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215 Cards in this Set
- Front
- Back
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What class of med is given for obesity?
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anorexiants
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What meds are given for obesity?
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Didrex
Dexedrine Meridia |
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Side effects of anorexiants
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nrevousness*
insomnia irritability |
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What causes a migraine?
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inflammation and dilatation of the blood vessels in the cranium
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Treatment of migraine depends on
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intensity of pain
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What med is given for migraines?
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Sumatriptan (Imitrex)
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What class of med is given for migranes?
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selective serotonin receptor agonist
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What is the common side effect of Sedative hypnotics?
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REM Rebound
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What is REM Rebound?
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vivid dreams, nighmares caused by abruptly stopping the drug
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What do you consider first before sedative-hypnotics?
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sleep hygiene
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What are some non-pharmacologic methis of sleep?
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decrease loud noises at night*
arise at specific hour no naps avoid caffeine 6 hrs before bed avoid heavy meals avoid exercise before bed warm bath/warm milk read or listen to music |
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What are barbituates?
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sedative hypnotics
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What are some examples of barbituates?
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seconal, propofol (diprivan)
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Client teaching of barbituates?
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-avoid alc/narcotics/antidepressants
-Herbal Aler: kava kava, valerian -do not drive -take 30 min befre bed; short acting effect in 15 min |
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What are benzodiazepines used for?
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minor tranquilizers or anxiolytic (decrease anxiety); anticonvulsant; anti-depressant, pre-op meds
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What is Ativan used for?
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seizures and status epilepticus
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What class of drug is Ativan?
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Benzodiazepines
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When is restoril given?
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insomnia
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Ativan
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lorazepam
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Restoril
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temazepam
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Patient teaching of Restoril?
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patient should be instructed to call for help before getting OOB after admin.
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Romazicon
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flumazenil
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Class of Romazicon
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benzodiazepine antagonist
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Use of Romazicon
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mgt of benzodiazepine overdose = unusually drowsy & difficult to arouse
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Ambien
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Zolpidem
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When is Ambien given?
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short term treatment of insomnia
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Patient teaching of ambien
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take med just before bed
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Class of Ambien
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nonbenzodiazepines
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Patient on Xanax; Why so tired during the day?
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side effect
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rationale of tapering xanax?
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so that they do not get dependant and to prevent REM rebound
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Difference between Ambien and Xanax?
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Xanax, a benzodiazepine is longterm
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What is used immediately post-op?
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Adrete score
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What is priority of aldrete score?
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Airway
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Class of Anectine
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Neuromuscular blocking agent
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Anectine
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Succinylcholine
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Action of Anectine
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blick acetecholine resulting in muscle relaxtion and hypotension
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Side effects of neuromuscular blocking agents (anectine)
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malignant hyperthermia
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What is malignant hyperthermia
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rare life threatening condition that is usually triggered by exposure to certain drugs used for general anesthesia
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Signs and symptoms of malignant hyperthermia
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muscular rigidity
tachycardia increased respirations rapid temp (as high as 109) |
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What s concious sedation?
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altered stateof concoiusness that minimizes pain and discomfort though the use of pain relievers and sedatives
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Patients actions under concious sedation?
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able to speak and respond to verbal cues thoughout procedure, communicating andy discomfort they experience
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When is concious sedation used?
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wisdom teeth
colonoscopy bone surgery |
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Treatment of malignant hyperthermia
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Dantrolene (dantrium)
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What med is used for IV anesthesia?
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Diprivan (propofol)
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What meds are used for consious sedation?
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Versed/Fentyanyl
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Where is a spinal inserted?
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subarachnoid space L3 or L4
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Side effects of spinal
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spinal headache*
hypotension |
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Adverse reaction of spinal
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resp. distress or failure
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What os the treatment of spinal headache?
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caffeine
bedrest flat for 24 -48 hrs dark room IV hydration blood patch |
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What is an epidural blood patch? use?
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own blood is taken and injected into epidural space at site of leak to clot the hole; use: spinal headache
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What are hydantoins?
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anticonvulsants are most commonly used in the treatment of seizures associated with epilepsy
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Phenytoin
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Dilantin
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What is the class of phenytoin
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anticonvulsants/antiepileptics/hydantoins
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Phenytoin is
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teratogenic
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Where is a spinal inserted?
