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136 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the PNS Trasmitters?
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-Acetylcholine
-Norepinephrine -Epinephrine |
A.N.E
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How many Transmitters do CNS have?
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more than 24
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What are the characteristics of the Blood-Brain Barrier?
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-impedes the entry of drugs into the brain
-provides protection -however, blocks therapeutic drug agents as well. |
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PAIN CONTROL
What are ANALGESIC? |
-Loss of sensibility to PAIN
ex: Aspirin, Tylenol and Morphine |
Aspirin, Tylenol and Morphine
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PAIN CONTROL
What are ANESTHESIA? |
-Loss of pain and all other sensation as well.
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Lidocaine and nitrous oxide
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LOCAL ANESTHEICS
MOA of LIDOCAINE? |
-Stops Neuro conduction inthe axon by blocking sodium channel
-Non-selective action |
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What is the ROUTE for LIDOCAINE?
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-Topically for Surface Anesthesia
-Injection such as nerve blocks, epidural and spinal analgesics |
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When is LIDOCAINE use?
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-Pain Control such as for procedures like suturing
-Also used to treat for DYSRHYTHMIAS |
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What are the ADVERSE EFFECTS for LIDOCAINE?
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-They only occur with excessively high doses and resulting systemic absorption
*CNS: excitation followed by depression *cardiac suppresion-bradycardia, heart block *Allergic reactions are rare *In utero-depressed contractility and prolonged labor |
C.C.A.In
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General Anesthetics?
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Are drugs that produce unconsciousness and lack of responsiveness to ALL painful Stimuli
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Types of General Anesthetics?
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Inhaled and Intravenous
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Inhaled Anesthetics?
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Halothane and Nitrous Oxide
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Intravenous Anesthetics?
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-Thiopental (Pentothal)
-Ketamine->dissolove anesthesia |
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Medications Used for Anesthesia *Before*?
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pre-Anesthetic medication
*atropine, valium |
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Medications used for Anesthesia *during*?
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Neuromuscular Blocking Agents
*Succinylcholine* **NEUROSMUSCULAR BLOCKING AGENTS PREVENT CONTRACTION OF ALL SKELETAL MUSCLES, INCLUDING THE DIAPHRAGM AND OTHER MUSCLE CONTRATION, THAT IS WHY DURING SURGERY PT'S NEED MECHANICAL SUPPORT FOR RESPIRATION |
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Medications used for AnesthesiA *AFTER*?
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POST-ANESTHETIC AGENTS
* ANTIRMITICS, ANALGESIC |
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WHAT ARE ANALGESICS?
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MEDICATIONS THAT RELIEVE PAIN WITHOUT CAUSING LOSS OF CONSCIOUSNESS!
"PAINKILLERS" |
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WHAT IS PAIN FOR PATIENTS?
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PAIN IS A SUBJECTIVE AND INDIVIDUAL EXPERIENCE. IT CAN BE DEFINED AS WHATEVER THE PERSON SAYS IT IS AND IT EXIST WHENEVER HE OR SHE SAYS IT DOES.
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WHAT IS PAIN THRESHOLD?
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LEVEL OF STIMULUS NEEDED TO PRODUCE THE PERCEPTION OF PAIN.
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WHAT IS PAIN TOLERANCE?
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THE AMOUNT OF PAIN A PERSON CAN ENDURE WITHOUT HINDERING NORMAL FUNCTION
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WHAT IS THE PATHOPHYSIOLOGY OF PAIN?
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THE NEURAL MECHANISMS BY WHICH PAIN IS PERCEIVED ARE PART OF A PREOCESS THAT INVOLVES 4 MAJOR STEPS:
1.TRANSDUCTION 2.TRANSMISSION 3.PERCEPTION 4.MODULATION |
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What 2 Types of pain are there?
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NOCICEPTIVE PAIN AND NEUROPATHIC PAIN
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What is NOCICEPTIVE PAIN?
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pain resulting from an activation of primary afferent nociceptors by MECHANCIAL, THERMAL or CHEMICAL stimuli.
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What is NEUROPATHIC PAIN?
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Pain resulting from damage to Peripheral Nervous System or Central Nervous system tissue or from altered processing of pain in the central nervous system.
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What is an OPIOD ANALGESIC?
