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164 Cards in this Set
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- Back
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Mood disorder
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Depression and Bipolar- major depressive, dysthymic, bipolar, manic and hypomanic episode disorders, and cyclothymic disorder
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Comorbid condition
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completed or attempted suicide. Disorders include mood disorder, psychoses, personality disorder, anxiety, severe insomnia, substance use, painful disease, and family history
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Antidepressant black box warning*
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Suicide risk is higher when feeling better because patient has energy to follow through.
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Antidepressants*
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Prozac, Paxil, Nardil, Wellbutrin, and Tofranil block norepinephrine breakdown and slow serotonin reuptake. Similar effectiveness in treating depression. Takes about 4 weeks for therapeutic effects.
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Tricyclic antidepressant TCAs*
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*antidepressant and adjuvant analgesic
*treats major depression by blocking norepinephrine reuptake. *Adverse effects are cardiotoxicity, congestive heart failure, obesity, and dysrhythmias. *Tofranil AntiSLUDGE side effects |
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Tofranil*
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*TCA that treats major depression by blocking norepinephrine reuptake.
*Also treats nocturnal enuresis (as adjunct) Symptoms improve in 2-4 weeks. First pass effect. Interacts with other TCAs. *Adverse effects are cardiotoxicity, congestive heart failure, obesity, and dysrhythmias. Has anticholinergic effects AntiSLUDGE |
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Selective serotonin reuptake inhibitors SSRIs*
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Drugs of choice for depression because has low incidence of adverse effects.
*Treats general anxiety disorder (Paxil & Lexipro), social anxiety disorder & OCD (both with Zoloft), PTSD, and Panic disorder *Produces selective blockade of serotonin reuptake. Adjuvant analgesic Prozac and Paxil |
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Prozac*
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SSRI antidepressant and antianxiety agent
*produces excitation rather than sedation. *Safe to use during pregnancy. *Side effects are headache and nervous anxiety. Do not use with MAOIs. *Half life is 30 days. |
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Paxil*
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SSRI antidepressant and antianxiety agent. Category D.
Adverse effects are GI reactions, CNS disturbance, and * fatal MAOI interactions. |
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Atypical antidepressants*
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Mixed Serotonin-norepinephrine reuptake inhibitors (SNRI)- *Effexor and bupropion; serotonin(only) reuptake- *Trazodone ; alpha2 adrenergic/serotonin - histamine receptor blocker- Mirtazapine
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Mixed SNRIs*
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Atypical antidepressants that exhibits more anticholinergic effects, CNS sedation, and cardiac abnormalities than SSRIs.
*Effexor and bupropion. |
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Effexor*
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Atypical antidepressants- Mixed SNRI that is *category X.
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Bupropion*
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Atypical antidepressants- Mixed SNRI that has *CNS stimulant properties. No weight gain or sexual dysfunctions. Adverse reaction are seizures.
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Serotonin (only) reuptake*
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Atypical antidepressants that have low anticholinergic effects, elevates mood, and reduces depression symptoms. Side effects are confusion, light headedness, drowsiness, and orthostatic hypotension.
Trazodone* |
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Trazodone*
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Atypical antidepressant - Serotonin (only) reuptake agent that is used for insomnia (*sedative), but is chemically unrelated to other classes.
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alpha2 adrenergic/serotonin - histamine receptor blocker
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Atypical antidepressant that increases norepinephrine release to decrease anxiety, agitation, insomnia, and migraines.
Mirtazapine |
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Mirtazapine
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Atypical antidepressant- alpha2 adrenergic/serotonin - histamine receptor blocker that is used to treat migraines.
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Monoamine Oxidase Inhibitors - MAOIs*
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Atypical antidepressant that is 2nd or 3rd choice because of high side effect potential.
