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28 Cards in this Set
- Front
- Back
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EOL OPIOID
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1. morphine sulfate
*dyspnea *dilates pulmonary BV & reduces congestion *anxiety from air hunger *lower dose than for pain *given before activity *via IV *Narcan is antedote |
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EOL ANTICHOLINERGICS
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1. Atropine ophthalmic solution o/sl
2. Hyoscyamine (Levsin)--oral/sublin 3. Scopolamine--transderm *dries up secretions that cause death rattle *used for dyspnea *position pt on side with towel *no sunctioning *retention and dryness are SE |
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EOL SEDATIVES
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*promote relaxation of pt
*dyspnea *benzos--pams |
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EOL CORTICOSTEROIDS
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1. Prednisone (deltasone)
*used for bronchospasms and inflammation in and outside of lung *used for dyspnea |
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EOL DIURETIC
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1. Furosemide (Lasik)
*used in dyspnea *for fluid overload, crackles, edema to reduce congestion *preferred for heart failure & pulmonary edema *given iv, subq, IM |
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EOL ANTIBIOTICS
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*used for respiratory infection
*dyspnea *considered for comfort measures |
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EOL ANTIEMETICS
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1. Prochlorperazine (Compazine)
2. Dexamethasone (Decadron) 3. Metoclopramide (Reglan) *if n/v is caused by constipation, an enema is used *manage odors that can cause nausea and keep room at an appropriate temp *combined in rectal suppository *uremia, hypercalcemia, urinary retention |
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EOL ANTIPSYCHOTICS
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1. Haloperidol (Haldol, Peridol)
*nosy, agitated delirium not caused by other drugs, pain, constipation *don't give more than one antipsychotic *lorazepam can also be given for mild agitation and restlessness *music therapy and aroma therapy *treat underlying cause |
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Nonpharmacologic for dyspnea
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*circulate cool air
*wet cloth to face *position bed upward to increase chest expansion *deep breathing and imagery *possible Foley catheter |
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EOL BENZODIAZEPINES
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1. Lorazepam (Ativan)
2. Diazepam (Valium) 3. Midazolam (Versed) sedation *given if morphine isn't cutting it *calms fear and anxiety *sublingual and rectal *EOL seizures |
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EOL BARBITURATES
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1. Phenobarbital
*second choice for seizures after benzos |
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CNS STIMULANTS
(AMPHETAMINE) |
1. Amphetamine sulfate (Adderall)
*adhd in older people *minimal dose 2. Dextroamphetamine sulfate *WT loss and narcolepsy *can cause aggression *can cause sudden death ----amphetamine 3. Methylphenidate HCL (Ritalin) *ADHD. given 2x/day before meals *caffeine may increase effects *don't give with depression *doesn't disrupt sleep 4. Dexmethylphenidate (Focalin) ----amphetamine like *increase attention span *narcolepsy *stimulate release of norepi & dopamine *cause euphoria and alertness *se: sleeplessness, tremors, irritability, incr heart rate, incr blood pressure, palpitations, hypertension, diarrhea, anorexia *for narcolepsy and ADHD *don't take at night due to causing insomnia *avoid alcohol, taper off drug *limit caffeine intake *sugarless gum *nursing mothers should avoid *monitor WT and ht in kids |
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CNS STIMULANTS
ANOREXIANTS |
1. Benzphetamine HCL
--avoid during preg, potential for abuse 2. Phentermine HCL --taken in morning for appetite suppression *appetite suppressants for short term use under 12 weeks *phenylpropanololamine was removed from market due to hemorrhagic stroke in women *not for children under 12 |
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CNS STIMULANT
LIPASE INHIBITORS |
*drug of choice for WT loss
*decrease GI absorption of fats *excreted in feces *SE: oily spotting, wet flatus, HA, N/V, hypoglycemia |
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CNS STIMULANT
ANALEPTICS |
1. caffeine citrate
*incr heart rate and BP *restore mental alertness 2. theophylline *neonatal apnea *affect brainstem, cerebral cortex, spinal *stimulate respiration *SE: nervous, restless, tremors, insomnia, palpitations, incr urine, N/D, ringing in ear *more than 300 mg affects CNS and heart *half life of caffeine is 5 hrs |
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RESPIRATORY STIMULANT
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1. Doxapram HCL
*treats respiratory distress caused by OD, COPD, post anesthesia *not for neonatal *can increase blood pressure |
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CNS DEPRESSANTS
Side Effects |
*SE of sedative hypnotics:
-hangover= residual drowsiness -REM rebound= vivid dreams and nightmares -dependance -tolerance -excessive depression -resp depression -hypersensitivity=skin rxns |
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CNS DEPRESSANTS
BARBITURATES |
1. Pentobarbital sodium
