Term
Sulfasalazine (Antibiotic:Sulfonamides) MOA |
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Definition
Bacteriostatic MOA: Inhibit growth of bacteria by preventing synthesis of folic acid; also known as an antimetabolite. |
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Term
Sulfasalazine (Antibiotic:Sulfonamides) Drug Effect & Use |
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Definition
Drug Effect: Effective against organisms that synthesize own folic acid. Uses: UTIs caused by e. coli, Klebielle spp., p. mirabilis, p. vulgaris, staph. aureas, pseudomonas, & naarcodiosis. Adjunct tx of malaria & toxoplasmosis. Tx of respiratory infections. |
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Term
Sulfasalazine (Antibiotic:Sulfonamides) SE/ADE |
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Definition
SE/ADE: Blood dyscrasias (bone marrow depression) GI: N/V/D, abd. pain, anorexia, stomatitis, hepatic injury. GU: Crystalluria, hematuria, proteinuria (leads to nephrotic syndrome & toxic nephrosis.) Skin: Photosensitivity, exfol. dermatitis, SJ syndrome. CNS: Convulsions, periph. neuritis, H/A, dizziness, vertigo, depression. |
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Term
Sulfasalazine (Antibiotic:Sulfonamides) Nursing Implications & Teaching |
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Definition
Drink 2-3L fld. to prevent crystalluria. Avoid UV rays. Avoid OTC meds. Vit C and aspirin interact w/ antibiotics. Decrease effectivness of oral contraceptives. Need back up method possibly for several days after completion. For all meds causing blood dyscrasias: Report sore throat, bruising, joint pain, bleeding, muscle weakness. |
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Term
Aztreonam (Antibiotic:Monobactrum) MOA: |
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Definition
| Bactericidal: Disrupts cell wall synthesis causing leakage of cell contents and death. |
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Term
Aztreonam (Antibiotic:Monobactrum) Drug Effect/Therapeutics: |
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Definition
Gram negative enterobacteria. Urinary tract, skin, intra-abdominal and gyn. infections. Good alternative for infections susceptible to penicillin when patient allergic to penicillin or cephalosporins. IV and IM only. |
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Term
Aztreonam (Antibiotics:Monobactrum) SE/ADE |
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Definition
GI: N/V/D, GI upset. Elevated hepatic enzynmes. Inflammation, phlebitis and discomfort at injection site. Hypersensitivity reactions. |
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Term
Amoxicillin (Antibiotics:Penicillins) MOA |
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Definition
Bactericidal Wide spectrum of effectiveness against gram -/+. Inhibition of cell wall synthesis of bacteria. |
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Term
Amoxicillin (Antibiotics:Penicillins) Drug Effects/Therapeutics |
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Definition
Drug effects: Only effect bacterial cell wall. Uses: Streptococcus, enterococcus, staphylyococcus. |
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Term
Amoxicillin (Antibiotics:Penicillins) SE/ADE |
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Definition
GI most common: N/V/D, abd. pain, glossitis, stomatitis, gastritis, sore mouth, furry tongue. Superinfection. Hypersensitivity reactions. |
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Term
Amoxicillin (Antibiotics:Penicillins) Teaching |
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Definition
Monitor after 1st/2nd doses for allergic reactions. Better absorbed with 8 oz. water, empty stomach. Avoid citrus, caffeine, colas, fruit/tomato juice, milk. |
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Term
Cefaclor (Antibiotics:Cephalosporins) MOA |
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Definition
Bactericidal/bacteriostatic: Interferes w/ bacteria cell wall synthesis. |
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Term
Cefaclor (Antibiotics:Cephalosporins) SE/ADE |
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Definition
GI: Mild diarrhea, n/v, anorexia, abd. pain, flatulence, pseudomembranous colitis. CNS: H/A, lethargy, dizziness, paresthesia. Nephrotoxicity, especially if preexisting renal disease. Superinfection. |
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Term
Cefaclor (Antibiotics:Cephalosporins) Teaching |
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Definition
Take w/ meals due to GI distress. No ETOH due to antabuse-like effect: flushing, throbbing, H/A, n/v, chest pain, palpitations, dyspnea, syncope, vertigo, blurred vision. Extreme cases can lead to cardiovascular collapse, convulsions, death. Yogurt/buttermilk w/ active cultures may decrease diarrhea. |
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Term
Tetracycline (Antibiotics:Tetracyclines) MOA |
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Definition