Prevents MAO enzyme from converting norepinephrine, serotonin, and dopamine into inactive products. Used to treat atypical depression, panic attacks, bulimia, and OCD. *Therapeutic effects continue for 1-2 weeks after stopping. *Adverse effects are direct CNS stimulation, agitation, hypomania, orthostatic hypotension, and *hypertensive crisis with tyramine containing foods (Blocks tyramine breakdown and releases norepinephrine stored) *Monitor vital signs, review meds to make sure no drug interaction, and has CYP450 effect. Nardil |
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Nardil*
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Atypical antidepressant - *Safest MAOI
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Bipolar*
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Serious psychiatric disorder characterized by extreme mood swings from depression to euphoria. Major suicide risk and non adherence problem.
Treated with *Lithium, valproic acid, carbamazapine, risperadal for manic episodes. Treated with *Effexor and bupropion for depressive episodes |
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Lithium*
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Antimanic preventative agent used for mania of bipolar disorder. Doesn't cause CNS depression, excitation, or euphoria. Increases serotonin synthesis.
Long term use adverse effects can cause serious toxicity (*narrow therapeutic to toxic level- TAKE LEVELS *Serum level cap at 1.5 causes cardiac dysrhthymias), dysrhythmias, circulatory collapse, leukocytosis, thyroid changes, and renal damage. *Enters breast milk. Don't miss dose |
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Valproic acid/Depacon*
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antiseizure agent drug of choice for bipolar mania mood stabilizing in pregnant women because of less adverse effects.
GABA analog to treat generalized tonic clonic, absence, and myoclonic seizures. Produces less sedation and cognitive impairment than phenytoin and phenobarbital. |
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Carbamazapine/Tegretol*
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Anticonvulsant agent used to treat mania for bipolar disorder when unresponsive to lithium.
*Controls partial and generalized tonic-clonic seizures |
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Risperadal*
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*Atypical antipsychotic agent controls acute symptoms during mania episodes and long term mood stabilizer. Lower EPS effects
*dopamine antagonist that is well tolerated. Relieves negative and positive symptoms of psychosis and acute manic phase of bipolar disorder. |
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Effexor and Bupropion*
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Antidepressant SSRI used to treat depressed stage of bipolar disorder.
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Psychoses
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Severe mental disorder with inability to recognize reality (delusions, hallucinations, lack of insight/judgement, mood and affect vary). Schizophrenia or schizoaffective ( mood disorder and schizophrenia)
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Antipsychotic drugs*
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Improve thought process and behavior. Equally effective. Phenothiazines- *Chlorapromazine HCL ; Nonphenothiazines- *Haldol; Atypical- *Risperadol or Clozapine.
Used to treat schizophrenia, manic-depressive, Tourette's, emesis preventation, and dementia. Common adverse effects are EPS and NMS. *Regulate amount of neurotransmitters by increasing, decreasing or blocking them from working. |
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Extrapyramidal Reaction symptoms- EPS*
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*Acute dystonia (muscle spasms), akathisia (can't relax), Parkinsonism, tardive dyskinesia (tongue and face movement). Need to monitor in antipsychotic drugs
*Treated with Cogentin and Artane (anticholinergics) |
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Neuroleptic malignant syndrome- NMS
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potentially fatal reaction to antipsychotic medications. High fever, tachycardia, and muscle rigidity symptoms.
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Phenothiazine*
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Antipsychotic drug class that treats schizophrenia but has high adverse effects.
*Chlorapromazine HCl |
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Chlorapromazine HCl (Thorazine)*
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Antipsychotic -phenothiazine agent that starts on high doses and then tapered. Sedation pronounced on start. Dopamine agonist. Not for seizure prone. *Decreases blood brain barrier, PD symptoms, and anticholinergic symptoms.
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Nonphenothiazine*
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Antipsychotic drug class that has same effect and adverse effects as phenothiazines.
*Haldol |
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Haldol*
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*Antipsychotic -nonphenothiazine agent treats schizophrenia and acute psychosis. Preferred drug for Tourette's.
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Atypical antipsychotics*
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Antipsychotic drug class that is second generation. Targets more specific dopamine receptors and blocks, which lowers EPS. *Drug of choice.