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MORPHINE
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What is an OPIOID ANTAGONISTS?
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NALOXONE (NARCAN)
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WHAT are NON-OPIOID Anagesics?
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-Ibuprofen (Motrin, Advil)
-Acteaminophen (Tylenol) |
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What is an OPIOID?
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An opioid is a chemical substance that has a morphine-like action in the body. The main use is for pain relief.
These agents work by binding to opioid receptors, which are found principally in the central nervous system and the gastrointestinal tract. The receptors in these two organ systems mediate both the beneficial effects, and the undesirable side effects. There are four broad classes of opioids: *endogenous opioid peptides (opioids produced naturally in the body); *opium alkaloids, such as morphine (the first alkaloid isolated from opium) and codeine; *semi-synthetic opioids, such as heroin and oxycodone; and fully synthetic opioids, such as pethidine and methadone. *Although the term opiate is often used as a synonym for opioid, it is more properly limited to the natural opium alkaloids and the semi-synthetics derived from them. |
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What is an OPIATE?
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In medicine, the term opiate describes any of the narcotic alkaloids found in opium.
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What is NARCOTIC?
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A narcotic is an addictive drug, derived from opium, that reduces pain, induces sleep and may alter mood or behavior.
The derivation of the word is from the Greek word narkotikos, meaning "benumbing or deadening," and originally referred to a variety of substances that induce sleep (such state is narcosis). |
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Topic= OPIOIDS
what is the MOA of MORPHINE? |
MOA : act to mimic OPIOID like neurotransmitters and bind to opioid receptors
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Topic= OPIOIDS
What are the IND of MORPHINE? |
Morphine is used to
-relief of moderate to severe pain -sedation -cough suppression |
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WHAT ARE MORPHINE'S PHARMACOLOGICAL EFFECTS?
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-ANALGSIA
-SEDATION -EUPHORIA -DECREASED ANXIETY -RESPIRATORY DEPRESSION -COUGH SUPPRESSION -CONSTIPATION -URINARY RETENTION -ORTHOSTATIC HYPTENSION |
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WHAT ARE MORPHINE'S ABSORPTION AND DISTRIBUTIONS?
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*Routes-Oral, IM, IV, or SubQ,
epidural, intrathecal -only a small amount crosses the blood brain barrier -oral morphine has strong first pass effect |
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What are morphine's adverse effects?
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AE:
*Respiratory effects *Constipation *Orthostatic Hypotension *Urinary Retention *Cough Suppression *Emesis *Euphoria/ Dysphoria *Can Cause tolerance and dependence |
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What are MORPHINE's CAUTIONS/ CI?
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-Pregnancy/ L&D - depression of newborn
-head injury -infants -elderly |
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what are MORPHINE'S DRUG INTERACTIONS?
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-CNS DEPRESSANTS
-ANTI-CHOLINERGICS -ANTI-HYPERTENSIVES |
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WHAT ARE MORPHINE'S TOXCITY?
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-COMA
-REPIRATORY DEPRESSION -PINPOINT PUPILS |
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NURSING IMPLICATIONS?
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-PAIN ASSESSMENT
-ADVERSE EFFECTS -PATIENT TEACHING |
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ADDICTION to OPIOIDS?
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-opioid tolerance
-opioid dependence -psychological dependence "pain is what the patient says it is" |
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NARCOTIC WITHDRAWAL ABSTINENCE SYNDROME?
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-BEGINS 10 HRS AFTER LAST DOSE
-DURATION 7-10DAYS *SYMPTOMS -SWEATING, YAWNING, RHINNOREA -ANOREXIA, TREMOR, IRRITABILITY -WEAKNESS, NAUSEA, VOMITING, DIARRHEA, ABDOMINAL CRAMPS, BONE AND MUSCLE PAIN - |
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OPIOID ANTAGONIST
***NALOXONE/ (NARCAN)*** MOA?? |
MOA: COMPETES AT OPIOID RECEPTOR SITES TO BLOCK OPIOID ACTIONS.
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WHAT IS THE PHARMACOKINETICS OF NALOXONE (NARCAN)?
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-IV =immediate effects and last an hour
-half life is about 2 hrs |
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WHAT DRUG IS A NON-CENTRALLY ACTING ANALGESICS?
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-CLONIDINE
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Pain management in special populations?