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subarachnoid space L3 or L4
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Admin of phenytoin?
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take with food at the same time daily
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Side effects of spinal
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spinal headache*
hypotension |
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Adverse reaction of spinal
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resp. distress or failure
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What os the treatment of spinal headache?
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caffeine
bedrest flat for 24 -48 hrs dark room IV hydration blood patch |
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What is an epidural blood patch? use?
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own blood is taken and injected into epidural space at site of leak to clot the hole; use: spinal headache
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What are hydantoins?
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anticonvulsants are most commonly used in the treatment of seizures associated with epilepsy
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Phenytoin
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Dilantin
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What is the class of phenytoin
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anticonvulsants/antiepileptics/hydantoins
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Phenytoin is
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teratogenic
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Admin of phenytoin?
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take with food at the same time daily
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Side effection of pheynytoin?
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gingival hyperplasia (gum overgrowth)
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nursing intervention with phenytoin?
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meticulous oral hygiene
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What med does dilantin interact with?
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Decreases:anticoagulants, oral contraceptives, antihistamines, corticosteroids
Increases: cimetidine, INH Decrease abs. of dilantin: -antacids, calcium prep, carafate, antieoplastic drugs Increases seizure activity: antipsychotics & certain herbs |
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How is dilantin admin?
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direct injection into large vein; do not use continuous infusion
50mg/min - larger can cause hypotension, cardiac arrhythmias |
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When are anticonvulsants taken?
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with food at the same time everyday
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How to prepare liquid anticonvilsants?
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shake well
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Why do you not stop anticonvulsants abruptly?
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avoid rebound seizure activity
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Other patient teaching of dilantin?
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frequent dental visits; do not drive in the beginning, may turn urine pinking red and brown
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anticonvulsants and pregnancy
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teratogenic: highest incidence of birth defects
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Status epilepticus treatment
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anticonvulsants:
-Valium (diazepam) -Ativan (lorazepam) -Phenytoin (dilantin) |
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What is the action of drugs used to treat parkinsons disease?
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reduce symptoms or replace dopamine deficit
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What causes parkinsons?
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imbalance of dopamine and acetylcholine
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Cardinal symptoms of parkinsonism?
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rigidity, tremors, bradykinsea, akinsea
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What changes cause alzheimers?
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-degeneration of cholinergic neuron and deficiency in acetylcholine
-formation of neuritic plaques |
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What class of meds are given for parkinsonism?
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dopaminergics
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What meds are given for parkinsonism?
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carbidopa
levodopa sinemet |
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side effects of dopaminergics
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n/v, dystonic mvmt, o. hypo., discoloration of sweat and urine, psychosis, tachycardia, palpitations, nightmares, suicide tendencies
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Diet of patient on dopaminergic
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low portein so it does not interfere with drug transport
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Time line of dopaminergic
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therapy may take weeks for symptoms to subside
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Taking food with dopaminergic
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may decrease GI upset but will slow drug absorbtion rate
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What is avoided when taking dopaminergic?
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vitamin B6 because it can inhibit conversion of levodopa to dopamine
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What other class of drug can be given for parkinsonism?
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anticholinergics
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What other meds are given for parkinsonism?
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artane
cogentin (block cholinergic receptors) |
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What do anticholinergics do?
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reduce rigidity and some of the tremorsl no effect on bradykinsia
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What else are anticholinergics given for?
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pseudoparkinsonism
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What is Atricept? Use?
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acetycholinesterase inhibitor
alzheimers |
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What class of drug is given for alzheimers?
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acetycholinesterase inhibitor
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What do acetycholinesterase inhibitor do?
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improve memory loss by elevation acetylcholine concentration
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WHat is myasthenia gravis?
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auto immune disease that results from lack of acetylcholine reaching the cholinergic receptors causing ineffective muscle contraction
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symptoms of myasthenia gravis?
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weakness and fatigue of muscles; early signs are diplopia and ptosis
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WHat class of meds are given for MG?
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acetycholinesterase inhibitors
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What meds are given for MG?
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mestinon
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Important teaching for MG meds?