(Use limited due to bacterial resistance.) Bacteriostatic: Inhibit protein synthesis in bacteria. Bind to portion of ribosome 30S subunit which shuts down growth & repair. |
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Term
Tetracycline (Antibiotics:Tetracyclines) Drug Effects/Therapeutics |
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Definition
Inhibit growth of gram-/+ bacteria, some protozoa, Chlamydia, mycoplasma (pneumonia), rickettsia. Used for acne tx, Lyme’s disease, H. pylori. Tx of SIADH: Demeclocycline (inhibits action of ADH) Tx of Pleural/Pericardial Effusions: Doxycycline |
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Term
Tetracycline (Antibiotics:Tetracyclines) SE/ADE |
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Definition
Discoloration of teeth in fetus and children under age of 8; retard skeletal growth of fetus. GI: N/V/D, abd. pain, glossitis, pseudomembranous colitis; hepatotoxicity. Hema: Blood dyscrasias, exacerbation of SLE. Skin: Photosensitivity, rash. Superinfection. |
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Term
Tetracycline (Antibiotics:Tetracyclines) Teaching |
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Definition
Avoid sun exposure. No milk products, antacids, iron products within 2 hours. Take with 8 oz. water on empty stomach 1 hour before meals or 2-3 hours after meals. Contraindicated for children under 8 years old, pregnant and nursing mothers. Backup contraception needed if using oral contraceptives. |
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Term
Gentamicin (Antibiotic:Aminoglycosides) MOA |
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Definition
Bactericidal. Bind to and disrupt protein synthesis. |
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Term
Gentamicin (Antibiotic:Aminoglycosides) Drug Effects/Therapeutics: |
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Definition
Treatment of serious gram- infections and specific conditions with gram+ cocci; used in combination with other antibiotics. |
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Term
Gentamicin (Antibiotic:Aminoglycosides) SE/ADE/Toxicities |
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Definition
Ototoxicity (8th CN) hearing/balance issues. Crosses placenta and can cause deafness in fetus. Nephrotoxicity, urinary casts, proteinuria, elevated BUN and creatinine. CNS: H/A, paresthesia, neuromuscular blockage, dizziness, vertigo, confusion, depression, weakness. GI: N/V/D, wt. loss, stomatitis, hepatic toxicity. CV: Palpitations, hypotension, hypertension. Other: Skin rash, fever, superinfection, bone marrow depression. |
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Term
Gentamicin (Antibiotic:Aminoglycosides) Teaching |
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Definition
S/S of toxicitites. Drug interactions. Contraindicated in pregnant women. Neonates & premies use with caution due to risk of toxicity. Poor oral absorption, potent antibiotics with serious toxicities. |
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Term
Cipro (Antibiotic:Fluoroquinolones) MOA |
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Definition
Potent, broad spectrum with good po absorption; relatively mild SE/ADR. Bactericidal, destroy bacteria by altering DNA, interfere with DNA gyrase, enzyme needed for DNA synthesis. |
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Term
Cipro (Antibiotic:Fluoroquinolones) Drug Effect/Therapeutics: |
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Definition
| Treatment of a variety of bacterial infections. Tx of UTIs, STDs, respiratory & skin infections. |
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Term
Cipro (Antibiotic:Fluoroquinolones) SE/ADE/Toxicities |
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Definition
Increased LFT (AST and ALT.) GI: N/V/D, dry mouth, pseudomembranous colitis, flatulence, heartburn. CNS: H/A, dizziness, insomnia, depression, (most common) restlessness, fatigue, convulsions. Skin: Photosensitivity, rash, urticaria, pruritus, flushing. Superinfection, Bone marrow depression. Drug-drug interactions: If taken with drugs that cause QTc interval, severe to fatal cardiac dysrhythmias. |
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Term
Cipro (Antibiotic:Fluoroquinolones) Teaching |
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Definition
Drink 2-3L flds. to prevent crystallization in kidneys. Report rash, fever, sore throat, H/A, agitation and confusion to physician. Limit intake of alkaline foods/meds: antacids, dairy products, peanuts, vegetables, NaBicarbonate. May affect bone development in children. |
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Term
Erythromycin (Antibiotic:Macrolides) MOA |
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Definition
| Bacteriostatic. In high concentrations may be bactericidal. Prevent production of bacterial protein needed for growth, binds to cell membrane. |
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Term