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children
*assessment challenges *tools *physical indicatiors of pain *neonates and infants have high sensitivity to medication dude to underdevolped liver Elderly *undertreament of pain *heightened drug sensitivity |
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MEDS for PD to Inc Dopamine are Dominergic Meds
they are LEVADOPA-CARBIDOPA (Sinemet) -> this is a combo drug. What's the MOA? |
MOA:
*LEVOPADA: promotes syntheis of dopamine. Transported across BBB and then converted to dopamine in CNS. *CARBIDOPA: Enhances effects of LEVADOPA, blocks peripheral conversion of levadopa to dopamine. (No therapeutic effects). (For it can be more available in the CNS). |
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When is LEVOPADA-Carbidopa(Sinemet) used?
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This med is used for PARKINSON's Disease.
*it doesn't cure PD, but prolongs the quality of life. *it takes awhile for the med to be therapeutic and it wears off over time. |
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What are the ADVERSE EFFECTS of LEVOPADA-Carbidopa?
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1.Nausea/vomiting
2.dyskinesias: involuntary mov'ts. 3.postural hypotension 4.psychosis (Halluncination and Paranoia) |
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What are the Drug interactions for LEVOPADA-Carbidopa?
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1. Monamine oxidase inhibitors
(Psychotic meds for depression) 2. antipsychotic drugs (blocks the dopamine -> dec the effects) 3.anti-cholinergics (INC the effects of LEVOPADA) |
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What are the nursing considerations when a patient is taking LEVOPADA-Carbidopa?
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1. high protein meals -can affect the absorbtion of LEVO and it can DEC the absorption.
2.On-off phenomena-sometimes the effects of the drugs wears off and PD is INC 3.Drug holiday-person stops taking the drug for a short period of time (10days) to see if it's still effective. |
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PD MED
What is the MOA of PRAMIPEXOLE (Mirapex)? |
MOA: activates DOPAMINE receptors in BASAL GANGLIA
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When do you use MIRAPEX?
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Mirapex is used for PD alone in early disease, with levadopa in advanced disease
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What are the adverse effects of MIRAPEX?
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Similiar to LEVODOPA, but less dyskinesias( invol. movement)
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ALZHEIMER'S DISEASE MEDS
What is the MOA of DONEPEZIL/ ARICEPT? |
DONEPEZIL/ ARICEPT are cholinesterase inhibitors.
MOA: acts as cholinesterase inhibitors-prevents breakdown of acetycholine by acetylcholinesterase. Results in INC ACETEYLCHOLINE and enhanced cholinergic effects. |
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When are DONEPEZIL/ ARICEPT used?
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these meds are used in the early stages of AD and they are not effective in the later stages.
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What are the Adverse effects of DONEPEZIL/ ARICEPT?
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1.GI symptoms
2.dizziness 3.bronchoconstriction **Similar to Cholinergic effects** |
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What are the Drug Interactions with DONEPEZIL/ ARICEPT?
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-Antihistamines
-tricyclic antidepressants (block the cholinergic receptor, which will reduce the effects of the med) |
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ALZHEIMER'S DISEASE MEDS
*NMDA receptor antagonists* DRUG:MEMANTINE what is the MOA of MEMANTINE? |
MOA:
Blocks specific NMDA receptor sites. NMDA receptors regulate CA entry into neurons. **INC CA impairs learning and memory, neurodegenration . **MEMANTINE blocks -> DEC CA entry **Basically, too much CA causes memory loss** |
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When is MEMANTINE use?
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IND: Memantine is used for MODERATE to SEVERE Alzheimer's Disease.
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AD MED
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What are the Adverse Effects of MEMANTINE?
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AE:
-Minimal Head Aches -Dizziness -Confusion -constipation |
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What are the Drug Interaction for MEMANTINE?
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DI:
SODIUM BICARBONATE: any drug that cause URINE to be ALKALINE will DEC the excretion of MEMANTINE = INC in the body = TOXIC to the body! MEMANTINE is excreted better normal URINE |
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MULTIPLE SCLEROSIS MEDS
IMMUNOMODULATORS ->INTERFERON beta-1a/Avonex(IM)or Rebif(Sq) What's its MOA? |
MOA:
Suppresses autoimmune destruction of myelin. **it suppresses it by stoppin the body from attacking the its own myelin** **It delays the progression of MS, it doesn't cure it!!** |
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When is IMMUNOMODULATORS ->INTERFERON beta-1a/Avonex(IM)or Rebif(Sq)used?
