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135 Cards in this Set
- Front
- Back
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Mr Verdi recently completed a marathon; after running 16 miles he had to drop out because of severe muscle spasms this type of pain is classified as
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Somatic Pain
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A 23 year old has been taken to the ER for a suspected OD of morphine tablets; which agent would be used to tx this OD
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Naloxone
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An analgesic is given to
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Relieve pain
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Moderate to severe pain is best tx with
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Morphine Sulfate
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Persistent or recurring pain that is often difficult to tx
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Chronic Pain
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What is not necessary to include in an assessment before giving an opioid analgesic
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Blood clotting time
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Pain that originates from the skeletal muscles, ligaments or joints
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Somatic Pain
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An anticonvulsant drug is ordered as part of a pts pain mgmt prog. The purpose of the anticonvulsant is to
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Relieve neuropathic pain
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Pain that originates from the organs or smooth muscles
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Visceral Pain
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What assessments should be included before giving an opioid anangesic
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Level of pain on pain scale
Prior analgesic use Allergies |
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Pain that originates from the skin or mucus membranes
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Superficial Pain
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Pain that is sudden & usually subsides when tx
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Acute Pain
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Adjunctive agents when used with anesthesia do not include
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inhaled gas
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Lidocaine is freq used for
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local anesthesia
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Possible complications as a result of NMBA use include
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Induction of apnea
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to decrease the possibility of a headache after spinal anesthesia you should instruct the pt to
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lie flat in bed
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Local anesthesia is not indicated for
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long duration surgery
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A sudden elevation is body temp in a pt who just returned from surgery may indicate
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Malignant hyperthermia
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Pain that is relates to a body part that has been removed
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Phantom Pain
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Pain that is thought to account for most migraine headaches
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Central Pain
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A hypnotic is an agent that
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Produces sleep
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Pain that is due to psychologic factors not physical cond. or disorders
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Psychogenic Pain
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A pt has been taking benzodiazepine for 5 wks is told by his dr that he wants him to stop using the medication. The best way to discontinue the medication is to
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Plan a gradual reduction in dosage
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What type of barbiturate is used as an anesthetic for short surgery procedures
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Ultrashort acting
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The cause of death from OD of barbiturates is
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Respiratory arrest
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Skeletal muscle relaxants are most effective when used in conjunction with
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Physical therapy
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Jaine has seizures characterized by temporary lapses in consciousness that last only a few seconds. Her teachers have said that she "Daydreams too much" these types of seizures are
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generalized seizures
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Which cond is a life threatning emergency in which pts typically dont regain consciousness
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Status eliepticus
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What drug would be used for the tx of status eliepticus
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Diezepam
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What is a possible side effect of phenobarbitol therapy
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Drowsiness
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Which antieplieptic agent is also used to tx neuropathic pain
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Gabapentin
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Your pt with parkinsons diesease has difficulty perf vol movements thsi is known as
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Dyskinesia
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Which drug may be used to tx parkinsons disease early but eventually loses effectiveness and must be replaced by abother agent
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Amatadine
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Mr ford is taking levodopa for parkinsons wants to take a vitamin supplement; what do you tell him
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Avoid supplements that contain vit B6 (pyridoxine)
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A pt who is newely dx with parkinsons & beginning medication therapy with entacapone, a COMT inhibitor asks the nurse "How soon will improvment occur?" The nurses best response is
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You should notice a difference right away
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Anticholinergics administered during tx of parkinsons are given to control or minimize drooling, muscle rigidity & tremors but not
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Constipation
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What drug has shown a neuroprotective effect when started early in therapy
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selegiline
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The unpleasant state of mind in which unreal or imagined dangers are anticipated
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Anxiety
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A state characterized by an expansive emotional state including sx of extreme excitement & elation and hyperactivity
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Mania
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A group of psychotropic agents prescribed to alleviate anxiety
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Benzodiazepines
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Emotional disorders characterized by changes in mood
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Affective disorders
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A major psychologic disorder characterized by episodes of maina, depression or mixed mood
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Bipolar affective disorder
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Classified as a monoamine oxidase inhibitor MAOI
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phenelzine
