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60 Cards in this Set
- Front
- Back
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Meds for Parkinson's Disease
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1. Dopaminergic agents (increase
dopamine) 2.Anticholinergic agents(block Ach) |
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Levadopa-Carbidopa (Sinemet)
type of drug |
Dopaminergic Med
- increases dopamine |
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Levopada
MOA |
-Promotes synthesis of dopamine
Transported across BBB and then converted to dopamine in CNS |
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Carbidopa
MOA |
-enhances effects of levadopa
-blocks peripheral conversion of levadopa to dopamine -No therapeutic effects |
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Levadopa-Carbidopa (Sinemet)
IND |
Parkinson's disease
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Levadopa-Carbidopa (Sinemet)
AE |
1. nausea/vomiting
2. dyskinesias: invol mov’ts 3. postural hypotension 4. psychosis |
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Levadopa-Carbidopa (Sinemet)
DI |
-MAO- used for depression; causes HTN crisis
-Antipsychotic drugs- block dopamine receptors (decrease affects of drug) -Anticholingerics- block cholinergic receptors, increasing levadopa effects |
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Levadopa-Carbidopa (Sinemet)
Nursing Considerations |
-high protein meals- should eat balanced diet
-On-off phenomenon-sometimes drug effects wear off so must decrease interval, adjust dosages, take sustained release -Drug holiday- person stops taking drug for short period of time, takes again in 10 days and it become effective again |
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Pramipexole/mirapex
type of drug |
Dopamine Agonists
blocks Ach |
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Pramipexole/mirapex
MOA |
- Activates dopamine receptors in basal ganglia
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Pramipexole/mirapex
Therapeutic effects |
Parkinson's disease, used in early stages alone, used w/levadopa in late PD
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Pramipexole/mirapex
AE |
similar to levadopa, less dyskinesias
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Meds for Alzheimer’s
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Cholinesterase Inhibitors
NMDA receptor antagonists |
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Donepezil/Aricept
type of med |
Cholinesterase Inhibitor
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Donepezil/Aricept
MOA |
1. acts as a cholinesterase inhibiter- prevents breakdown of Ach by acetylcholinterase—increases Ach, enhanced cholinergic
2.only 25-35% of pts respond |
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Donepezil/Aricept
IND |
early stages of Alzheimer's
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Donepezil/Aricept
AE |
1. GI- n/v, diarrhea, dyspepsia
2.dizziness 3.bronchoconstriction |
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Donepezil/Aricept
DI |
both block cholingeric receptors, decrease effects of aricept
1. antihistamines 2.trycyclic antidepressants |
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Memantine/Namenda
MOA |
- blocks NMDA receptor sites
- decrease Ca entry into nerve cells |
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Memantine/Namenda
IND |
moderate to severe AD—can be used early on but usually reserved for later, attempts to slow decline
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Memantine/Namenda
AE |
HA, dizziness, confusion, constipation
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Memantine/Namenda
DI |
1.sodium bicarbonate
2.any other drug that causes urine to be alkaline- having alkaline urine decreases excretion of memantine and it builds up in body |
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Meds for Muscular Sclerosis
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Immunodulators- prevent disease progression
Immunosuppresants- used during acute episode |
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Interferon Beta
type of med |
Immunodulators- prevent disease progression
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Interferon Beta
MOA |
- suppresses autoimmune destruction of myelin, unknown reasons why
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Interferon Beta
IND |
Muscular Sclerosis
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Interferon Beta
AE |
-Flu like symptoms- usually short term (a day or so), wears off over time
-Hepatotoxicity- injures liver cells, monitor liver cells -Bone marrow suppression |
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Mitoxantrone/Novantrone
type of med |
Immunosuppressants- used during acute episode
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Mitoxantrone/Novantrone
MOA |
-Cytotoxic drug, inhibits DNA, RNA synthesis
-Suppresses production of immune system cells—decrease autoimmune destruction of myelin |
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Mitoxantrone/Novantrone
IND |
