Unit 2 Prototypes

Front 1

Lexapro (Escitalopram)

-therapeutic and pharmacologic classes

Back 1

Therapeutic Class:

Antidepressant/Anxiolytic

Pharmacologic Class:

SSRI

Front 2

Lexapro (Escitalopram)

-Clinical Applications

Back 2

• GAD
  
• Depression
  

Off-Label Use: Panic d/o

Front 3

Lexapro (Escitalopram)

-Administration

Back 3

• Do not use until at least 14 days have elapsed since d/c MAOIs
  
• Dosing increments should be at least 1 week apart.
  
• Reduce dose in older pts and pts with renal or hepatic impairments.
  

Front 4

Lexapro (Escitalopram)

-Monitor for

Back 4

• increased levels of metoprolol in the plasma (a beta-blocker that affects the heart & circulation)
  
• weight gain
  
• sexual dysfunction (men & women)
  

Front 5

Lexapro (Escitalopram)

-Adverse and/or Side Effects

Back 5

• dizziness
• nausea
• insomnia
• somnolence (drowsy; ready to fall asleep)
• confusion
• seizures
  

Front 6

Lexapro (Escitalopram)

-Contraindications

Back 6

• Pts who are breastfeeding.
• Pts who have taken MAOIs in the last 14 days

Alcohol should be avoided.

Front 7

Lexapro (Escitalopram)

-Black Box Warnings!

Back 7

increased risk of suicidal thinking

Front 8

Lorazepam (ativan)

Back 8

• Sedative-hypnotic/anxiolytic/benzo
  
• Anxiety, mild sedative,
  
• epilepsy
  
• Long 1/2 life of 20 hrs
  
• Adverse:Drowsiness, sedation, amnesia, weakness
  
• Monitor: BP and respirations
  

Front 9

Zolpidem (Ambien)

Back 9

• Sedative-hypnotic
• nonbenzo/nonbarb
  
• CNS depressant
  
• Sleeping pill
  
• Adverse:Day sedation, confusion, amnesia, dizziness, depression, nausea, vomiting
  

Contraindicated in breastfeeding

Front 10

Chlorpromazine (Phenoothiazines)

Back 10

• Antipsychotic
• schizophrenia/D2 dopamin receptor antagonist
  
• Relieves positive symp of schizo & mania Adverse:dizziness, drowsiness, orthostatic hypotension
  
• Extrapyramidal & Neuroleptic malig. syndr.
  

Front 11

Haldol (haloperidol)

Back 11

• Nonphenothiazine
  
• Antipsychotic/schizophrenia/D2 dopamin receptor antagonist
  
• Acute/Chronic psychotic disorder
• Adverse: Extrapyramidal effects
  

Front 12

Risperidone (Resperdal)

Back 12

• Atypical Antipsychotic
• Antipsychotic/schizophrenia/D2 dopamin receptor antagonist/Serotonin receptor antagonist
• Reduces excitement,paranoia,neg beh.
• Adverse:Extrapyramidal symptoms, hyperactivity, fatigue, nausea, dizziness, orthostatic hypotension, hyperglycemia
  

Front 13

Morphine

Back 13

• Opiod analgesic/opiod receptor agonist
• Produces analgesic
• used for pain relief when nonnarcotics have failed
• Adverse:dysphoria, hallucination, nausea, constipation, dizziness, itching, respiratory depression
  

Front 14

Naloxone (Narcan)

Back 14

• Used for treatment of acute opioid OD/misuse
• Opioid receptor antagonist
• Used for reversal of opioid effects
• Adverse:Increased BP, tremors, hyperventilation, nausea, vomiting, drowsiness
  

Front 15

Aspirin (Acetylsalicylic acid)

Back 15

• NSAID
• nonopioid analgesic
• Inhibits prostaglandin synthesis involved in the process of pain and inflammation and produces mild to moderate relief or fever
• Adverse: gastric discomfort and bleeding
  

Front 16

Sumatriptan (Imitrex)

Back 16

• Antimigraine
• Causes vasoconstriction (does not affect BP)
• Adverse:Dizziness, Drowsiness, warming sensation
  

Front 17

Atropine (atro-pen)

-Administration

Back 17

• Oral
• Subcutanous
  

Front 18

Atropine (atro-pen)

-Monitor for

Back 18

• dry mouth
• constipation
• urinary retention
• increased heart rate
  

Front 19

Atropine (atro-pen)

-Adverse and/or Side Effects

Back 19

• can't see
• can't pee
• can't sh!t
• can't spit
• and increased heart rate
  

Front 20

Atropine (atro-pen)

-Contraindications/ Not recommended for pts with:

Back 20

• glaucomaobstructive d/o of the GI tract
• paralytic ileus
• bladder neck obstruction
• benign prostatic hyperplasia
• myasthenia gravis
• cardiac insufficiency
• acute hemorrhage
  

Front 21

Physostigmine (Antilirium)

-About

Back 21

• indirect-acting parasympathomimetic that inhibits the destruction of Ach by AchE
• it reverses toxic and life-threatening delirium caused by atropine
• not intended as a first-line agent for anticholinergic toxicity or Parkinson's

Front 22

Physostigmine (Antilirium)

-therapeutic and pharmacologic classes

Back 22

Therapeutic Class:

antidote for atropine-induced delirium

Pharmacologic Class:

Acetylcholinesterase inhibitor

Front 23

Physostigmine (Antilirium)

-Clinical Applications

Back 23

reverses toxic and life-threatening delirium caused by atropine

Front 24

Physostigmine (Antilirium)