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Pts on MAOI's need to be taught to avoid food that contain this substance
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Tyramine
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Antidepressant agents that block the reuptake of amine neurotransmitters
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Tricyclics
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An abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, & worthlessness out of proportion to reality
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Depression
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The most freq prescribed benzodiazepine
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diazepam
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The most widely used tricyclic antidepressant
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amitriptyline
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An atypical antipsychotic agent used to tx schizophrenia
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risperidone
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A second generation antidepressant
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sertaline
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The drug of choice for mania
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Lithium
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A term used to describe a major emotional disorder that impairs the mental function of the affected individual to the extent that the individual cannot participate in everyday life
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Psychosis
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Pts taking the newer antipsychotic agents such as quetiapine (Seroquel) should be cautioned about which problem when beginning this therapy
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Postural hypotension
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When giving hydroxyzine IM what measures should be taken
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Use the Z track method
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Extrapyramidal effects of drugs dont produce
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Elation & a sense of well being
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Frank has been started on antidepressant therapy he asks you how long it will take for him to feel better; you best response should be
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It may take 4 to 6 wks before you see an improvement
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The pt on MAOI therapy must be taught to avoid food tyramine containing foods in order to prevent which medical emergency
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Severe hypertensive crisis
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To tx respriatory insufficiency associated with COPD
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doxapram
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Decreased drowsiness
Increased Resp Euphoria |
Are results of stimulation of the CNS by stimulant drugs
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Serotonin agonists are newer CNS stimulants used to tx
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Migraine headaches
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Caffeine should be avoided by pts who have a hx of
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Cardiac dysrhythmias
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The dr has ordered orlistat (Xenical) the nurse recognizes that this drug is used to tx
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Obesity
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When a child is taking drugs for ADHD the nurse should instruct the caregivers to closely monitor the child's
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Physical growth; especially weight
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A drug used to tx somatic pain
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Indocin (Indomethacin),
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Pain that results from injury or damage to the peripheral nerve fibers
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Neuropathic Pain
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Cancer pts often build this when on opioid analgesics
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Tolerance
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For breakthrough pain you would
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Titrate the dose with a bolus which is immediate action with a short duration
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Aspirin and oxycodone
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Percodan
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Cause resp center depression, most dangerous effect.
Pupils constrict and become pinpoint, avoid giving these to pts with head injuries |
Opioid analgesics
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Tylenol and oxycodone
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Percocet
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Misuse and addiction of these drugs is low, but can be habit forming ex:
nalbuphine pentazocine HCL butophanol |
Narcotic agonists/antagonists
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No euphoria when taking this narcotic agonist/antagonist
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nalbuphrine (Nubain)
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Long term use need to monitor liver, renal, & clotting functions
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acetylsalicyclic acid (aspirin ASA)
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OD of Morphine treated with
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Narcan
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High doses can cause kidney damage, renal failure, & hepatotoxixity.
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acetaminophen (Tylenol)
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Most toxic effect of this drug OD is hepatic necrosis
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acetaminophen (Tylenol)
Antidote: acetylcystene (Mucomyst)Put in flavored water or soda to disguise taste |
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Common use Migraine headaches. Potential interaction with aspirin, warfarin(can increase bleeding)
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Feverfew
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Impaired gas exchange
R/T CNS depression prod by general anesthesia |
Nursing Diagnosis for General Anesthesia for the elderly
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Are eliminated primarily by the lungs but also by the liver
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Inhaled Gas
Inhaled Volatile liquids |
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This vasoconstrictor is added to limit site of action locally thereby keeping it in the area longer
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Xylocaine with epinephrine
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Main concern post op anesthesia
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ABC's & Malignant Hyperthermia
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These prevent nerve transmission in certain muscles, leading to paralysis of the muscle
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NMBA's
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Have on hand cholinesterase inhibitors like neostigmine and mechanical ventilation
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For NMBA's
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Effectively reduces pt anxiety, sensitivity to pain, and recall of medical procedure used for procedures like endoscopys
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Moderate sedation or Conscious sedation
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Measures to take before using sedatives or hypnotics
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Est set sleep patterns
Avoid heavy exercise before bed Avoid heavy meals late in eve Drink warm milk before bed contains triptophan |
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A drug that induces sleep
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Hypnotic
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Inhibitory amino acid which produces a calming effect
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GABA
gamma aminobutric acid |
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Reduces nervousness, irritability, excitability without causing sleep
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Sedative
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Drowsiness