*Risperdal and Clozapine |
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Clozapine
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Atypical antipsychotic agent. Not used because it causes blood dyskerinsias. No EPS
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Parkinsons Disease*
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*Ineffecient amount of dopamine. Causes tremors, muscle rigidity, bradykinesia (slow movement), and postural inability.
*Treated with AntiPD dopamine agonists- Levodopa(dopamine replacement) and Mirapex; or anticholinergic agents *for symptom treatment - *Congentin and *Artane. |
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Levodopa*
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Anti parkinsons *dopamine replacement (metabolized to dopamine) agent that loses effectiveness after a few years. Report side effects such as chewing motions, bobbing, face grimacing, rocking, nightmares, depression, confusion, hallucinations, tachycardia, and palpitations. Expect nausea, vomiting, anorexia, and orthostatic hypotension. Pyridoxine (vitamin B6) reverses all effects.
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Mirapex *
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Anti parkinsons *nondopamine dopamine agonist agent.
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Congentin and Artane*
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2 Anticholinergic drugs used for treating *Parkinson's disease symptoms and EPS.
Useful for minimal symptoms. Used in patients unable to take Levodopa. Slows gastric emptying. |
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Epiliepsy
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Recurrent seizures caused by disturbances in the electrical activity of the brain. Treated with Anticonvulsant drugs
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Anticonvulsant drugs*
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Used to inhibit convulsions and are adjuvant analgesics.
*Inhibits neuron firing by suppressing sodium, suppress calcium influx, increases GABA by inhibiting neuron firing (by increasing GABA synthesis/amount, block reuptake, or activate GABA receptors) or blocks glutamate receptors. *Hydatoin- Dilantin; Iminostilbenes- Carbamazepine; Succinimides- Ethosuximide; GABA analog- Gabapentin; GABA agonist- Valproic acid |
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Hydatoin*
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*Anticonvulsant drug class manages most seizures but has many adverse effects. Most common and least toxic. Used to treat tonic clonic generalized and partial seizures. No alcohol. Teach patient urine color may change to pink, red, or brown.
Dilantin |
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Dilantin*
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Anticonvulsant hydatoin agent treats seizures, has narrow therapeutic range.
* Causes gum hyperplasia (gum swelling). Given PO or IV in saline. *Adverse effects are CNS, GI, GUM hyperplasia, and interacts negatively with many other drugs and alcohol. |
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Iminostilbenes
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Anticonvulsant drug class first choice for tonic clonic seizures and partial seizures. Affect sodium channels. Has analgesic, anticholinergic, antidysrhthymic, antidepressant, and sedative effects. Has muscle relaxant and neuromuscular properties.
Carbamazepine |
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Carbamazepine
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Anticonvulsant/seizure iminostilbenes agent. Treats most seizures, mania, and trigeminal neurolgia pain. Autoinduction within first two months. Causes bone marrow depression and neural tube defect. PO.
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Succinimides
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Anticonvulsant drug class of choice for absence seizures
Ethosuximide |
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Ethosuximide/Zarontin
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Anticonvulsant succinimide agent for absence seizures. Preferred in children. Effective in myoclonic and akinetic epilepsy.
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Gabapentin/ Neurontin *
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*Anticonvulsant GABA analog agent effective as single drug therapy for new onset epilepsy used to treat neuropathic pain. PO only
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Muscle spasms
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involuntary contractions most commonly caused by injury or overuse of skeletal muscle. Treated with nonpharmacologic interventions, NSAIDs, and skeletal muscle relaxants (centrally or peripherally acting)
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NSAIDs non steroid anti inflammatory drugs
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Aspirin, naproxen, and ibprofen relieve inflammation and take pressure off nerves to increase mobility. Medication of choice for mild to moderate pain. Primarily used for anti-inflammation effects, antipyretic, and analgesic properties. GI tract side effects are nausea, anorexia, dyspepsia, and ulceration of GI mucosa.
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Musculoskeletal relaxants
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Relieves muscular spasms and pain associated with traumatic injuries and chronic debilitating disorders, dividing into centrally acting- Flexeril/cyclobenzaprine and peripherally acting- Dantrium/dantrolene. None safe in pregnancy, lactation, or children.