-MS pts who don’t respond well to other meds (b/c much stronger)
-Given IV every three months |
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Mitoxantrone/Novantrone
AE |
-Bone marrow suppression
-Cardiotoxicity -Fetal harm |
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Mitoxantrone/Novantrone
Nursing Considerations |
-Infection protection
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Traditional Meds for Seizures
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-Phenytoin/Dilartin
-Carbamezepine/Tegretol -Valproic acid/Depakote -Phenobarbitral |
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Non-traditional Meds for Seizures
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Fewer side effects
-Neurontin -Lyrica |
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Phenytoin/Dilantin
type of med |
traditional for seizures
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Phenytoin/Dilantin
MOA |
-Sodium channel blocker
-Slows entry of sodium into neurons resulting in suppression of neuron activity -Selective for hypersensitive neurons |
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Phenytoin/Dilantin
IND |
-Partial seizures
-Tonic-clonic seizures |
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Phenytoin/Dilantin
AE |
At therapeutic levels
-Mild sedation -Gingival hyperplasia -Skin rash -Teratogenic At toxic levels -Ataxia -Increased sedation -Cognitive impairment -Double vision -Pupil goes back and forth (nystagmus) |
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Phenytoin/Dilantin
DI |
-P450 inducer,decrease effects of Warfarin, oral contracepts ,glucocorticoids
-Drugs that increase dilanin levels - Alcohol, cinetidine/tagamet, valium, valproic acid |
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Phenytoin/Dilantin
Nursing considerations |
-Monitor drug levels
-Stress adherence -Take at night -Don’t abruptly stop med |
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Carbamazepine/Tegretol
type of med |
traditional anti-epileptic drug
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Carbamazepine/Tegretol
MOA |
Na channel blocker
-slows entry of Na into neurons -> suppresses neuron activity -Selective for hyperactive neurons |
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Carbamazepine/Tegretol
IND |
partial seizures, tonic-clonic seizures
Serum levels: narrow therapeutic range 10-20mcg/ml. |
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Carbamazepine/Tegretol
AE |
-Minimal CNS effects
-Visual disturbances -Bone marrow suppression -Rash -Ataxia |
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Carbamazepine/Tegretol
DI |
-P450 enzyme inducer so same effects as dilantin (on warfarin, oral contraceptives)
-Dilantin decreases tegretol effects -Grapefruit juice- inhibits metabolism of tegretol |
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Valproic Acid/Depakote
type of med |
traditional anti-epileptic drug
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Valproic Acid/Depakote
MOA |
-Blocks Na and Ca channels—suppresses neuron activity
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Valproic Acid/Depakote
IND |
-all partial and generalized seizures
-bipolar disorders, migraine |
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Valproic Acid/Depakote
AE |
-GI- n/v, indigestion
-Hepatotoxicity -Pancreatitis -Teratogenic |
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Phenobarbital
MOA |
-Potentiates effects of GABA--- sedation
-Oldest med for seizures |
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Phenobarbital
IND |
-Partial seizures
-Tonic-clonic seizures -Sleeping aid |
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Phenobarbital
AE |
-Sedation
-Dependency -Interferes w/metabolism of vit D and K -Respiratory depression (toxic levels) |
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Meds for Spasms and Spasticity
Central acting |
o Valium
o Baclofen o Flexeril o Soma o Zanaflex |
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Diazepam/Valium
type of med |
central acting for spasms & spasticity
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Diazepam/Valium
MOA |
-Acts to enhance GABA—increases CNS sedation
-Considered a narcotic |
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Diazepam/Valium
IND |
-Relieve muscle spasm and spasticity
-Decrease pain -Seizures- given IV during event -Antianxiety |
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Diazepam/Valium
AE |
-CNS depression
-Physical dependence |
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Baclofen/Lioresal
MOA |
-Acts on spinal cord nerves suppress hyperactive reflexes regulating muscle movement, mimics actions of GABA
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Baclofen/Lioresal
IND |
-Reduces spasticity in cerebral palsy, spinal cord injury, MS
-Given PO but sometimes implant pump into abdomen--- goes into spinal cord sheath |
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Baclofen/Lioresal
AE Nursing Considerations |
-CNS depression
-Nausea -Constipation -Urinary retention -Don’t stop abruptly, must stop slowly -Can cause seizures if stop quickly |