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IND:
this med is used for MS |
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What are the adverse Effects of IMMUNOMODULATORS ->INTERFERON beta-1a/Avonex(IM)or Rebif(Sq)used?
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-Flu-like symptoms= short term over time, they'll get use to meds.
-hepatotoxicity=injure the liver cells -bone marrow suppression= dec= prod rbc -> ANEMIC -dec wbc-> infection -dec platelets-> inc Bleeding |
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MEDS for MULTIPLE SCLEROSIS
IMMUNOSUPPRESSANTS MED=MITOXANTRONE/NOVANTRONE what it's MOA? |
MOA:
Suppresses the production of immune system cells ->dec AUTO-IMMUNE destruction of MYELIN |
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When do you use IMMUNOSUPPRESSANTS
MED=MITOXANTRONE/NOVANTRONE? |
IND:
This med is used for MS pts who do not respond to other drugs. this is given IV and every 3 months! |
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What are the Adverse Effects of IMMUNOSUPPRESSANTS
MED=MITOXANTRONE/NOVANTRONE? |
AE:
-Bone Marrow Suppression=very toxic to the bone marrow -Cardiotoxicity=Irreversible damage to the heart -Fetal harm Nursing Consideration: Infection Protection bc the DEc of Prod of WBC!! |
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EPILEPSY/ SEIZURES
DEF?? |
Epilepsy: group of seizure disorders characterized by excessive excitability of the neurons in CNS. You don't need to have an EPILEPSY to ahve a SEIZURE-healthy people can have this w/ many reasons and don't know why.
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What are the two type of SEIZURES?
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1. PARTIAL SEIZURES:
BEGIN LOCALLY A.Simple partial Seizures: one hemishphere. NO LOSS OF CONSCIOUSNESs B. Complex Partial Seizures: Both Hemispheres, Change in LOC GENERALIZED SEIZURES -Both Hemispheres, Loss of CONSCIOUSNESS A.Absence (Petit mal): brief LOC but no motor activity (blank stare) B.Tonic-Clonic:stiffening of body, followed by jerking of extremities, LOC |
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ANTI-EPILEPTIC DRUGS:
Traditional AED =PHEYTOIN/ Dilantin what its MOA? |
MOA: NA channel blocker-> slows the entry of Na into neurons -> suppresses neuron activity. Selective for hyperactive neurons & preventsthe spread of other areas. Doesn't affect the healthy neurons..only the bad ones.
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When is Traditional AED =PHEYTOIN/ *Dilantin* med use?
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IND:
-partial seizures, tonic-clonic seizures (Serum levels: narrow therapeutic range 10-20mcg/ml) **Important to monitor drug levels** |
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What are the adverse effets of Traditional AED =PHEYTOIN/ *Dilantin*?
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AE (At therapeutic levels)
*mild sedation *gingival hyperplasia=growth of gum tissue *skin rash* *teratogenic=harmful to the fetus AT TOXIC LEVELS: **ATAXIA=unsteady gait **INC sedation **Cognitive impairment **double Vision **Nystagmus(back and forth Mov't of eyes) the pupil goes goes back N forth. |
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What are the DRUG INTERACTIONS of Traditional AED =PHEYTOIN/ *Dilantin*?
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DI: P450 Hepatic drug metabolizing enzyme inducer: it DEC the effects of other drugs like WARFARIN, Oral Contraceptives, glucocorticoids.
Drugs that INC DILANTIN levels by reducing it's metabolism, which may inc TOXICITY *Alcohol *Cimetidine (anti-ulcer med) *Valium *Valproic Acid |
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What are the nursing consideration for this MED
Traditional AED =PHEYTOIN/ *Dilantin*? |
-monitor drug levels
-take at night it cause sedation -don't abruptly stop med= it'll cause seizures (slowly gradually dec it bc it might create REBOUND SEIZURES) |
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AED MED TRADITIONAL
Carbamazepine/ *Tegretol*(similar to Dilantin) whats the MOA |
MOA:Sodim channel blocker, same mechanism as DILANTIN
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What are the nursing consideration for this MED
Traditional AED =PHEYTOIN/ *Dilantin*? |
-monitor drug levels
-take at night if cause sedation -don't abruptly stop med= it'll cause seizures (slowly gradually dec it bc it might create REBOUND SEIZURES) |
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When is this MED used?