Acute spasms= IV Orthopedic procedures = Parental |
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Centrally acting musculoskeletal relaxants
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Musculoskeletal relaxants class drug of choice for muscle spasms. Flexeril/cyclobenzaprine
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Flexeril/cyclobenzaprine
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Centrally acting musculoskeletal relaxant agent that depresses neuron activity in brain or spinal cord to treat acute spasms from muscle trauma and decreases pain, increases range of motion, and has sedative effect.
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Peripherally acting musculoskeletal relaxants
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Musculoskeletal relaxants class is direct acting on muscles and have minimal CNS effects. Most effective for muscle spasm contractions of neurologic origins.
Dantrium/dantrolene |
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Dantrium/dantrolene
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Peripherally acting musculoskeletal relaxant is an antispasticity agent. Inhbits calcium ion release of Na pump.
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CNS stimulants*
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Increase alertness, enhance ability to concentrate, and delay fatigue. Treats ADHD, NARCOLEPSY, weight management, and reverses respiratory distress. Amphetamines-Adderall; Amphetamine like- Strattera; Analeptics- caffeine
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Amphetamines*
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Promote norepinephrine release causing euphoria and alertness to control NARCOLEPSY, or ADHD. Can cause sleepiness, weigh loss, restlessness, tremors, irritability, increased HR, cardiac problems, and impotence. Can cause withdrawals.
Adderall |
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Amphetamine like (non stimulant)*
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SNRSI causes euphoria and alertness to control NARCOLEPSY or ADHD. Can cause sleepiness, weigh loss, restlessness, tremors, irritability, increased HR, cardiac problems, and impotence. Can cause withdrawals.
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Analeptics
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Increase alertness or stimulates respiratory system. Caffeine (methylaxntine) and Modafinil
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Caffeine
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Methylaxanthine agent is a CNS and respiratory stimulant. Has natural and potent psychoactive properties. Used to treat infant apnea, bronchodilator, relaxes smooth muscle, mild diuresis, and relieves headache.
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Pain
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5th vital sign influenced by anxiety, fatigue, depression. Classified by duration and source
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Analgesics
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Pain relieving medicine with no loss of consciousness or reflex activity
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Nocieception
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Perception of painful stimuli or injurious influences. Transmitted by sensory nerve receptors throughout body
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Somatic nociceptor*
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*Sharp, localized pain sensations (organ, skin, bone, muscle and joints)
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Visceral nociceptor*
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*General dull, throbbing, or aching pain in organ (abdominal and thoracic)
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Neuropathic pain*
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*Caused by injury or irritation to Peripheral or CNS nerve tissue described as burning, shooting, radiating, or numbing pain. Not for opioids.
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Idiopathic pain
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Nonspecific pain of unknown origin
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Pain transmission process
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allows multiple targets for pharmacologic intervention. 4 phases= Transduction, transmission- nociceptor to spinal cord, perception, and modulation.
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Transduction 1st phase of pain transmission process
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Stimulates PNS nociceptors to cause inflammation mediators
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Transmission 2nd phase of pain transmission process
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Pain impulse travels by A (alpha, beta, or delta) and C fibers
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A fibers
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Myelin wrapped and carry signals for intense, well defined pain. Alpha, Beta, or Delta
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Alpha A fiber
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Fastest and responds to pressure or touch on muscle
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Beta A fiber
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Slower and responds to pressure or touch on skin
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Delta A fiber
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Slowest and responds to tissue injury producing sharp pain sensation.
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C fiber
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Unmyelinated and carries signals more slowly. Conducts poorly localized pain (burning or dull ache)
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Gate control theory
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Gating mechanism for transmission of pain in the spinal cord. Faster alpha A or beta A fibers reach spinal cord and shut gate before C fibers reach, effectively blocking pain impulse.