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should be admin on time
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When is prednisone used?
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In MG to decrease symptoms when mestinon is does not work
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When is Imuran used?
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immunosuppressive agent, used in conjunction with prednisone
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What is Tensilon?
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AChE inhibitor; short acting
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when is tensilon used?
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diagnosis of MG ( increases muscle strength immediately if MG)
can distinguish between MG & cholinergic crisis ( makes muscles weaker in cholinergic crisis) |
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What is myasthenia crisis?
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muscle weakness continues after therapy due to inadequate dosing
death can occur due to paralysis of resp. muscles MED: neostigmine (AChE inhib) |
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What is multiple sclerosis?
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autoimmue disorder that attacks the mylein sheath of nerve fibers in the brain causing lesions called plaque
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What is given for acute MS attackes?
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glucocorticoids/methylprednisone
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Treatment of MS?
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dantrolene (dantrium)
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MS patients should avoid
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histamine blockers(tagamet,zantac) NSAIDs, beta blockers (propanolol
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What class of meds are given to trear muscle spasms?
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skeletal muscle relaxants
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What is spasticity?
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muscular hyperactivity that causes contraction of the muscles, resulting in pain limited mobility
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side effects of skeletal muscle relaxants?
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drowsiness
CNS depression dizziness vomiting diarrhea |
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What benzodiazepine is beneficial is spasticity?
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valium (diazepam)
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Meds given for muscle spasms?
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flexeril, robaxin, valium
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What receptor does epinephrine stimulate?
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Beta 2
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Mydriasis
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dilate pupils
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What route is epinephrine not given?
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orally
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Who gets albuterol?
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asthmatics
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Contradicted in albuterol?
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DM b/c of glycogenesis
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When is atenolol used?
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HTN
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What is a selective blocker?
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only effects a certain receptor
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What is lopressor?
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selective beta 1 blocker
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Who is lopressor good for?
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asthmatics
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Side effects of lopressor?
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breadycardia and ortho hypo
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Beta Blocker patient teaching?
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do not stop taking abruptly(rebound HTN)
Teach to take BP and pulse |
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neurotransmitter of parasympathetic system
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achetylcholine
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When is pilocarpine used?
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glaucoma
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Action of pilocarpine?
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relieves IOP by miosis and opening canal of schlemm and promotes drainage of aqueous humor
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What class of urecholine?
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cholinergic/sympathomimetic
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when is urecholine used?
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urinary bladder contraction
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NPO patient hasnt voided. nurse should ..
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feel bladder
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Pt drank a lot and has not voided . .
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feel bladder
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Contradiction of urecholine?
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asthma
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Normal urinary output?
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30 mL/hr
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Antidote for urecholine?
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atropine
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Antidote for cholinergic crisis?
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atropine
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Signs and symptoms of cholinergic crisis?
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muscle weakness
increase salvation resp arrest |
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Meds for MG
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Tensilon, mestinon, neostigmine
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How do you asses if MG med is working?
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if they cn chew/swallow, ability to perform ADLs
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Cause of MG?
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missing AChE
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Side effects of anticholinergics
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increase BP, increase Pulse, bronchodilator, decrease salvation & perspiration, urinary retention (relaxes bladder)
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What class is atropine?
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anticholinergic
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When is atropine used?
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pre-op to decrease salvation which prevents aspiration when intubated
peptic ulcers |
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What does an anticholinergic do?
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increase HR
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When is an anticholinergic used?
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during a code when vagus nerve gets stimulated
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Side effects of atropine?
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dry mouth, constipation, hypotension
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If patient is constipated ..
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encourage fluid and fiber
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If patient has dry mouth . .
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give frequent oral care, hard candy, chewing gum, mouthwash
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When is scolopine used?
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motion sickness
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contradiction of scolopine?
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glaucoma
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class of scolopine?
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anticholinergic
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When causes parkinsons?
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imbalance of AChE and dopamine
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Signs and symptoms of parkinsons
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shuffling gait, drooling
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Why are they given meds?
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because it has dopamine that they lack
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What do the meds of parkinsons do?
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decrease shaing and muscular rigidity
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What does ritalin do?
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increases attention spand
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What lacks in ADHD?