Erythromycin (Antibiotic:Macrolides) Drug Effect/Therapeutics |
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Definition
| Limited to bacteria. Uses: Streptococci, influenzae, respiratory infections, syphilis, Lyme’s, gonorrhea, chlamydia, mycoplasma infections, H pylori, mycobacterium avium complex (MAC.) Tx of gastroparesis due to gastric irritation by medication. Increases GI motility. |
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Term
Erythromycin (Antibiotic:Macrolides) SE/ADE |
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Definition
CV: palpitations, chest pain. CNS: dizziness, confusion, abnormal thinking, uncontrollable emotions. GI: N/V/D/A, flatulence, pseudomembranous colitis, HEPATOTOXITY, cholestatic jaundice. Skin: Rash, pruritus, urticaria, thrombophlebitis. Other: Heaing loss and tinnitus (ototoxicity.) |
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Term
Erythromycin (Antibiotic:Macrolides) Teaching |
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Definition
Monitor hearing and s/s liver toxicity. |
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Term
Clindamycin (Antibiotics:Lincosamides) MOA |
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Definition
More toxic than macrolides. Bind to bacterial cell membranes and change protein function same as macrolides. |
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Term
Clindamycin (Antibiotics:Lincosamides) SE/ADE |
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Definition
| Severe GI symtoms including pseudomembranous colitis. |
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Term
Vancomycin (Antibiotic) MOA |
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Definition
| Bactericidal. Binds to cell wall and inhibits cell wall synthesis causing death. |
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Term
Vancomycin (Antibiotic) Uses |
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Definition
| MRSA, gram+ bacteria. Oral used to treat antibiotic induced pseudomembranous colitis. Staphylococcal enterocolitis (local effect on GI tract). IV for bone, joint, blood stream infections by staphylococcus spp. |
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Term
Vancomycin (Antibiotic) SE/ADE |
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Definition
Ototoxicity, Nephrotoxicity. |
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Term
Vancomycin (Antibiotic) Nursing Implication |
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Definition
Check IV placement carefully-infiltration can cause tissue irritation and damage. Peak: 18-26 mg/mL. Trough: 5-10 mg/mL. Use cautiously with neonates and older adults. |
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Term
Zyvox (Antibiotic:Linezolid) Uses |
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Definition
| Treatment of VREF, hospital acquired pneumonia, complicated skin and skin structure infections, gram+ infections in infants and children. |
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Term
Zyvox (Antibiotic:Linezolid) SE/ADE |
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Definition
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Term
| What is used to tx pseudomembranous colitis? |
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Definition
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Term
Amphotericin B (Antifungals:Polyene) MOA |
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Definition
| Binds to sterols (ergosterol) in cell membrane forming a channel that allows potassium and magnesium ions to lead out of cell through the cell membrane; alters cellular metabolism and leads to death. |
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Term
Amphotericin B (Antifungals:Polyene) Drug Effects/Therapeutics: |
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Definition
Limited to ability to kill or inhibit growth of fungal cells. Used for severe systemic mycosis; used in combination with flucytosine due to synergistic effects. |
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Term
Amphotericin B (Antifungals:Polyene) SE/ADE |
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Definition
Many ADE/SE/Toxicities. Infusion related fever, chills, headache, malaise, anorexia, nausea, vomiting, hypotension, tachycardia, muscle and joint pain. Premedicate with antipyretic (acetaminophen), antihistamine, and antiemetic. ADE: Cardiac dysrhythmias, neurotoxicity, nephrotoxicity, hypokalemia, hypomagnesemia, pulmonary filtrates and respiratory problems. |
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Term
Amphotericin B (Antifungals:Polyene) Teaching |
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Definition
Monitor VS, I/O, BUN and creatinine, weight. Several formulations with different dosages- be sure you have correct one. Extravasation can cause skin necrosis. Give test dose of 1 mg per 20 ml over 30 minutes to determine tolerance. IV, po and topical forms available. |
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Term
Nystatin (Antifungals) MOA |