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Perception 3rd phase of pain transmission process
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Conscious experience of pain
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Modulation 4th phase of pain transmission process
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Neurotransmitter (norepinephrine, serotonin, or endogenous opioids- endorphines and enkalphins) can inhibit pain
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Nonpharmacologic interventions
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Utilized to reduce and augment analgesic complementary and alternative therapies
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Opioid/Narcotic analgesic agents*
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*Morphine-like, meperidine-like, and methadone-like
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Pure opioid agonist*
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*Drug activates mu and kappa receptors. CNS, CV, GI tract, and urinary tract significantly affected. Dependence occurs when increasing doses and tolerance. Morphine like- Morphine sulfate and Codeine
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Morphine / Roxanol *
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Strong pure opioid agonist agent for acute and chronic pain. Preanesthetic for agitated patients, shortness of breath in terminally ill.
*Raises pain threshold, reduces anxiety, and induces sleep during pain. Medullary actions: *Depresses respiratory center by being less sensitive to CO2, depresses cough center, and affects chemoreceptor trigger zone. Peripheral actions: Depresses GI tract, urine retention, hypotension, bradycardia, and reduces pupil size. *ADVERSE effects: Constipation, urine retention, respiratory depression, nausea, and hypotension. |
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Codeine*
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*Moderate pure opioid agonist. Morphine like agent
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Agonist-antagonist/ Partial opiate agonist
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Used for short term moderate to severe pain. Occupy one receptor and block or have no effect on the other. Effective with out prior administration of opiate agonist. For overdose antidote use antagonist.
Talwin/pentazocine |
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Talwin/pentazocine
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Agonist-antagonist/ Partial opiate agonist. Used for moderate to severe pain and as a supplement to general anesthesia.
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Respiratory depression
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Most serious adverse effect (especially for opiate naive). Use narcotic antagonists if respiration falls below 10 per min. Monitor if IV route used. Causes increased intracranial pressure because carbon dioxide content increases
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Orthostatic hypotension
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Caused by inhibiting baroreceptor reflex and causes peripheral vasodilation. Dizziness or fainting
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Opiate antagonist*
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Drug blocks mu and kappa receptors. No effect other than to reverse agonists.
*Naloxone/Narcan |
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Nalaxone/Narcan*
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*Opiate antagonist reverses respiratory depression and used post op to reverse surgery drug effects. *Reverses morphine effects.
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Opiates ladder effect*
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*Start from bottum and go up until you find an opiate that works.
Pain level less than 4= nonopiod analgesics 4-6= PO opioids added to baseline treatments 7-10= parental opioids |
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Nonopiates*
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Reduce pain by acting of CNS.
*Tramadol/Ultram |
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*Tramadol/Ultram
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Centrally acting nonopioid supresses cough and used for pain after orthopedic and gynecologic procedures and chronic pain. No anti-inflammatory activity. Respiratory depression unlikely.
* NOT for older patients. |
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Corticosteriod
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Reduce inflammatory swelling on brain, spinal cord, and spinal nerves.
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Bone specific agent
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Used for bone cancer or metastases pain
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Migraine
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severe headache related to specific triggers. Throbbing and pulsating pain. Sometimes preceded by an aura. Nausea, vomiting, and extreme light sensitivity symptoms.
Mild- NSAIDs Moderate to severe- Serotonin and/or dopamine agonists. Use Triptans- Sumatriptan/Imitrex or ergot alkaloids (2nd choice) |
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Sumatriptan/Imitrex
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Triptan serotonin receptor agonist anti migraine agent for acute migraines. Constricts cranial vessels and reduce transmission pain pathway
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General anesthesia
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Acts on CNS to abolish perception of pain and reaction to painful stimuli. Loss of sensation and consciousness. Used in major surgery.
IV = Opioids- Fentanyl/Sublimaze; Benzodiazepines- Midazolam/Versed and Valium; NMDA receptor agonist- Propofol/Diprivan; Antipsychotic- Droperidol/Insapsine; Inhalation= Gases- Nitrous oxide; Volatile liquid- Isoflurane/Forane |
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IV anesthetics
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General anesthesia deep sedation with loss of reflexes.