AED MED TRADITIONAL Carbamazepine/ *Tegretol* |
IND: this med is used for partial seizures
*tonic clonic seizures *bipolar disorders *trigeminal *or glossopharynegeal nerve pain |
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What are the Adverse effects of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
AE:
*minimal CNS cognitive effects *visual disturbance=nystagmus, blurred vision *Bone Marrow suppression (some patients) *Ataxia: affect gait *Rash |
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AED MED TRADITIONAL
Carbamazepine/ *Tegretol*(similar to Dilantin) whats the MOA |
MOA:Sodim channel blocker, same mechanism as DILANTIN
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What are the Drug Interaction of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
*P450 enzyme inducer (same as dilantin)
*Dilatin causes dec in Tegretol levels *grapefruit juce (inhibits the metobolism of Tegretol which will inc the effects) |
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When is this MED used?
AED MED TRADITIONAL Carbamazepine/ *Tegretol* |
IND: this med is used for partial seizures
*tonic clonic seizures *bipolar disorders *trigeminal *or glossopharynegeal nerve pain |
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What are the Adverse effects of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
AE:
*minimal CNS cognitive effects *visual disturbance=nystagmus, blurred vision *Bone Marrow suppression (some patients) *Ataxia: affect gait *Rash |
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AED MED TRADITIONAL
VALPROIC Acid/ Depakote what the MOA? |
Blocks both Na and Ca channels -> suppressed the neuron activity
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When do you use AED MED TRADITIONAL
VALPROIC Acid/ Depakote? |
IND:
all partial and generalized seizures, bipolar disorders and migraine |
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What are the Drug Interaction of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
*P450 enzyme inducer (same as dilantin)
*Dilatin causes dec in Tegretol levels *grapefruit juce (inhibits the metobolism of Tegretol which will inc the effects) |
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What are the adverse effects of TRADITIONAL
VALPROIC Acid/ Depakote? |
AE:
*GI *nausea *vomitting *indigestion *hepatotoxicity=toxic to the liver *pancreatitis *teratogenic=harmful to the fetus |
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AED MED TRADITIONAL
VALPROIC Acid/ Depakote what the MOA? |
Blocks both Na and Ca channels -> suppressed the neuron activity
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What is the MOA of TRADITIONAL *PHENOBARBITAL*?
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MOA: This med will sedate the the patient. it effects GABA-> CNS Sedation. This med is cheapest and oldest med for Seizures
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What are the nursing consideration for this MED
Traditional AED =PHEYTOIN/ *Dilantin*? |
-monitor drug levels
-take at night if cause sedation -don't abruptly stop med= it'll cause seizures (slowly gradually dec it bc it might create REBOUND SEIZURES) |
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When do you use AED MED TRADITIONAL
VALPROIC Acid/ Depakote? |
IND:
all partial and generalized seizures, bipolar disorders and migraine |
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When DO YOU USE TRADITIONAL *PHENOBARBITAL*?
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*PARTIAL SEIZURES
*TONIC-CLONIC SEIZURES (SOMETIMES USED AS A SLEEPING AID) |
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What are the adverse effects of TRADITIONAL
VALPROIC Acid/ Depakote? |
AE:
*GI *nausea *vomitting *indigestion *hepatotoxicity=toxic to the liver *pancreatitis *teratogenic=harmful to the fetus |
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What are the ADVERSE EFFECTS of PHENOBARBITAL?
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*Sedation
*Interferes with Metabolism of Vitamin D (need for Ca absorbtion and Vit K is needed for clotting). *Respiratory depression at toxic levels (Respiratory arrest) *Dependent bc its a barbiturate |
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AED MED TRADITIONAL
Carbamazepine/ *Tegretol*(similar to Dilantin) whats the MOA |
MOA:Sodim channel blocker, same mechanism as DILANTIN
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MEDS for MUSCLE SPASMS and SPATICITY
(Centrally-Acting Meds) **Diazepam/ Valium** MOA? |
MOA:
Acts to enhance GABA -> CNS Sedation |
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What is the MOA of TRADITIONAL *PHENOBARBITAL*?