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Definition
| Polyenes: Binds to sterols (ergosterol) in cell membrane forming a channel that allows potassium and magnesium ions to lead out of cell through the cell membrane. Alters cellular metabolism and leads to death. |
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Term
Nystatin (Antifungals) Uses |
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Definition
| Used topically to treat candidal diaper rash, oral and vaginal candidiasis. Oral dose available, used to prevent candidal infections in immunosuppressed patients and intestinal candidiasis. Not available in parenteral form due to toxicity. |
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Term
Nystatin (Antifungals) ADE |
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Definition
CNS: H/A, dizziness, fever, shaking, chills, malaise. GI: N/V, dyspepsia, anorexia, hepatic dysfunction. |
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Term
Isoniazid (Antitubercular) MOA |
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Definition
Inhibit protein synthesis Inhibit cell call synthesis Alters DNA and RNA activity |
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Term
Isoniazid (Antitubercular) Effects |
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Definition
Prophylaxis and treatment of TB. Single-drug therapy ineffective due to drug resistance in treatment of TB. Multiple-drug therapy more effective, less resistance, and may shorten treatment from 2 years to 6-9 months; may be in treatment for as long as 24 months. First-line: Isoniazid (INH) Mainstay of TB treatment and most widely used agent. Used as single agent for prophylaxis 6 months to one year to prevent infection after an exposure or high risk status. |
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Term
Isoniazid (Antitubercular) SE/ADE |
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Definition
| peripheral neuritis, hepatotoxicity, hyperglycemia, bone marrow depression (blood dyscrasias), Vit. B6 deficiency, fatigue,GI (nausea, vomiting, anorexia) numbness and tingling in extremities, depression and jaundice. |
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Term
Isoniazid (Antitubercular) Teaching |
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Definition
| Neuro assessment particularly for neuropathy. Monitor blood sugars, LFT, CBC, Hgb,/Hct., BUN/creatinine. |
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Term
Amantadine (Antiviral) MOA |
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Definition
| kill viruses by inhibiting viral replication through interference with attachment of virus to cell, reading of the viruses genetic make-up or in making a new virus. |
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Term
Amantadine (Antiviral) Use |
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Definition
| Treatment and prophylaxis of influenza A; most effective if given before exposure or within 48 hours of S/S-will reduce fever and palliate symptoms. |
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Term
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Definition
lightheadedness, dizziness, insomnia, orthostatic hypotension, urinary retention. Anticholinergic side effects, also used to treat Parkinson’s disease. |
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Term
Amantadine (Antiviral) Teaching |
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Definition
Start drug within 48 hours of symptoms. Vaccination for the influenza. Adm full course. Change position slowly and avoid driving or hazardous tasks. |
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Term
Ganciclovir (Antiviral) Uses |
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Definition
CMV, also HSV1 and HSV 2, Epstein Barr, VZV. |
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Term
Ganciclovir (Antiviral) SE/ADE |
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Definition
| bone marrow toxicity, carginogenic |
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Term
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Definition
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Term
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Definition
| rash, phletitis, increased bleeding times, nausea, vomiting, diarrhea, tremors, lethargy, crystalluria, nephrotoxicity, neurotoxicity, bone marrow suppression |
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Term
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Definition
| Check BUN and creatinine, CBC, platletes, monitor other nephrotoxic medications, I/O, daily weight. Patient should drink 2-3liters per day. |
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Term
Nevirapine (Antiviral:RT Inhibitor) MOA |
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Definition
| inhibit HIV reverse transcriptase (HIV-RT) which is responsible for viral replication early in virus cycle-prevents infection of new cells by preventing transfer of information allowing virus to replicate; cannot prevent production of infection by already infected cells. |