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seratonin, dopamine, norepinephrine
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What are amphetamines?
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stimulants
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What can continuous use of amphetamines cause?
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dysrhythmias
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When are amphetimines used?
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obesity
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what do you avoid with amphetamines?
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coffee
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What do anorexiants do?
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decrease apetite
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side effect of anorexiants?
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nervousness
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Side effect of CNS Stimulants for resp distress
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nervousness
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What dois the action of Imutrex?
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vasoconstriction
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What are hypnotics?
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CNS Depressants
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REM Rebound
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vivid dreams and nightmares caused by stop taking meds
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Medication for too much benzodiazapine?
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vermosicom
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Class of xanex?
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benzodiazepine for sleep
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airway is
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#1 priority
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Side effect of sustenol choline
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malignant hyperthermis
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Lidocaine is ..
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a local anesthetic
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Med for seizures?
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dilantin
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When do you take seizure med?
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at same time every day with food
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If taking dilantin and BC . .
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increase dose of dilantin
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Patients who are on dilantin need ..
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a soft toothbrush
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What meds are given to status epileptic?
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ativan/valium
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Side effections of flexonil?
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drowsiness and decrease resp.
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side effects of andernergic drugs?
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HTN, Tachycardia, palpitations, dysrhythmics
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vital signs of andrenergic drugs?
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report increase BP and Pulse
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beta blockers decrease what drug?
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epinerphrine
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contradiction of adrenergic drugs?
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dysrhythmias, glaucoma, shock
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Why do you monior I/O with adrenergic drugs?
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retention can occur d/t increase drug dose of continued use
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What are you looking at the IV site with adrenergic drugs?
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infiltration which can cause necrosis
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What is the antidote for epinephrine and dopamine?>
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regitine
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What labs do you check with adrengrenergic drugs?
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increase BS
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How do you admin nasal sprays? why?
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head upright to decrease systemic absorbtion and avoid nasal congestion rebound
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Adrenergic drugs are not good for ..
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nursing moms
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OTC diet and cold mds are contradictions are contradicted in
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DM, dysrhythmias
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Why should you avoid excess use of bronchodilator sprays ?
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can decrease s&s of BPH and peripheral vascular disease (raynauds)
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Cholinergic effects on organs
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-decrease BP
-decrease pulse -constrict bronchioles -miosis -increase bladder contractions -increase peristalsis & secretions -increase salvation |
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Class of reglan
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direct acting cholinergic
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Use of reglan
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GERD
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action of reglan
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increase gastric emptying time
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What do anticholinergics do?
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block the effect of AChE; decrease salvation and dilation of bronchioles
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anticholinergic patients should avoid
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hot enviornments and excess physical activity b/c drugs increase HR and decreas sweating
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Anticholinergics contradicted in ..
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glaucoma
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If anticholinergic patients feel "racing effect" they should
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take HR
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Diet with anticholinergics
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fluids and fiber
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side effects of anticholinergics
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dry mouth, nausea, HA, rash, dry skin, constipation, photophobia, blurred vision
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Use of pilocarpine?
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glaucoma
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Class of pilocarpine?
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direct acting cholinergic
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Urecholine class
|
direct acting cholinergic
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Action of urecholine
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contracts bladder to increase urination, increase peristalsis, increase secretions, miosis, bronchoconstriction
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use of urecholine
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increase urination and abd distention
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contradictions of urecholine
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asthma, bradycardia, hypotension, COPD, Peptic ulcer
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Antidote of urecholine
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atropine sulfate
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Admin of urecholine
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take med as prescribed
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Report urecholine s/e ie:
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decrease in pulse less than 60 or profound dizziness
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monitor pts on urecholine fr
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hypotension, urinary obstruction, increase in AST amylase, lipase, amylase
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patient teaching of MG meds
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take meds on time to avoid resp muscle weakness
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contradiction of atropine
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glaucoma
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Raise side rails for patients on atropine because
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CNS stimulation (excitement, confusion, drowsiness)
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diet with atropine?
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fiber and fluids
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patients on atropine should get
|
oral care
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patients on atropine should avoid
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hot enviornments
|
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scopoline is a
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antihistimine-anticholinergic
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