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MOA: This med will sedate the the patient. it effects GABA-> CNS Sedation. This med is cheapest and oldest med for Seizures
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When is this MED used?
AED MED TRADITIONAL Carbamazepine/ *Tegretol* |
IND: this med is used for partial seizures
*tonic clonic seizures *bipolar disorders *trigeminal *or glossopharynegeal nerve pain |
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When do you use
**Diazepam/ Valium** ? |
IND:
*relieve muscle spasms and spaticity *Decrease PAIN *active seizures *anti-anxiety |
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What are the Adverse effects of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
AE:
*minimal CNS cognitive effects *visual disturbance=nystagmus, blurred vision *Bone Marrow suppression (some patients) *Ataxia: affect gait *Rash |
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When DO YOU USE TRADITIONAL *PHENOBARBITAL*?
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*PARTIAL SEIZURES
*TONIC-CLONIC SEIZURES (SOMETIMES USED AS A SLEEPING AID) |
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What are the ADVERSE EFFECTS of PHENOBARBITAL?
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*Sedation
*Interferes with Metabolism of Vitamin D (need for Ca absorbtion and Vit K is needed for clotting). *Respiratory depression at toxic levels (Respiratory arrest) *Dependent bc its a barbiturate |
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What are the Adverse Effects of **Diazepam/ Valium**?
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*CNS Depression
*Physical dependence |
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What are the Drug Interaction of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
*P450 enzyme inducer (same as dilantin)
*Dilatin causes dec in Tegretol levels *grapefruit juce (inhibits the metobolism of Tegretol which will inc the effects) |
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MEDS for MUSCLE SPASMS and SPATICITY
(Centrally-Acting Meds) **Diazepam/ Valium** MOA? |
MOA:
Acts to enhance GABA -> CNS Sedation |
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AED MED TRADITIONAL
VALPROIC Acid/ Depakote what the MOA? |
Blocks both Na and Ca channels -> suppressed the neuron activity
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MEDS fOR MUSCLE SPASMS and SPATICITY
(centrally-Acting MEDS) **BACLOFEN/Lioresal** |
MOA:
Suppress hyperactive reflexes, mimics actions of GABA on the Spinal Cord |
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When do you use
**Diazepam/ Valium** ? |
IND:
*relieve muscle spasms and spaticity *Decrease PAIN *active seizures *anti-anxiety |
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When do you use AED MED TRADITIONAL
VALPROIC Acid/ Depakote? |
IND:
all partial and generalized seizures, bipolar disorders and migraine |
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What are the adverse effects of TRADITIONAL
VALPROIC Acid/ Depakote? |
AE:
*GI *nausea *vomitting *indigestion *hepatotoxicity=toxic to the liver *pancreatitis *teratogenic=harmful to the fetus |
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What is the MOA of TRADITIONAL *PHENOBARBITAL*?
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MOA: This med will sedate the the patient. it effects GABA-> CNS Sedation. This med is cheapest and oldest med for Seizures
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What are the Adverse Effects of **Diazepam/ Valium**?
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*CNS Depression
*Physical dependence |
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When DO YOU USE TRADITIONAL *PHENOBARBITAL*?
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*PARTIAL SEIZURES
*TONIC-CLONIC SEIZURES (SOMETIMES USED AS A SLEEPING AID) |
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What are the nursing consideration for this MED
Traditional AED =PHEYTOIN/ *Dilantin*? |
-monitor drug levels
-take at night if cause sedation -don't abruptly stop med= it'll cause seizures (slowly gradually dec it bc it might create REBOUND SEIZURES) |
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MEDS fOR MUSCLE SPASMS and SPATICITY
(centrally-Acting MEDS) **BACLOFEN/Lioresal** |
MOA:
Suppress hyperactive reflexes, mimics actions of GABA on the Spinal Cord |
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AED MED TRADITIONAL
Carbamazepine/ *Tegretol*(similar to Dilantin) whats the MOA |
MOA:Sodim channel blocker, same mechanism as DILANTIN
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What are the ADVERSE EFFECTS of PHENOBARBITAL?