Opioids- Fentanyl/Sublimaze; Benzodiazepines- Midazolam/Versed and Valium; NMDA receptor agonist- Propofol/Diprivan; Antipsychotic- Droperidol/Insapsine; Short acting barbiturates |
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Opioid IV anesthetic
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General anesthesia type. Provides analgesia and accomplish neurolept anesthesia (indifference). Conscious sedation.
Fentanyl/Sublimaze |
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Fentanyl/Sublimaze
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Opioid IV general anesthetic - opioid agonist agent has short duration for pre medication, balanced anesthesia induction, anesthesia maintenance, and post op pain. Can cause respiratory depression
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Benzodiazepines *
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*Mostly used as anti anxiety, sometimes anti-insomnia, and general IV anesthesia type used to produce relaxation, sedation, and amnesia.
*Increases GABA -"pam" *Common side effect is hangover effect because it suppresses REM sleep. *Short term treatment. Likely to be abused = Schedule IV Midazolam/Versed and Valium *Lorazpam/Ativan |
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Midazolam/Versed *
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*Benzodiazepines IV general anesthetic - CNS depressant (anti anxiety) GABA receptor agonist. Can cause respiratory depression. Relaxes skeletal muscles.
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Valium *
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*Benzodiazepines IV general anesthetic. Premedication for anxiety relief and relaxes skeletal muscles.
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N-methyl-D-aspartate (NMDA) receptor agonist IV anesthetic
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general anesthesia type used to induce and maintain anesthesia.
Propofol/Diprivan |
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Propofol/Diprivan
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NMDA receptor agonist IV general anesthesia induction and maintenance. Has antiemetic effect
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Antipsychotic IV anesthetic
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General anesthesia type
Droperidol/Inapsin |
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Droperidol/Inapsin
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Antipsychotic IV general anesthetic reduces nausea and vomiting adverse effects of opioids. Produces sedation by reducing anxiety and motor activity.
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Neuroleptanalgesia
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General anesthesia that combines fentanyl with droperidol to produce a state which patients are conscious, but insensitive to pain, and disconnected with surroundings.
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Neuroleptanesthesia
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General anesthesia induced by IV and combination with inhalation of a weak anesthetic
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Inhalation
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General anesthesia type. Rapid onset loss of consciousness. Depth based on 4 stages. Pediatric patients require higher concentration, and geriatric patients require lower concentration. Kidney function affected. Shivering common side effect during recovery. Adverse effect malignant hyperthermia. All are respiratory depressant except Nitrous oxide.
Gases- Nitrous oxide; Volatile liquid-Isoflurane/Forane |
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Nitrous oxide
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General anesthesia gas inhalant. GABA receptor agonist, opioid agonist. Limited to minor surgery- dental, diagnostic, and surgical. Has strong analgesic properties.
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Volatile liquid
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General anesthesia inhalation type used to induce and maintain deep anesthesia.
Isoflurane/Forane |
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Isoflurane/Forane
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General anesthesia volatile liquid inhalation. Drug of choice. GABA and glutamate receptor agonist. Effective and safe, excellent muscle relaxant.
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Local anesthesia
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Used for neuropathic pain. Reversibly blocks nerve conduction, leading to loss of sensation and prevents muscle activity. Eventually enters systemic circulation and can affect other organs by acting as CNS stimulants (vasodilation). Safer than general but there is less control over onset and drug duration.
Esters- Procaine/Novacaine; Amide- Lidocaine |
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Esters
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Local anesthesia used as topical and spinal anesthetics by decreasing sodium that enters neuron to depress depolarization and prevent conduction of pain impulse.
procaine/Novacaine |
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procaine/Novacaine
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Local anesthesia ester. Spinal, infiltration, or peripheral nerve block anesthesia. Adverse effects are myocardial depression, anaphlyactic reaction, cardiac arrest, respiratory arrest, seizure, and fatal bradycardia.
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Amide
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Local anesthesia replaced ester class because lower incidence of adverse effects.
