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60 Cards in this Set

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Levadopa (dopar)

uses
Parkinson's disease- use this instead of dopamine because Levadopa can cross the BBB, and has longer half-life.
Levadopa (dopar)

adverse effects
dyskinesias- movement disorders
nausea, vomiting- reduced by low doses with food. But, avoid food if possible.
hypotension
dysrhytmias
visual hallucinations (clozapine reduces psychosis)
darken sweat & urine
drug holidays (10 day interruption) increases effectiveness
Levadopa (dopar)

nurse teach
effects aren't immediate, increase over first few months
food delays absorption by slowing gastric opening
high PRO foods reduce therapeutic effects
do not use if pt. has skin lesions
sweat and urine will be dark
MAOIs cause hypertensive crisis
Carbamazepine (tegretol)

uses
epilepsy- drug of choice for partial seizures; not effective for absence, myocolonic, or atonic seizures

provides symptomatic control in pts with bipolar disorder

trigeminal and glossopharyngeal neuralgias- severe stabbing pain on trigeminal (face area) and glossopharyngeal (head) nerves; reduces pain in these areas.
Carbamazepine (tegretol)

adverse effects
unsteadiness, headache
bone marrow suppression- leukopenia (subsides with discontinuation)
increase risk of neural tube defects
hypo-osmolarity- inhibits renal excretion of water
photosensitivity reactions, Stevens-Johnson syndrome
Carbamazepine (tegretol)

nurse teach
to reduce CNS effects (headache) initiate therapy at low doses & take largest daily dose at bedtime

accelerates inactivation of other drugs (BC and warfarin)

avoid grapefruit juice
Phenytoin (dilantin)

uses
epilepsy- treats all forms except absence seizures

cardiac dysrhythmias
Phenytoin (dilantin)

adverse effects
ddiplopia (double vision)
excessive growth of gum tissue
morbilliform (measles-like) rash
can cause cleft palate, heart malformations, fetal hydantoin syndrome (growth defects, mental deficiency, craniofacial distortion )
bleeding tendencies in newborns
hirsutism (overgrowth of hair in unusual places)
Phenytoin (dilantin)

nurse teach
difficult to maintain effective, safe amount of drug due to low capacity of liver to metabolize drug
stop taking if rash develops
gastric discomfort can be reduced by giving with meal
neonatal bleeding reduced by giving prophylactic Vit K 1 month prior to birth and during delivery
Lidocaine (xylocaine)

uses
local anesthetic
treats dysrhythmias
slows conduction in atria, ventricles, and his-purkinje system
reduces automasticity of V and H-P
accelerates repolarozation
Lidocaine (xylocaine)

adverse effects
drowsiness, confusion, paresthesias
Lidocaine (xylocaine)

nurse teach
effects extended by coadministration of epinephrine
benzodiazepines (general)

uses
anxiety- 1st choice drug
insomnia- 1st choice drug
seizure disorders
produce conscious sedation
benzodiazepines (general)

adverse effects
CNS depression- drowsiness, lightheadedness, incoordination

anterograde amnesia- impaired recall of events that take place after dosing

respiratory depression
can cross placental barrier- cleft lip, inguinal hernia, cardiac anomalies
benzodiazepines (general)

nurse teach
interferes with daytime activities- take at night.
potential fetal harm, can cross into milk
should be taken on intermittent schedule-- (3-4 days/ week) to reduce physical dependence.
diazepam- valium

uses

(benzodiazepines)
generalized anxiety disorder
seizures
muscle spasm
alcohol withdrawal
induction of anesthesia
diazepam- valium

adverse effects

(benzodiazepines)
drowsiness, difficulty concentrating
anterograde anemia- impaired recall of events that take place after dosing
insomnia, rage
respiratory depression
can cross placental barrier- cleft lip, inguinal hernia, cardiac anomalies
venous thrombosis, vascular impairment
diazepam- valium

nurse teach

(benzodiazepines)
take at bedtime (affects daytime routine)
may experience anterograde amnesia
fetal harm, cross into milk
take with food if gastric upset occurs
intermittent schedule
withdrawal from long-term use causes panic, paranoia, delirium, HTN, muscle twitches
lorazepam- ativan

uses

(benzodiazepines)
generalized anxiety disorder
seizures
alcohol withdrawal
induction to anesthesia
panic disorder
lorazepam-ativan

adverse effects

(benzodiazepines)
drowsiness, difficulty concentrating
anterograde anemia- impaired recall of events that take place after dosing
insomnia, rage
respiratory depression
can cross placental barrier- cleft lip, inguinal hernia, cardiac anomalies
venous thrombosis, vascular impairment
lorazepam- ativan

nurse teach

(benzodiazepines)
take at bedtime (affects daytime routine)
may experience anterograde amnesia
fetal harm, cross into milk
take with food if gastric upset occurs
intermittent schedule
withdrawal from long-term use causes panic, paranoia, delirium, HTN, muscle twitches
midazolam-versed

uses

(benzodiazepines)
induction of anesthesia- conscious sedation, patient is unperturbed and passive, but responsive to commands- suitable for minor surgeries and endoscopic procedures
midazolam- versed

adverse effects

(benzodiazepines)
drowsiness, difficulty concentrating
anterograde anemia- impaired recall of events that take place after dosing
insomnia, rage
respiratory depression
can cross placental barrier- cleft lip, inguinal hernia, cardiac anomalies
venous thrombosis, vascular impairment
midazolam- versed