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*Sedation
*Interferes with Metabolism of Vitamin D (need for Ca absorbtion and Vit K is needed for clotting). *Respiratory depression at toxic levels (Respiratory arrest) *Dependent bc its a barbiturate |
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When is this MED used?
AED MED TRADITIONAL Carbamazepine/ *Tegretol* |
IND: this med is used for partial seizures
*tonic clonic seizures *bipolar disorders *trigeminal *or glossopharynegeal nerve pain |
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MEDS for MUSCLE SPASMS and SPATICITY
(Centrally-Acting Meds) **Diazepam/ Valium** MOA? |
MOA:
Acts to enhance GABA -> CNS Sedation |
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When do you use
**Diazepam/ Valium** ? |
IND:
*relieve muscle spasms and spaticity *Decrease PAIN *active seizures *anti-anxiety |
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What are the Adverse Effects of **Diazepam/ Valium**?
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*CNS Depression
*Physical dependence |
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What are the Adverse effects of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
AE:
*minimal CNS cognitive effects *visual disturbance=nystagmus, blurred vision *Bone Marrow suppression (some patients) *Ataxia: affect gait *Rash |
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MEDS fOR MUSCLE SPASMS and SPATICITY
(centrally-Acting MEDS) **BACLOFEN/Lioresal** |
MOA:
Suppress hyperactive reflexes, mimics actions of GABA on the Spinal Cord |
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What are the Drug Interaction of AED MED TRADITIONAL
Carbamazepine/ *Tegretol*? |
*P450 enzyme inducer (same as dilantin)
*Dilatin causes dec in Tegretol levels *grapefruit juce (inhibits the metobolism of Tegretol which will inc the effects) |
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AED MED TRADITIONAL
VALPROIC Acid/ Depakote what the MOA? |
Blocks both Na and Ca channels -> suppressed the neuron activity
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When do you use AED MED TRADITIONAL
VALPROIC Acid/ Depakote? |
IND:
all partial and generalized seizures, bipolar disorders and migraine |
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What are the adverse effects of TRADITIONAL
VALPROIC Acid/ Depakote? |
AE:
*GI *nausea *vomitting *indigestion *hepatotoxicity=toxic to the liver *pancreatitis *teratogenic=harmful to the fetus |
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What is the MOA of TRADITIONAL *PHENOBARBITAL*?
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MOA: This med will sedate the the patient. it effects GABA-> CNS Sedation. This med is cheapest and oldest med for Seizures
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When DO YOU USE TRADITIONAL *PHENOBARBITAL*?
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*PARTIAL SEIZURES
*TONIC-CLONIC SEIZURES (SOMETIMES USED AS A SLEEPING AID) |
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What are the ADVERSE EFFECTS of PHENOBARBITAL?
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*Sedation
*Interferes with Metabolism of Vitamin D (need for Ca absorbtion and Vit K is needed for clotting). *Respiratory depression at toxic levels (Respiratory arrest) *Dependent bc its a barbiturate |
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MEDS for MUSCLE SPASMS and SPATICITY
(Centrally-Acting Meds) **Diazepam/ Valium** MOA? |
MOA:
Acts to enhance GABA -> CNS Sedation |
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When do you use
**Diazepam/ Valium** ? |
IND:
*relieve muscle spasms and spaticity *Decrease PAIN *active seizures *anti-anxiety |
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What are the Adverse Effects of **Diazepam/ Valium**?
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*CNS Depression
*Physical dependence |
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MEDS fOR MUSCLE SPASMS and SPATICITY
(centrally-Acting MEDS) **BACLOFEN/Lioresal** |
MOA:
Suppress hyperactive reflexes, mimics actions of GABA on the Spinal Cord |
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When do you use BACLOFEN/ Lioresal?
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IND:
Reduce Spasticity in PTS with Cerebral Palsy, Spinal Cord injury and MS. |
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What are the Adverse Effects of BACLOFEN/ Lioresal?
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AE:
*CNS Depression *NAUSEA *CONSTIPATION *URINARY RETENTION |
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What are the nursing consideration when a patient is on BACLOFEN/ Lioresal?
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*gradual Withdrawal. Not to stop it abruptly bc the PT may have REBOUND SPASMS
Given PO or an IMPLANT pump and its set at a set dose to teh spinal cord. |
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