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Term
Nevirapine (Antiviral:RT Inhibitor) Uses |
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Definition
| HIV infected adults and children (older than 2 months); liver dysfunction. |
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Term
Nevirapine (Antiviral:RT Inhibitor) SE/ADE |
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Definition
| rash (may become life-threatening), fever, H/A, abnormal LFT, stomatitis, numbness, muscle pain, hepatitis. |
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Term
Zidovudine (Antivirals) Uses |
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Definition
| Treatment of symptomatic HIV in adults and children, prevent maternal transmission. |
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Term
Zidovudine (Antivirals) SE/ADE |
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Definition
| bone marrow suppression, munbness, tingling, burning and pain in LE, abdominal pain, rash, GI intolerance (N/V/A), neutropenia (Fever, chills, sore throat, seizures), H/A, muscle pain, difficulty swallowing, arthralgia, insomnia, confusion, mental changes, blue-brown bands on fingernails. |
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Term
Saquinavir (Antivirals:Protease Inhibitor) MOA |
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Definition
| block protease, an enzyme required for viral replication late in virus life cycle-suppresses production of infectious virons in infected cells; improved prognosis; combined with other agents to reduce viral plasma levels to undetectable levels. |
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Term
Saquinavir (Antivirals:Protease Inhibitor) SE/ADE |
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Definition
SE/ADE: nausea, diarrhea, stomatitis, abdominal pain, burning or prickling sensation, skin rash, weakness, H/A, hyperglycemia |
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Term
Saquinavir (Antivirals:Protease Inhibitor) Use |
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Definition
treatment of adults part of combination therapy |
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Term
Enfuvirtide (Antiviral:Fusion Inhibitor) MOA |
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Definition
| prevent fusion of virus with human cell membrane, preventing virus from entering human cell. |
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Term
Enfuvirtide (Antiviral:Fusion Inhibitor) Use |
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Definition
| combined with other agents to treat adults and children older than 6with evidence of HIV replication; sub-cut |
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Term
Enfuvirtide (Antiviral:Fusion Inhibitor) SE/ADE |
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Definition
| insomnia, depression, peripheral neuropathy, nausea, diarrhea, pneumonia, injection site reactions |
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Term
| Nursing Implications of Antiretrovirals |
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Definition
Monitor renal and hepatic function Complete course of drug May need to adm around the clock Monitor nutritional status Stop drug I if rash occurs, esp if blisters occur Patient should report fatigue, severe H/A, difficulty breathing, severe rash. |
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Term
Adefovir (Antivirals:Tx Hep B) MOA |
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Definition
prevent viral replication by blocking reverse transcriptase, decreasing viral load |
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Term
Adefovir (Antivirals:Tx Hep B) Use |
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Definition
| treatment of hepatitis B with evidence of active viral replication and elevations of liver enzymes |
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Term
Adefovir (Antivirals:Tx Hep B) SE/ADE |
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Definition
| H/A, dizziness, nausea, diarrhea, elevated liver enzymes; hepatomegaly with steatosis (adefovir), lactic acidosis, renal impairment |
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Term
Impramine (Antidepressants: Cyclic) MOA |
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Definition
| correct the imbalance in neurotransmitter concentrations at nerve endings in CNS by blocking reuptake of neurotransmitters thus allowing an accumulation of neurotransmitters |
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Term
Impramine (Antidepressants: Cyclic) Effect/Use |
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Definition
| Inhibit reuptake of norepinephrine and serotonin; blocks muscarinic, histaminergic, adrenergic, dopaminergic, and serotonergic receptors (usually responsible for adverse effects.) Second-line in treatment of depression, adjunct analgesia, trigeminal neuralgia, OCD (Clomipramine), childhood enuresis (imipramine). |
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Term