nurse teach

(benzodiazepines)
take at bedtime (affects daytime routine)
may experience anterograde amnesia
fetal harm, cross into milk
take with food if gastric upset occurs
intermittent schedule
withdrawal from long-term use causes panic, paranoia, delirium, HTN, muscle twitches
propofol (diprivan)

uses
induction and maintenance of anesthesia
sedate patients undergoing mechanical ventilation and certain noninvasive procedures (radiation therapy, MRI, endoscopy)
propofol (diprivan)

adverse effects
profound respiratory depression (including apnea)
hypotension
propofol (diprivan)

nurse teach
risk for bacterial infection due to medium of oils and eggs

may cause sepsis and death in surgery
morphine

uses

opiods
relieves pain, causes drowsiness, mental clouding, anxiety reduction, sense of well-being.
relieves post-op pain, chronic pain/ cancer, pain with delivery/labor, pre-op for sedation and reduction of anxiety
morphine

adverse effects

opiods
respiratory depression
constipation
orthostatic hypotension- lowers BP
urinary retention
cough suppression
nausea and vomiting
exaggerated sense of well-being- contributes to drug abuse
miosis- hard to see
delirium, agitation
morphine

nurse teach

opiods
avoid alcohol
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
MS Contin

uses

opiods
chronic, severe pain, such associated with cancer
MS Contin

adverse effects

opiods
respiratory arrest
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
drowsiness, mental clouding
MS Contin

nurse teach

opiods
avoid alcohol
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
fentanyl-sublimaze

uses

opiods
parenteral- induction and maintenance of surgical anesthesia; rapid onset, short duration
can cause muscle rigidity which can interfere with anesthesia induction
fentanyl- sublimaze

adverse effects

opiods
respiratory arrest
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
drowsiness, mental clouding
fentanyl-sublimaze

nurse teach

opioids
avoid alcohol
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
codeine

uses

opioids
relief of mild to moderate pain (usually PO)
cough suppressant- extremely effective
codeine

adverse effects

opioids
respiratory depression
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
sedation- drowsiness, mental clouding
miosis
codeine

nurse teach

opioids
avoid alcohol
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
meperidine- demerol

uses

opioids
pain relief

good for pts who can't take other opioids and with drug-induced rigors or shivering
meperidine- demerol

adverse effects

opioids
respiratory depression
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
sedation- drowsiness, mental clouding
miosis
meperidine- demerol

nurse teach

opioids
to avoid toxicity- treatment should not exceed 48 hours and dosage should not exceed 600mg/24 hrs
avoid alcohol
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
oxycodone (percocet)

uses

opioids
controlled-release oxycodone- relieves moderate to severe pain for extended time
oxycodone (percocet)

adverse effects

opioids
respiratory depression
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
sedation- drowsiness, mental clouding
miosis
oxycodone (percocet)

nurse teach

opioids
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
darvocet- propoxyphene

uses

opioids
pain relief
darvocet- propoxyphene

adverse effects

opioids
respiratory depression
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
drowsiness, mental clouding
miosis
prolonged usage- hormonal changes resulting in immunosupression
darvocet- propoxyphene

nurse teach

opioids
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
lortab- hydrocodone

uses

opioids
relieves pain
cough suppression
lortab- hydrocodone

adverse effects

opioids
respiratory depression
constipation
orthostatic hypotension
urinary retention
cough suppression
nausea, vomiting
exaggerated sense of well-being
drowsiness, mental clouding
miosis
prolonged usage- hormonal changes resulting in immunosupression
lortab- hydrocodone

nurse teach

opioids
need physical activity and increase fluids
may need laxatives or stool softeners
encourage to void every 4 hours
cough at regular intergvals
hypotension can be minimized by moving slowly when going from laying down to standing
NSAIDs

uses

opioids
suppression of inflammation
relieves mild to moderate pain
reduction of fever
dysmenorrhea- inhibits prostaglandin synthesis in uterine smooth muscle
suppression of platelet aggregation
cancer prevention
protection against alzheimers
NSAIDs

adverse effects

opioids
distress, heartburn, nausea
ulceration, perforation, bleeding- GI
bleeding- 2 aspirin/ week doubles bleeding time for 1 week
renal impairment- reduced urine output
salicylism- syndrome- tinnitus, sweating, headache, dizziness
reye's syndrome- fatty liver degeneration
fetal risk
NSAIDs

nurse teach

opioids
take aspirin with full glass of water or food
to prevent ulcers- take PRO pump inhibitors- suppresses acid, increase protection and maintains normal blood flow
to minimize blood loss in surgery, high doses should be discontinued 1 week prior to surgery
warfarin- intensifies anticoagulant effects
alcohol- increases risk for gastric bleeding
ibuprofen- negate effects
Acetaminophen (tylenol)

uses

opioids
pain, fever
preferred for use by children suspected of having chickenpox or influenza
acetaminophen (tylenol)

adverse effects

opioids
might raise BP in women
acetaminophen (tylenol)

nurse teach

opioids
alcohol- increaes risk of liver injury
warfarin- increases risk of bleeding

avoid alcohol
adjuvant analgesics

uses
enhance analgesia from opiods
treat side effects from opioids
antiseizure
local anesthetics
reduces pain, anxiety, nausea
reduce cerebral and spinal edema
reduce bone pain in cancer pts.
adjuvant analgesics

adverse effects
orthostatic hypotension
sedation
dry mouth, urinary retention, constipation
weightloss, insomnia
adrenal insufficiency, osteoporosis, hyperglycemia
increase vulnerability to infection
thinning of skin
adjuvant analgesics

nurse teach
take at bed time to take advantage of sedative effects