Lidocaine |
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Lidocaine
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Local anesthesia amide class surface and infiltration agent. Apply safely to eyes, skin, or mucosal areas. Can effect heart electric action. Can cause laryngeal edema, bradycardia, anaphlyacted reaction, respiratory arrest, seizures, and rectal bleeding (dibucain) by injection. No adverse effects by topical application.
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Injectable anesthesia
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Onset of local anesthesia determined by concentration of drug and size of nerve.
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Pre Op anesthesia adjuncts
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Benzodiazepine- Versed for anxiety
Zantac or Pepcid to reduce possibility of aspiration pneumonia Anticholinergics- Atropine to reduce secretions and can block bradycardia |
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Pain management
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Opioids and NSAIDs as anesthesia adjuncts
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Neuromuscular blockers
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Skeletal muscle relaxants as anesthesia adjuncts
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Post Op anesthesia adjuncts
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Antiemetic- Promethazine as anesthesia adjuncts
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Antiseizure drug classes*
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*Uses barbituates, hydantoins, iminostilbenes plus valproic acid.
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Goal of barbituates, hydantoins, iminostilbenes plus valproic acid*
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*To decrease seizures and increase threshold of activity.
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Pain*
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Is what patient says it is (*subjective). 2 components= perception and interpretation.
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Opiate Nursing assessment*
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*Take health and drug history. Take pain level, how it feels, and what alleviates.
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Opiate Nursing Interventions*
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*Give pain medications, see maximum dose, know bowel sounds, and urine output. Have Narcan antidote.
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Opiate Nursing Client teaching*
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*Give side effects, addiction and dependency teaching.
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Opiate Nursing Evalution*
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*Monitor adverse effects, if need to up the dose or medicine, or use different route. (Use IV instead of IM)
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Musculoskeletal relaxant Client teaching
Flexeril/cyclobenzaprine and Dantrium/dantrolene |
Use non pharmacologic therapy to avoid spasms. Avoid activities requiring mental alertness or coordination. Don't take other drugs without Dr.'s knowledge. Drug interaction with alcohol, antihistamines, sleeping aids, or drugs causing drowsiness. Take with milk or food to avoid nausea. Do not stop abruptly- can cause hallucinations.
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Benign prostatic hyperplasia BPH *
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*Abnormal enlargement of the prostate, the most common benign neoplasm in older men.
*Decreases outflow of urine by obstructing the urethra, causing difficult urination. *Other symptoms are nocturia (night time urination), increased urinary frequency (small amount urine), urgency, decreased force of stream, and sensation bladder did not empty. Caused due to overgrowth of epithelial cells (static factor) or excessive numbers of alpha 1 adrenergic receptors that when activated compress the urethra (dynamic factor). * Treated with Finasteride/Proscar |
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Proscar/Finasteride *
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*Drug of BPH- benign prostatic hyperplasia. Treated effectively. Inhibits metabolism of testosterone (antiandrogen). Shrinks enlarged prostate. Prescribed for male baldness (PROPECIA 5 times higher).
Taken PO. *Can cause renal failure, diminished libido, sexual dysfunction. Cytochrome P450 interaction. Dont take with testosterone, anticholinergics, or saw palmetto. *Category X *TEACH patient not to let women or children touch/handle tablets. |
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gamma aminobutyric acid neurotransmitter
GABA NT * |
*Most common inhibitory CNS transmitter.
Significant in seizure and anxiety disorders |
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Dopamine neurotransmitter *
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*Neurotransmitter effect is excitatory. Significant in Parkinsons* disease, psychoses, motivation, and pleasure.
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acetylcholine Ach neurotransmitter *
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*Primary neurotransmitter of autonomic nervous system
CNS effect can be excitatory or inhibitory to control voluntary skeletal muscle movement. ANS effect is to activate the parasympathetic nervous system. |
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norepinephrine NE neurotransmitter *
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*Primary neurotransmitter of autonomic and sympathetic nervous system
CNS effect can be excitatory or inhibitory ANS effect is to activate the parasympathetic nervous system. Significant in depression, memory and panic attacks. |
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Pain medications*
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*Measured against morphine
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Laxatives (Stool softener)*
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*Consider holding drug when there are too many stools. Usually geriatric dependence.
