Term
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Definition
| anti-cholinergic; blocks parasympathetic actions of Ach and induces Sx of fight-or-flight response (increased HR, broncholdilation, decreased motility in GI tract, mydriasis, decreased secretions from glands); used to treat hypermotility of GI tract (IBS), suppress secretions during surgery, increase HR with bradycardia, dilate pupils; was once widely used for bronchodilation in asthma (now rarely used for this); adverse effects: dry mouth, urinary retention, increased HR; initial CNS excitement may progress to delirium and coma; contraindicated w/ glaucoma (increases IOP), paralytic ileus, blockages of GI or bladder, BPH, myasthenia gravis, cardiac insufficiency, acute hemorrhage; Nurse should: monitor BP, P, R before and at least 1 hr. after subcut admin.; should not be given IM; oral and subcut are not interchangeable |
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Term
Drugs used to treat anxiety
pg 155 |
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Definition
| Antidepressants: Tricyclic antidepressants, MAOIs, selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants: serotonin norepinephrine reuptake inhibitors (SNRIs); CNS depressants: benzodiazepines, barbituates, other drugs |
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Term
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Definition
| fatigue, restlessness, inability to sleep, fearful feelings, feelings of dread, difficulty concentrating, muscle tension, nervousness |
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Term
Assessments for nurse to consider for administration of Anticholinergics
pg 148 |
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Definition
| assess BP, HR, temp, and elimination patters initially and throughout therapy; monitor BP, P, R before administration and for at least one hour after subcut administration |
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Term
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Definition
| a drug w/ the ability to to produce a calming effect at lower doses and the ability to induce sleep at higher doses; CNS depressants |
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Term
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Definition
| derived from barbituric acid; powerful CNS depressants described for their sedative, hypnotic, and antiseizure effects; used since early 1900s; depress CNS function at all levels; bind to GABA receptors and intensify its effects throughout the brain; tolerance develops to sedative effects but not respiratory depressant effects; high risk of dependence; withdrawal is extremely severe and can be fatal; OD= profound resp. depression, hypotension, shock; low doses reduce anxiety, mod doses for seizures, high doses for anesthesia; contraindicated in pregnancy/nursing women, impaired resp function, other CNS depressants |
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Term
Phenobarbital (Luminal)
pg 176 |
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Definition
| long-acting barbituate; used for seizures; should not be used for pain relief (may increase sensitivity to pain); enhances GABA action; IM may cause local inflammatory reaction in tissues, IV rarely used (risk for necrosis); Schedule IV; Side effects= drowsiness, vitamin deficiencies (D, folate, B9, B12), laryngospasms; decreases effectiveness of many drugs |
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Term
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Definition
| intense feelings of immediate apprehension, fearfulness, terror, or impending doom, accompanied by increased ANS activity; usually lasts < 10 min |
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Term
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Definition
| simple partial and complex partial (psychomotor); Sx: olfactory, auditory, and visual hallucinations; intense emotions, twitching of arms, legs, and face; aura (preceding), brief period of confusion or sleepiness afterward w/ no memory of seizure, fumbling w/ or attempting to remove clothing, no response to verbal commands; Drugs: phenobarbital, phenytoin, carbamazepine, valproic acid |
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Term
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Definition
| absence (petit mal), atonic (drop attacks), tonic-clonic (grand-mal); Sx: lasting a few seconds, seen most often in children, misdiagnosed often (especially children) as ADD or daydreaming; falling or stumbling for no reason, lasting a few seconds, aura, intense muscle contraction (tonic) followed by alternating contraction and relaxation of muscles (clonic), crying at beginning as air leaves lungs; loss of bowel/bladder control, shallow breathing w/ periods of apnea; disorientation and deep sleep after seizure; Drugs: Absence- diazepam, valproic acid, ethosuximide; Tonic-Clonic drugs- phenobarbital, diazepam, lorazepam, phenytoin, carbamazepine, valproic acid |
