non-Benzodiazepine Somnifacients agents exert their pharmacological effect by
potentiating GABA
Non-Bonzodiazepines effects over Bonzodiazepines
have less residual effect and are thought to cause less physiological and psychological dependence
Non-Benzodiazepine Somnifacients effect on food
decrease food bioavailability
Effect on person if awakened while taking Non-Benzodiazepine Somnifacients
short term anesia
Pharmacological effect of NON-BENZODIAZEPINE ANXIOLYTIC:
buspirone (BuSpar)
Binds to serotonin and dopamine receptors in the CNS resulting in decreased transmission of these neurotransmitters
NON-BENZODIAZEPINE ANXIOLYTIC nursing considerations
monitor for (EPS) extrapyramidal side effects
abnormal movements, eg. Parkinson
dystonia
tardive dyskinesia
hormones: melatonin
synthesized from serotonin and is secreted by the pineal gland
melantonin secretions is stimulated by
darkness and suppressed by light received through the retina
hormones: melatonin nursing considerations
act very rapidly
decreases food bioavailability
short-term amnesia i awakened
alcohol increase action causing psycho-motor impairments
DRUGS USED FOR PAIN MANAGEMENT (Analgesics
opiods
Opiods pharmacological effects
bind with opiate receptors in the central nervous system altering the perception of and the emotional response to pain
besides reducing pain opiods.....
can be used to suppress cough, slow respiratory rate and decrease peristalsis, pre-medication before surgery
Analgesia is more effective if
given before the pain becomes severe
best way to manage chronic pain
Chronic pain is better managed by scheduled doses around the clock rather than by PRN administration
Effect when meperidine is given with MAOI's
hyperpyrexia
Assessment of pain includes
location,
intensity (use intensity scale)
quality
pattern
precipitating factors
alleviating factors
associated symptoms
coping mechanisms
Opioid Agonists/Antagonists: are thought to have _____addiction potential because________.
a lower addiction potential because of their antagonistic properties
Opioid Agonists/Antagonists are________ likely to cause respiratory depression
less likely to cause respiratory depression
Opioid Agonists/Antagonists cause___________if given to a client who is _______.
withdrawal symptoms, opiod dependent
Opiods Nursing Considerations
shouldnt be given in head trauma(can mask symptoms)
shouldnt be given in shock (decrease BP)
shouldnt be given in respiratory depression
use caution in clients with history of addition (dont deny pain control)
use cautiously in pt with urinary retention/asthma
cause constipation
dont crush SR preparations-respiratory distress
Opioid Antagonists are used
for opioid overdoses
compete with opiates for binding sites
Opioid Antagonists
used to relieve anxiety
anxiolytics and somnifacients
produce sedation before surgeries and procedures and to induce sleep, not an analgesic
anxiolytics and somnifacients
DRUGS USED TO TREAT ANXIETY AND SLEEP DISORDERS
anxiolytic and somnifacients
can be used as adjuncts to analgesia
anxiolytic and somnifacients
Hydantonins pharmacological effects
decrease excitability in the motor cortex of the brain by suppressing sodium influx through the sodium channels
hydantoins
decreases the neuronal action potential
highly protein bound
narrow therapeutic index
hepatoxic
Classifications of Anti-Depressants
(TCA's) Tricyclic Anti-Depressants
(MAOI's) Monamine Oxidase Inhibitors
(SSRI's) Selective Serotonin Reuptake Inhibitors
TCA's pharmacological effect
reuptake of serotonin 5HT and norepinephrine by the pre-synaptic region
Problems associated with TCA's
1) sedation 2) lowered seizure threshold 3) heart block with large doses 4) orthostatic hypotension 5) anti-cholinergic effects 6) increased appetite with weight gain and 7) inorgasmia.
best time to take TCA's
at bedtime
SSRI's
increase the level of serotonin in the brain by decreasing presynaptic neuronal reuptake
have fewer side effects
SSRI's
SSRI's side efects
loss of appetite and decrease sexual function
Anti-Depressant therapeutic effects seen in
4-6 weeks
Anti- Depressant therapy is seen within
should be seen at least 6 months to 1 year
Nursing Considerations for Anti-Depressants
4-6 weeks to see effects
therapy is 6 months -1year
increase suicidal ideation in teenagers
avoid taking meds with grapefruit and grapefruit juice
Anti Manic agents are used for
bipolar disorder by blocking release of dopamine and norepinephrine
Anti-Manic's
has a very narrow therapeutic index
fluid intake of 2500-3500 per day
adequate NA intake
Anti-Manic pregnancy category
D
Benzodiazepines pharmacologial effects
CNS depression by potentiating GABA and inhibiting impulses subcortically in the limbic system, thalamus and hypothalamus
3 types of Non-Opiods
NSAIDS
Acetaminophen
Salicytes
used as adjuncts for chronic pain, raise pain threshold
anti-depressants & anti-convulsants
Parkinson’s disease
a degenerative disorder of the CNS caused by the destruction of the neurons in the substantia nigra that produce the neurotransmitter dopamine
neurons during Parkinson's Disease controls
balance, posture and involuntary muscle movement
Why is dopamine used in Parkinson's Disease
Dopaminergic drugs are used to increase dopamine levels
Parkinson's disease dopamenergic nursing considerations
1. Administer anti-Parkinson medications on time to avoid a worsening of symptoms.
2. Abrupt discontinuation of these drugs can lead to a Parkinsonian crisis.
3. Foods high in pyridoxine (vitamin B6) can decrease the effects of these drugs.
4. Change positions slowly to avoid faintness or dizziness.
Parkinson's disease nursing considerations
1. Monitor for anti-cholinergic effects such as blurred vision, dry mouth, urinary retention, constipation and tachycardia