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60 Cards in this Set

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Meds for Parkinson's Disease
1. Dopaminergic agents (increase
dopamine)

2.Anticholinergic agents(block
Ach)
Levadopa-Carbidopa (Sinemet)

type of drug
Dopaminergic Med

- increases dopamine
Levopada

MOA
-Promotes synthesis of dopamine

Transported across BBB and then converted to dopamine in CNS
Carbidopa

MOA
-enhances effects of levadopa

-blocks peripheral conversion of levadopa to dopamine

-No therapeutic effects
Levadopa-Carbidopa (Sinemet)

IND
Parkinson's disease
Levadopa-Carbidopa (Sinemet)

AE
1. nausea/vomiting

2. dyskinesias: invol mov’ts

3. postural hypotension

4. psychosis
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
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
Pramipexole/mirapex

type of drug
Dopamine Agonists

blocks Ach
Pramipexole/mirapex

MOA
- Activates dopamine receptors in basal ganglia
Pramipexole/mirapex

Therapeutic effects
Parkinson's disease, used in early stages alone, used w/levadopa in late PD
Pramipexole/mirapex

AE
similar to levadopa, less dyskinesias
Meds for Alzheimer’s
Cholinesterase Inhibitors

NMDA receptor antagonists
Donepezil/Aricept

type of med
Cholinesterase Inhibitor
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
Donepezil/Aricept

IND
early stages of Alzheimer's
Donepezil/Aricept

AE
1. GI- n/v, diarrhea, dyspepsia

2.dizziness

3.bronchoconstriction
Donepezil/Aricept

DI
both block cholingeric receptors, decrease effects of aricept

1. antihistamines

2.trycyclic antidepressants
Memantine/Namenda

MOA
- blocks NMDA receptor sites

- decrease Ca entry into nerve cells
Memantine/Namenda

IND
moderate to severe AD—can be used early on but usually reserved for later, attempts to slow decline
Memantine/Namenda

AE
HA, dizziness, confusion, constipation
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
Meds for Muscular Sclerosis
Immunodulators- prevent disease progression

Immunosuppresants- used during acute episode
Interferon Beta

type of med
Immunodulators- prevent disease progression
Interferon Beta

MOA
- suppresses autoimmune destruction of myelin, unknown reasons why
Interferon Beta

IND
Muscular Sclerosis
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
Mitoxantrone/Novantrone

type of med
Immunosuppressants- used during acute episode
Mitoxantrone/Novantrone

MOA
-Cytotoxic drug, inhibits DNA, RNA synthesis

-Suppresses production of immune system cells—decrease autoimmune destruction of myelin
Mitoxantrone/Novantrone

IND
-MS pts who don’t respond well to other meds (b/c much stronger)

-Given IV every three months
Mitoxantrone/Novantrone

AE
-Bone marrow suppression

-Cardiotoxicity

-Fetal harm
Mitoxantrone/Novantrone

Nursing Considerations
-Infection protection
Traditional Meds for Seizures
-Phenytoin/Dilartin

-Carbamezepine/Tegretol

-Valproic acid/Depakote

-Phenobarbitral
Non-traditional Meds for Seizures
Fewer side effects

-Neurontin

-Lyrica
Phenytoin/Dilantin

type of med
traditional for seizures
Phenytoin/Dilantin

MOA
-Sodium channel blocker

-Slows entry of sodium into neurons resulting in suppression of neuron activity

-Selective for hypersensitive neurons
Phenytoin/Dilantin

IND
-Partial seizures

-Tonic-clonic seizures
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)
Phenytoin/Dilantin

DI
-P450 inducer,decrease effects of Warfarin, oral contracepts ,glucocorticoids

-Drugs that increase dilanin levels

- Alcohol, cinetidine/tagamet, valium, valproic acid
Phenytoin/Dilantin

Nursing considerations
-Monitor drug levels
-Stress adherence
-Take at night
-Don’t abruptly stop med
Carbamazepine/Tegretol

type of med
traditional anti-epileptic drug
Carbamazepine/Tegretol

MOA
Na channel blocker

-slows entry of Na into neurons -> suppresses neuron activity

-Selective for hyperactive neurons
Carbamazepine/Tegretol

IND
partial seizures, tonic-clonic seizures

Serum levels: narrow therapeutic range 10-20mcg/ml.
Carbamazepine/Tegretol

AE
-Minimal CNS effects

-Visual disturbances

-Bone marrow suppression

-Rash

-Ataxia
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
Valproic Acid/Depakote

type of med
traditional anti-epileptic drug
Valproic Acid/Depakote

MOA
-Blocks Na and Ca channels—suppresses neuron activity
Valproic Acid/Depakote

IND
-all partial and generalized seizures

-bipolar disorders, migraine
Valproic Acid/Depakote

AE
-GI- n/v, indigestion

-Hepatotoxicity

-Pancreatitis

-Teratogenic
Phenobarbital

MOA
-Potentiates effects of GABA--- sedation

-Oldest med for seizures
Phenobarbital

IND
-Partial seizures

-Tonic-clonic seizures

-Sleeping aid
Phenobarbital

AE
-Sedation

-Dependency

-Interferes w/metabolism of vit D and K

-Respiratory depression (toxic levels)
Meds for Spasms and Spasticity

Central acting
o Valium
o Baclofen
o Flexeril
o Soma
o Zanaflex
Diazepam/Valium

type of med
central acting for spasms & spasticity
Diazepam/Valium

MOA
-Acts to enhance GABA—increases CNS sedation

-Considered a narcotic
Diazepam/Valium

IND
-Relieve muscle spasm and spasticity

-Decrease pain

-Seizures- given IV during event

-Antianxiety
Diazepam/Valium

AE
-CNS depression

-Physical dependence
Baclofen/Lioresal

MOA
-Acts on spinal cord nerves suppress hyperactive reflexes regulating muscle movement, mimics actions of GABA
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
Baclofen/Lioresal

AE

Nursing Considerations
-CNS depression
-Nausea
-Constipation
-Urinary retention


-Don’t stop abruptly, must stop slowly
-Can cause seizures if stop quickly