-Administration

Back 24

• IM or IV
• admin slowly over 5 mins to avoid seizures and respiratory distress
  

Front 25

Physostigmine (Antilirium)

-Monitor for

Back 25

• BP
• pulse
• respirations
  

Front 26

Physostigmine (Antilirium)

-Adverse and/or Side Effects

Back 26

• bradycardia
• Pulse -asystole (flat-line)
• restlessness & nervousness
• hypersalivation & urinary frequency
• muscle twitching & seizures
• respiratory paralysis
  

Front 27

Physostigmine (Antilirium)

-Contraindications/ Not recommended for pts with:

Back 27

• asthma
• epilepsy
• diabetes
• cardiovascular disease
• bradycardia
• known or suspected tricyclic antidepressant (TCA) intoxication
  

Front 28

Phenlephrine (Neo- Sunephrine)

-therapeutic and pharmacologic classes

Back 28

Therapeutic class:

• Nasal Decongestant
  

Pharmacologic class:

• Mydriatic drug (pupil dilation)
  
• Antihypotensive
  
• selective α -agonist
  

Front 29

Phenlephrine (Neo- Sunephrine)

-Administration

Back 29

Routes of Administration:

• Intranasal
• Topical
• Parenteral
  

Front 30

Phenlephrine (Neo- Sunephrine)

-Monitor for

Back 30

• bradycardia
• hypertension
  

Front 31

Phenlephrine (Neo- Sunephrine)

-Adverse Effects

Back 31

• anxiety
• restlessness
• tremor
  

Front 32

Phenlephrine (Neo- Sunephrine)

-Black Box Warnings!

Back 32

• Severe reactions, including death, may occur with IV infusion even when appropriate dilution is used to avoid rapid diffusion.
  
• IV administration should only be used when no other route is feasible.
  

Front 33

Phenlephrine (Neo- Sunephrine) Contraindications

Back 33

Not appropriate for pts with:

• acute pancreatitis
• heart disease
• hepatitis
• narrow-angle glaucoma
  

Front 34

Bethanechol (Duvoid, Urecholine)

Back 34

• Parasympathomimetic/Cholinergic
• Nonobstructive urinary retention agent
• Stimulates smooth muscle contraction
• salivation
• sweating
• abdominal cramps
• hypotension
  

Front 35

Chlorpromazine (Phenoothiazines)

Back 35

• Antipsychotic
• schizophrenia
• D2 dopamine receptor antagonist
• Relieves positive symp of schizo & mania
• Adverse: dizziness, drowsiness, orthostatic hypotension
• Extrapyramidal & Neuroleptic malig. syndr.
  

Front 36

Haldol (haloperidol)

Back 36

• Nonphenothiazine
• Antipsychotic
• schizophrenia
• D2 dopamin receptor antagonist
• Acute/Chronic psychotic disorder
• Adverse: Extrapyramidal effects
  

Front 37

Risperidone (Resperdal)

Back 37

• Atypical Antipsychotic
• Schizophrenia
• D2 dopamin receptor antagonist
• Serotonin receptor antagonist
• Reduces excitement, paranoia, neg beh.
• Adverse: Extrapyramidal symptoms, hyperactivity, fatigue, nausea, dizziness, orthostatic hypotension, hyperglycemia
  

Front 38

Levodopa, Carbidopa & Entacapone (Stalevo)

Back 38

• Antiparkinson drug
• dopaminergic drug
• Restores neurotransmitter dopamine
• Use: Parkinsons
• Adverse: uncontrolled or purposeless movements, loss of appetite, nausea & vomiting
• Assess gait, muscle twitching
  

Front 39

Benztropine (Cogentin)

Back 39

• Antiparkinson Drug
• Cholinergic receptor blocker
• Blocks cholinergic stimulation
• Use: Parkinsons
• Adverse: Anticholinergic effects
• Assess for: Dry mouth, constipation, tachycardia, sedation
  

Front 40

Donepezil (Aricept)

Back 40

• Alzheimers drug
• Acetylcholinesterase inhibitor
• Use: Alzheimers
• Adverse: vomiting, diarrhea, dark urine, irritability, insomnia
• Assess: Urine color, sleep, Fluid/Electrolyte balance
  

Front 41

Imipramine (Tofranil)

Back 41

• Antidepressant
• tricyclic
• Blocks reuptake of serotonin & norepinephrine
• Black box warning: suicidal thinking
• Adverse: Sedation, drowsiness, blurred vision, hypertension, dysrhythmias
  

Front 42

Sertraline (Zoloft)

Back 42

• Antidepressant
• SSRI
• Inhibit reuptake of serotonin
• Black box: suicidal thinking
• Adverse: Agitation, insomnia, headache, dizziness, fatigue

Front 43

Phenelzine (Nardil)

Back 43

• Antidepressant
• MAOI
• Inhibits monoamine oxidase & intensifies norep.
• Blackbox: suicidal thinking
• Adverse: constipation, dry mouth, orthostatic hypotension, insomnia, nausea
• Contraindicated: hepatic/renal function, Cardio and cerebrovascular disease, Hypertension
• w/ foods contain tyramine

Front 44

Lithium (Eskalith)

Back 44

• Mood stabilizing
• bipolar affective disorder
• Decrease neuron excitability
• Adverse: Dizziness, fatigue, short term mem loss, nausea, vomiting, increase urination, muscle weakness
• Blackbox: toxicity/ monitor plasma levels