Lethargy Dizziness Agitation Inability to deal with stress Hangover feeling due to supressing REM sleep |
Barbiturates GABA
Main Side effects |
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Tx for OD of barbiturates
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No antagonists main problem is resp depression leading to resp arrest. Tx is to support resp & maintain airway
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These have a hangover effect but not to the extent that bartiturates have
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Benzodiazepines
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Only useful for short term therapy, loses it's effectiveness after repeated doses
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choral hydrate (Noctec)
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Oldest GABA drug is
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Alcohol
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Safe for long term use
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Lunesta
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Musculoskeletal relaxants work more effectively if used with
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Physical therapy
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Used for multiple sclerosis bit need to monitor liver function
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dantrolene (Dantrium)
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Musculoskeletal relaxants all but this one are centrally acting
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dantrolene (It is peripherally acting)
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Risk for injury
R/T Decreased sensorium |
Nursing dx while on Musculoskeletal relaxants
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One hemisphere of brain involved, short alteration in consciousness
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Partial Seizure
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Drug of choice for status epilepticus
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Valium
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Both hemispheres are involved
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Generalized seizures
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Main goal in mgmt of seizures is
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Quality of life
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Any dopaminergic agent is contraindicated in
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Seizure Disorders
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Take at bedtime to prevent drowsiness during the day
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benztropine (Cogentin)
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Drug of choice for panic attacks
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clonazepam (Klonopin)
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If any of the antiparkinson's therapies are working you will see an improvement in mental status and ability to do
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ADL's & think more clearly
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Give this drug via Z track as it is irritating to the tissues
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hydroxyzine pamoate (Vistaril)
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New class adjunct therapy for Parkinson's
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COMT Inhibitors
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This drug has less sedation effects and is useful for long term therapy
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buspirone (Buspar)
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Less wearing effects
Longer therapeutic effects Quicker onset Longer duration of action |
COMT Inhibitors
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Antimaniac agent is a salt and levels exceeding 2.0 to 2.5 produce mod to severe toxicity. Take with food to avoid GI upset
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Lithium
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Give these at HS to minimize side effects & allows normal daytime routine
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Antianxiety (Anxiolytic) agents
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These antidepressant agents do not interfere with the cardiovascular system
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SSRI's
Selective Serotonin Reuptake Inhibitors |
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You do not want to combine antidepressants with this herb
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St. John's Wort
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This may occur with this class of antidepressants: Changes in mental status, restlessness, agitation, tremors, diarrhea, headaches, and ataxia(motor restlessness)
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SSRI's Seratonin syndrome
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With these antidepressants it may take about 8 weeks to see an effect so your pt would be more at risk for attempting
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Suicide
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Drowsiness with these antidepressants should decrease after the first few weeks of therapy
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Tricyclics
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With this tricyclic you want to avoid taking warfarin; as it increases its anticoagulant effect
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amitriptyline (Elavil)
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Once you discontinue these drugs they stay in the body for 2 wks
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MAOI's
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Thses agents block dopamine and can cause pseudoparkinson's causing extrapyramidal sx
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Antipsychotic agents
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Antidote for cheese effect or hypertensive crisis is
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nifedipine (Procardia) calcium channel blocker
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Tx extrapyramidal sx with
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Cogentin or Artane
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Phenothiazines cause these side effects
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Sore throat
Dry Mouth Blurred Vision |
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Side effects of haloperidol (Haldol)
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Drowsiness
Extrapyramidial reactions Confusion Postural Hypotension Blurred Vision |
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Suppress appetite
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Anorexiants
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Increase responsiveness and respirations
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Analepics
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Produce euphoria, mood elevation, increased mental alertness, tx ADD & Narcolepsy
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Amphetamines
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Nursing Dx: Sleep pattern disturbance
R/T use of this substance |
Caffeine
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Avoid these conditions when taking caffeine
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Peptic ulcers
Cardiac dysrhythmias MI Epilepsy |
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Avoid caffiene with this anorexiant
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sibutramine (Meridia)
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To hasten arousal post op recovery to tx respiratory insufficiency
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doxapram HCL (Dopram)
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Give this drug 6 hours before bedtime to diminish insomnia
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methylphenidate (Ritalin, Concerta, Metadate)
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SSRA (Selective Serotonin Reuptake Agonists) are used to tx
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Migraines
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Before giving an SSRA you want to assess these 2 things
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Coronary artery disease and
hypertension |
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An SSRA used to tx migraines
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sumatriptan (Imitrex)
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