Impramine (Antidepressants: Cyclic) SE |
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Definition
Related to receptors that are blocked (antagonist effect). CV: tremors, tachycardia, orthostatic hypotension, dysrhythmiasCNS: anxiety, confusion, extrapyramidal, sedation, tremors, fatigue, hallucinations, visual disturbances, loss of libido.GI: N/C, dry mouthGU: urine retentionOther: blurred vision, urine retention, weight gain, impotenceNote there are anticholinergic side effects associated with antimuscarinic drug effects. TCA overdose can be lethal-seizures and dysrhythmias-no antidote |
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Term
Impramine (Antidepressants: Cyclic) Uses |
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Definition
| depression, enuresis in children older than 6; control of chronic pain (unlabeled) |
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Term
Phenelzine (Nardil) (Antidepressant:MAOI) MOA |
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Definition
| inhibits enzyme MAO which is responsible for inactivating many neurotransmitters in particular dopamine, epinephrine, norepiniphrine, and serotonin; increased levels of these neurotransmitters at storage sites in the brain lead to reduction of depression |
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Term
Phenelzine (Nardil) (Antidepressant:MAOI) Drug Effect/Therapeutics |
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Definition
| Drug effect: Inhibition of MAO enzyme system prevents break down of dopamine, serotonin, norepinephrine, higher levels occur, which alleviates symptoms of depression Uses: depression not responsive to other treatments, second line treatment |
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Term
Phenelzine (Nardil) (Antidepressant:MAOI) SE/ADE |
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Definition
Side effects: CV: orthostatic hypotension, tachycardia, and palpitations CNS: dizziness, drowsiness, H/A, insomnia, excitement, nervousness, mania, hyperrelexia, tremors, confusion GI: anorexia, abdominal cramps, nausea, vomiting, diarrhea, constipation Other: blurred vision, impotence, skin rashes |
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Term
Phenelzine (Nardil) (Antidepressant:MAOI) Interactions/Toxicities |
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Definition
| Toxicity: tachycardia, circulatory collapse, seizures, coma, respiratory depression confusion. Interactions: Food containing amino acid tyramine can cause hypertensive crisis. See list of foods page 336 (Talbe 21.3). Keep nifedipine on hand for treatment Hypertensive crisis: occipital headache, palpitations, stiff neck, N/V, sweating, dilated pupils, photophobia, tachycardia, chest pain; can lead to intracranial bleed and fatal CVA Drug-drug interactions: Concurrent use of MAOIs and SSRIs-risk of serotonin syndrome; at least two week washout period between D/C SSRI and starting MAOI-6 week interval suggested. MAOI and TCA concurrent use can cause hypertensive crisis, coma, severe convulsions Sympathomimetics (adrenergics) can cause hypertensive crisis Meperidine use contraindicated with MAOIs. |
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Term
Fluoxetine (Prozac) (Antidepressants:SSRI) MOA |
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Definition
| Selectively inhibit serotonin reuptake with little effect on norepinephrine and dopamine. |
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Term
Fluoxetine (Prozac) (Antidepressants:SSRI) Drug Effect/Therapeutics |
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Definition
| Drug effects: Increased concentration of serotoninin CNS; little or no cardiovascular or anticholinergic effects; anoretic activity Uses: depression, bipolar disorders, obesity, eating disorders, panic attacks, OCD, treatment of substance abuse problems, social anxiety disorder, PTSD, premenstrual dysphoric disorder, neurologic disorder myoclonus |
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Term
Fluoxetine (Prozac) (Antidepressants:SSRI) SE/ADE |
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Definition
| Less systemic side effects, better tolerated by older adults, few drug-drug/drug-food interactions, little to no effect on cardiovascular system Side effects: CNS: H/A, dizziness, tremor, nervousness, insomnia, fatigue, drowsiness, tremor, agitation, seizures GI: N/D/C, dry mouth, weight loss/gain, taste changes GU: cyctitis, urgency, painful menstruation RESP: cough, dyspnea, URI Other: sweating sexual dysfunction (nefazodone, bupropion, mirtazapine-less common) Serotonin syndrome-potential hazardous side: anxiety, agitation, increased BP and temperature, involuntary muscle twitches, akathisia, tremor, seizure, coma; self-limiting with discontinuation of drug Highly bound to protein-interactions with other highly protein bound drugsInhibit cytochrome P-450 system (enzyme system in liver)-higher levels of drugs accumulate |
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Term
Fluoxetine (Prozac) (Antidepressants:SSRI) Teaching/Nursing Implications |