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Term
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Definition
| febrile, myoclonic, status epilepticus; Sx: tonic-clonic activity lasting 1-2 mins, rapid return to consciousness, most common in children between 3 months and 5 y/o; large jerking movements of a major muscle group, falling from a sitting position or dropping what is held; continuous seizure activity possibly leading to coma and death; Drugs for: febrile- diazepam, valproic acid, ethosuximide; myoclonic- phenobarbital, diazepam, valproic acid; status epilepticus- phenobarbital, diazepam, lorazepam, phenytoin, carbamazepine, valproic acid |
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Term
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Definition
| condition characterized by repeated seizures or one prolonged seizure attack that continues for at least 30 mins |
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Term
Phenytoin (Dilantin)therapeutic levels
pg 179 |
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Definition
| dosages are highly individualized d/t pt's ability to metabolize it; very narrow range between therapeutic and toxic |
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Term
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Definition
| used to treat depression or depression that accompanies anxiety; also used to treat general anxiety, OCD, panic, social phobia, PTSD |
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Term
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Definition
| limit the breakdown of norepinephrine, dopamine, and serotonin in the CNS; This creates higher levels of these neurotransmitters in the brain to facilitate neurotransmission and alleviate depression; 1st drugs approved to treat depression; considerations: avoid foods that contain tyramine, assess cardiovascular status, Nardil is contraindicated, heart failure, CVA, hepatic or renal dysfunction, and paranoid schizophrenia; 4-8 weeks for full therapeutic effects; Client teaching: no caffeine, do not drive until sedative effects are known, observe and report signs of impending CVA or MI; do not discontinue suddenly, wt. loss is common so eat high-calorie, nutritious meals |
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Term
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Definition
| block the excitement associated w/ schizophrenia, dimish hallucinations and delusions (usually w/in days); Side effects: sedation, drowsiness, extrapyramidal symtpoms, constipation, photosensitivity, orthostatic hypotension, dry mouth, urinary retention |
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Term
Atypical Antipsychotics
pg 218 |
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Definition
| Nurse: obtain baseline labs, monitor WBC differential every week for 6 months, assess for hallucinations, mental status, dementia, bipolar disorder; teaching: change positions slowly, avoid alcohol, caffeine, tobacco, increase intake of fruits, veggies, and fluid if constipation occurs; Side Effects: tachycardia, transient fever, sedation, dizziness, HA, light-headedness, somnolence, anxiety, nervousness, hostility, insomnia, nausea, vomiting, constipation, parkinsonism, akathisia |
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Term
Parasympathetic nervous system
pg 132 |
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Definition
| activated under nonstressful conditions and produces symptoms called rest-and-digest response; digestive processes are promoted, HR and BP decline, bronchi constrict |
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Term
Adrenergic Blockers
pg 136 |
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Definition
| Inhibit sympathetic nervous system; treat HTN,produce rest-and-digest symptoms; Nurse: monitor hepatic function, renal function; AP, BP prior to admin.; Side effects: dizziness, drowsiness, HA, fatigue, palpitations, dry mouth, wt. gain, edema, SOB, cough |
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Term
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Definition
| block action of acetylcholine, symptoms of SNS predominate:dilation of pupils, increased HR, drying of secretions, relaxation of bronchi; fight-or-flight; uses:GI disorders, opthalmic procedures, cardiac rhythm abnormalities, preanesthesia, asthma |
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Term
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Definition
| alters activity of dopamine, norepinephrine, serotonin; stabilization of moods during periods of mania, antidepressant during periods of depression; narrow therapeutic/toxic ratio; contraindicated in debilitated clients and clients w/ severe cardiovasular disease, dehydration, renal disease, and in cases of severe sodium depletion; side effects: dizziness, fatigue, short-term memory loss, increased urination, N/V, loss of appetite, abd pain, diarrhea, dry mouth, muscular weakness, slight tremors |
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