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60 Cards in this Set
- Front
- Back
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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.
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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 |
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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 |
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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. |
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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 |
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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 |
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Phenytoin (dilantin)
uses |
epilepsy- treats all forms except absence seizures
cardiac dysrhythmias |
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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) |
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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 |
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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 |
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Lidocaine (xylocaine)
adverse effects |
drowsiness, confusion, paresthesias
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Lidocaine (xylocaine)
nurse teach |
effects extended by coadministration of epinephrine
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benzodiazepines (general)
uses |
anxiety- 1st choice drug
insomnia- 1st choice drug seizure disorders produce conscious sedation |
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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 |
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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. |
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diazepam- valium
uses (benzodiazepines) |
generalized anxiety disorder
seizures muscle spasm alcohol withdrawal induction of anesthesia |
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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 |
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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 |
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lorazepam- ativan
uses (benzodiazepines) |
generalized anxiety disorder
seizures alcohol withdrawal induction to anesthesia panic disorder |
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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 |
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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 |
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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
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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 |
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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 |
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propofol (diprivan)
uses |
induction and maintenance of anesthesia
sedate patients undergoing mechanical ventilation and certain noninvasive procedures (radiation therapy, MRI, endoscopy) |
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propofol (diprivan)
adverse effects |
profound respiratory depression (including apnea)
hypotension |
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propofol (diprivan)
nurse teach |
risk for bacterial infection due to medium of oils and eggs
may cause sepsis and death in surgery |
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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 |
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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 |
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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 |
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MS Contin
uses opiods |
chronic, severe pain, such associated with cancer
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MS Contin
adverse effects opiods |
respiratory arrest
constipation orthostatic hypotension urinary retention cough suppression nausea, vomiting exaggerated sense of well-being drowsiness, mental clouding |
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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 |
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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 |
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fentanyl- sublimaze
adverse effects opiods |
respiratory arrest
constipation orthostatic hypotension urinary retention cough suppression nausea, vomiting exaggerated sense of well-being drowsiness, mental clouding |
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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 |
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codeine
uses opioids |
relief of mild to moderate pain (usually PO)
cough suppressant- extremely effective |
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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 |
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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 |
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meperidine- demerol
uses opioids |
pain relief
good for pts who can't take other opioids and with drug-induced rigors or shivering |
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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 |
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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 |
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oxycodone (percocet)
uses opioids |
controlled-release oxycodone- relieves moderate to severe pain for extended time
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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 |
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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 |
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darvocet- propoxyphene
uses opioids |
pain relief
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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 |
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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 |
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lortab- hydrocodone
uses opioids |
relieves pain
cough suppression |
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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 |
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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 |
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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 |
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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 |
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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 |
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Acetaminophen (tylenol)
uses opioids |
pain, fever
preferred for use by children suspected of having chickenpox or influenza |
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acetaminophen (tylenol)
adverse effects opioids |
might raise BP in women
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acetaminophen (tylenol)
nurse teach opioids |
alcohol- increaes risk of liver injury
warfarin- increases risk of bleeding avoid alcohol |
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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. |
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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 |
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adjuvant analgesics
nurse teach |
take at bed time to take advantage of sedative effects
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