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Definition
| 4-6 weeks for therapeutic effectAvoid alcoholCaffiene and cigarettes decrease effectivenssAvoid abrupt withdrawal.Increase fluids to decrease constipation.Take with meals to decrease GI upset. Nursing:Check mouth to verify that swallowed medicationMonitor renal and hepatic function Change position slowly for orthostatic hypotension. |
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Term
Thorazine (Antipsychotic:Neuroleptics) MOA |
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Definition
| MOA: Typical block dopamine receptors, prevent stimulation of postsynaptic neurons, depress RAS, limiting stimuli into brain, and have an anticholinergic, antihistamine, and alpha-adrenergic blocking effect Atypical-block dopamine and serotonin receptors |
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Term
Thorazine (Antipsychotic:Neuroleptics) Drug Effects/Therapeutics |
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Definition
| Drug effects Block dopamine receptors-antianxiety and antiemetic Block alpha receptors-hypotension and tachycardia Block histamine -sedation, drowsiness, hypotension Block serotonin-antiemetic effect when combined with dopamine blockage in chemoreceptor trigger zone Inhibits vagal nerve-antiemetic effect Uses Schizophrenia, manifestations of psychotic disorders (hyperactivity, combative behavior, agitation in elderly, severe behavioral problems in children) |
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Term
Thorazine (Antipsychotic:Neuroleptics) Contraindications |
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Definition
| Conditions exacerbated by dopamine-blocking effects, CNS depression, circulatory collapse, Parkinson’s disease, coronary disease, severe hypotension, bone marrow suppression, and blood dyscrasias Caution with glaucoma, peptic ulcer, urinary or intestinal obstruction, seizures (decreased threshhold), thyrotoxicosis (neurosensitivity), alcoholism (CNS depression) |
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Term
Thorazine (Antipsychotic:Neuroleptics) SE/ADE |
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Definition
| Side effects: caused by ability to block dopamine, muscarinic, (anticholinergic properties), histamine, and alpha-adrenergic receptors Antipsychotic selected by the least amount of side effects CNS: Sedation, weakness, tremor, drowsiness, delirium, extrapryamidal symptoms (EPS) (pseudoparkinsons, dystonia, akathisia, tardive dyskinesia),neuroleptic malignant syndrome Anticholinergic: dry mouth, flushing, constipation, urinary retention, sexual impotence, glaucoma, blurred vision, photophobia CV: hypotension, syncope,dizziness, cardiac arrhythmias, congestive heart failure, pulmonary edema;prolonged QT interval which can lead to serious cardiac dysrhythmia; increased cardiac events in elderly when used for behavioral control Resp: laryngospams, dyspnea, bronchospasm GI: dry mouth, constipation, paralytic ileus, hepatotoxicity, weight gain GU: urine hesitancy and retention, impaired erection, priapism, ejaculatory problems Hema: leukopenia and agranulocytosis, hemolytic anemia Skin: photosensitivity, hyperpigmentation, rash, pruritus, exfoliate dermatitis Meta; galactorrhea, irregular menses, amenorrhea, decreased libido, increased appetite, polydipsia, impaired temperature regulation Low-potency antipsychotics: low incidence of EPS and high incidence of sedation, anticholinergic, and cardiovascular side effects |
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Term
Thorazine (Antipsychotics:Neuroleptics) Nursing Implications |
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Definition
| Therapeutic effect 3-6 weeksMonitor complianceCheck mouth to determine if swallowed medicationFood or glass of water decrease GI symptomsPerspiration may increase-dehydration and heat exhaustion a concern-need to be well-hydrated and avoid hot climates, hot baths, saunasNo alcohol.Concurrent use with other CNS depressants may cause respiratory and cardiovascular collapseNeed to check OTC medications with physician or pharmacistPink or red urine with phenothiazines normalPhotosensitivity |
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Term
Clozapine (Antipsychotics:Neuroleptics) Difference from Thorazine |
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Definition
Higher potency. more selective in blocking dopaminergic receptors in mesolimbic system thus it is associated with less EPS, useful for patients who have failed treatment with other meds, esp. schizophrenia; monitor for agranulocytosis (risk 1-2% after first year)-weekly CBC, RBC, Hbg., Hct., reticulocytes first 4 weeks then monthly |
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Term
Early Extrapyramidal Symptoms (Antipsychotics) |
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Definition