*for those who have trouble falling asleep *short acting *used for preoperative *can cause suicidal ideation 2. Butabarbital sodium *intermediate *relieve anxiety and staying asleep insomnia *avoid using alcohol because cns depressant *can cause abnormal thinking 3. Mephobarbital *long acting *used with seizures *monitor for respiratory distress thiopental sodium *ultra short acting for general anesthesia --restricted to 2 weeks or less to reduce tolerance and se |
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CNS DEPRESSANTS
BENZODIAZEPINES |
minor tranquilizer that induces sleep
1. Alprazolam (Xanax) *can cause resp depression, suicidal ideation, not for older adults *not used with alcohol and certain abx *increases digoxin levels *grapefruit increase levels, green tea decreases effects *SE: lethargy, drowsy, dizzy, ha, constipation, depression *used for insomnia *not used longer than 6 wk 2. Lorazepam ( Ativan ) *insomnia, preop sedative, anxiety 3. Diazepam ( Valium ) -rapidly metabolized in liver to active -highly protein bound and more free drug when combined with other highly protein bound drug which increase adverse effects |
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CNS DEPRESSANTS
NON BENZODIAZEPINES |
1. Zolpidem tartrate
*short term for insomnia, less than 10 days *decrease dose in older adults *foods decrease absorption, don't take with alcohol *SE: HA, hangover, dizzy, n/v, anxiety, depression *tolerance and dependance *hypotension, suicide, dysrhythmia *avoid antidepressants, psychotic, narcotic can cause severe resp depression *take before bed, urinate prior |
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BENZODIAZEPINE ANTAGONIST
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1. Flumazenil (Romazicon)
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ANESTHETICS
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1. Halothane
*inhalation liquid *rapid induction time *highly potent, could decrease BP *not used in pregnancy 2. Nitrous oxide *inhalation gas *very rapid induction time *rapid recovery, given with oxygen, low potency 3. thiopental sodium * IV barbiturate *rapid induction for general surgery *short duration of action *keep pt warm during *can depress resp center, have ventilator assistance 4. Procaine HCL (Novacain) *ester, nerve block, epidural, spinal *dentistry *short acting 5. Bupivacaine *long acting *peripheral nerve block, epidural *amide |
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ANTICONVULSANTS
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-types of seizures: grand mal, petit mal, psychomotor
-drugs stabilize nerve cell membranes and suppress abnormal electric impulses -CNS depressants -taken throughout life -hydantoins are highly protein bound and compete with anticoagulant and aspirins causing an increase in their activity -gingko decreases phenytoin -don't stop taking abruptly -take with food -avoid alcohol |
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ANTICONVULSANTS
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1. Phenytoin (Dilantin)
*avoid antacids for gastric distress *no warfarin or gingko *decreases absorption of folic acid, calcium, vit d *caution with: preg, bradycardia, hypotension, hypoglycemia, suicidal, lupus *slowly absorbed *prevents grand mal and partial *SE: HA, dizzy, confusion, sluggish, slurred speech, rash, n/v, hypotension, discoloration of urine *adverse: leukopenia, hepatitis, depression *make sure pt is getting adequate nutrients |
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ANTICONVULSANTS
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2. Phenobarbital
*seizures, long acting barbiturate *grand mal, partial, epilepticus *used with phenytoin *high dose in adults cause coma and resp depression. can be fatal *causes confusion, depression, irritability in older adults and children *AE: suicidal ideation *can cause dependence |
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ANTICONVULSANTSno
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3. Fosphenytoin
*grand mal, epilepticus *decreases sodium and calcium ion influx *converts to phenytoin *dilute 4. clonazepam *used in absence seizures 5. Carbamazepine *grand mal, partial *for seizures that don't respond to other meds *treats bipolar disorder *don't crush or chew sustained release 6. Lamotrigine *grand mal, partial *blocks sodium influx *discontinue use if rash presents to prevent Stevens Johnson with valproic acid *given with other anticonvulsants 7.magnesium sulfate *for seizures caused by preeclampsia and eclampsia *nasal congestion *calcium gluconate *reduces cerebral palsy |
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PARKINSON
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1. carbidopa-levodopa
*decrease symptoms of Parkinson *initial drug for severe so *give before meals *can cause dyskinesia *less expensive *increases dopamine *taken by all patients at some point *SE: N/V, dark urine, HA, dysphagia, fatigue, bitter taste *AR: suicidal, hallucination, jerkong, hypotension, thrombocytopenia 2. amantadine *first used for flu, decrease symptoms. antiviral *treats drug induced *less SE than anticholinergic *used early to delay use of levodopa 3. selegiline hcl *inhibits dopamine from getting broken down *MAOIs *used as early treatment *decreases freezing *avoid tyramine in cheese and cured foods *avoid red wine and beer for 14 days --high fiber and fluid intake to prevent constipation -Take drug holiday or change dosage |
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ALZHEIMERS
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1. rivastigmine
*achesterase inhibitor *don't use with tobacco because it increases clearance *increases effect of theophylline *food decreases absorption *improves memory loss *SE: N/V/D, constipation, dizzy, depression, dry mouth, dehydration *AR: seizures, brady, cataract, mi, Stevens Johnson, suicidal 2. donepezil *for mild to moderate alzheimers |