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Proton Pump inhibitor*
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* Blocks gastric acid secretion and are the drugs of choice in the therapy of peptic ulcer disease and gastroesophageal reflux disease
*Prilosec/omeprazole |
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Zofran*
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*Treats chemotherapy induced nausea and vomiting and manages acute nausea and vomiting.
*Side effects are headache, constipation or diarrhea, and dizziness. *Serotonin (5 HT) receptor antagonist |
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Compazine*
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*Antipyschotic and antiemetic
*blocks dopamine receptors (dopamine antagonist) to inhibit signals to vomiting center in medulla *Phenothiazine Adverse effects are EPS, NMS, agranulocytosis, or orthostatic hypotension. |
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Irritable bowel Disease types*
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*Irritable Bowel Syndrome, Ulcerative Colitis, and Crohn's disease. Similar, presented differently.
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Pepto bismol*
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*Darkens stools
Antidiarrheal, treats heart burn, indigestion, and Helicobacter infections in patients with peptic ulcer disease. |
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Colace*
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*Surfactant type laxative - stool softener
*Monitor for dehydration Can cause abdominal cramping and diarrhea. Takes several days for effects |
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*Phenobarbital (Luminal)
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*Barbituate that is a sedative-hypnotic
*Passed through breastmilk. Used for maximum 2 weeks (adverse effects and drug interactions). *No antihistamines and alcohol |
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Lorazpam/Ativan*
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*Benzodiazepine that is a sedative-hypnotic, used for pain management, nausea, agitated patients, and anxiety.
*For short term insomnia, given before bedtime, and can cause morning drowsiness Not first choice drug |
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zolpidem/Ambien*
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*Short acting nonbenzodiazepine hypnotic.
*Can cause somnambulation (sleepwalking). Not good for geriatric use. Safety precautions. *Depresses RAS |
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BuSpar/buspirone*
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*Non-benzodiazepine drug treats anxiety.
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Hydroxyzine/Visaril/Atarax*
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*Antihistamine or anticholinergic agent that treats simple nausea due to motion sickness.
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Goal of drug therapy of peptic ulcers*
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*Alleviate symptoms, promote healing, prevent complications, and prevent recurrences
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Vitamin A*
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*Fat soluble vitamin
*Deficiency causes night blindness, skin lesions, mouthsores, and dysfunction of mucous membranes. |
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Vitamin D*
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*Fat soluble vitamin
*Critical in regulation of calcium and phosphous metabolism. *Used for adults with osteoporosis risk. *Excessive amounts are toxic, symptoms of hypercalcemia |
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Vitamin E*
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*Fat soluble vitamin
No known role in metabolism |
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Vitamin K*
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*Fat soluble vitamin
*Deficiency causes reduced absorption or disruption of intestinal flora Required to coagulate blood |
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*Fat soluble vitamin
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* Vitamin A, D, E, K
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Vitamin B complex*
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*water soluble vitamin
*Thiamin (1) Niacin and riboflavin |
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Vitamin C*
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*water soluble vitamin
*Sources = Citrus fruits, cantalope, strawberries, tomatoes, broccoli, cauliflower and cabbage. |
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Recommended Dietary Allowance RDA*
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*average daily dietary intake sufficient to meet nutrient requirement of 97% of healthy individuals
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Dietary reference intake*
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*Adequate Intake, Tolerable Upper Intake Level, Estimated Average Requirement, and RDA
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Thiamin (vit B1)*
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*water soluble vitamin
*Deficiencies cause beriberi (extreme weakness) |
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*Enteral nutritional therapy
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* Administering nutrition via the GI tract, either PO or through a feeding tube
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*Parental nutritional therapy
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*Administering nutrition via IV route.
Patients unable to eat or tolerate feeding tube. |
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*Prilosec/omeprazole
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*Proton Pump inhibitor
*Antiulcer drug Reduces acid secretion in the stomach by inhibiting the proton pump |