| Acute dystonia-(1-5 days): spasms of muscles of tongue, face, neck, and back, opisthotonus, muscular jerkiness and uncoordination, abnormal eye movements; treated with anticholinergics Parkinsonism-(5-30 days): bradykinesia, mask-like facies, tremor, rigidity, shuffling gait, drooling, cogwheeling, stooped posture treated with anticholinergic, amantdine or both Akathisia-(5-60 days): compulsive, restless movement; symptoms of anxiety and agitation treated with reduced dose or low potency antipsychotic |
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Term
Late Extrapyramidal Symptoms (Antipsychotics) |
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Definition
| Tardive dyskinesia (Months to years): oral facial dyskinesias, choreoathetoid movements; no treatment, prevention best |
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Term
Neuroleptic Malignant Syndrome (Antipsychotics) |
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Definition
| potentially life-threatening adverse effect that includes high fever, unstable BP, and myoglobinemia. |
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Term
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Definition
| potential hazardous side: anxiety, agitation, increased BP and temperature, involuntary muscle twitches, akathisia, tremor, seizure, coma; self-limiting with discontinuation of drug |
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Term
Valium (Benzodiazepines) MOA |
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Definition
acts in limbic system and RAS to make gamma-aminobutyric more effective; depresses CNS by inhibiting stimulation of the brain |
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Term
Valium (Benzodiazepines) Drug Effect/Therapeutics |
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Definition
Drug Effects: Calming effect on CNS, inhibition of hyperexcitable nerves, controls anxiety and agitation, reduces excessive sensory stimulation, induce sleep, skeletal muscle relaxation, effect on the same receptors that are implicated in alcohol addiction Does not suppress REM sleep as much as barbiturates; do not induce hepatic enzyme activity Uses: sedation, hypnotic, muscle relaxant, anxiety, alcohol withdrawl, agitation, depression, seizures, anesthesia induction, anesthesia for short procedures Diazepan (Valium)-anxiety, alcohol withdrawl, muscle relaxant, seizures, status epilepticus, preop anxiety and tension |
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Term
Valium (Benzodiazepines) SE/ADE |
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Definition
SE/ADE: CNS: H/A, sedation, drowsiness, paradoxical excitement or nervousness, dizziness, lethargy, apathy, hangover, cognitive impairment CV: palpitations, hypotension, hypertension, dysrhythmias, respiratory difficulties GI: dry mouth, N/V, constipation, elevated liver enzymes HEMA: blood dyscrasias GU: urine retention, hesitancy, loss of libido, changes in sexual functioning Less common: nightmares, hypokinesia |
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Term
Valium (Benzodiazepines) Withdrawal/Toxicity/Antidote |
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Definition
Withdrawal syndrome: nausea, H/A, vertigo, malaise, and nightmares Toxicity: somnolence, confusion, coma, diminished reflexes; only rarely results in hypotension and respiratory depression; more lethal when combined with alcohol and other CNS depressants Flumazenil (Romazicon) antagonist-reverses sedative effects in excessive OD, sedation when used as adjuncts for general anesthesia, diagnostic procedures, and medical procedures; IV only (Box 20.4, page 319) |
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Term
Phenobarbital (Barbituates) MOA |
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Definition
| Acts on brainstem in area called reticular formation; potentiates gama-aminobutyric acid (GABA), an inhibitory amino acid found in CNS, thus reducing nerve impulses traveling to the central cortex |
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Term
Phenobarbital (Barbituates) Effect/Therapeutics |
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Definition
Low dose-sedative (decreased nervousness, excitability, irritability); large dose-hyponotic; raise seizure threshold. Sedative, hypnotic, prevention of seizures, neonatal hyperbilirubinemia |
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Term
Phenobarbital (Barbituates) SE/ADE |
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Definition
CNS: drowsiness, lethargy, somnolence vertigo, ataxia, H/A, mental depression, thinking abnormalities, paradoxical anxiety, hallucinations GI: N/V/D/C, epigastric pain Resp: respiratory depression, apnea, bronchospasm, cough CV: vasodilation, hypotension, bradycardia, syncope Hypersensitivity: rash, serum sickness, Stevens-Johnson syndrome |
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Term
Phenobarbital (Barbituate) Teaching |
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Definition
| Avoid other CNS depressants Hypnotics only used short term: 7-10 days Many drug interactions. Avoid driving and heavy machine use-any activity where you need to be alert. |
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