·        skeletal muscle relaxant

·        adjunct to general anesthetics

·        Minimized patient movement to conserve energy and agitation to prevent ICP increases in ICU’s.

·        Diagnose myasthenia gravis

·        hypersensitivity

·        early pregnancy

Caution with patients with pulmonary disease or cancer

·        May exacerbate asthma, hypotension and cardiac disease

·        Use cautiously in persons suffering from hypovolemia, acid/base imbalance and electrolyte imbalance.

flushing

hypotension

  prolonged paralysis

 apnea

malignant hyperthermia

A pt is on turbocurarine (Tubarine) the nurse knows to try and        Decrease ____ and ____.

Have resuscitation equipment and cholinesterase inhibitor antidote at bedside

DEPOLARIZING 

NEUROMUSCULAR BLOCKING AGENT

·        IV or IM administration for rapid endotracheal intubation

·        endotrachial procedures

·        hypersensitivity

·        familial hx of malignant hyperthermia

·        open eye injury

·        acute narrow-angle glaucoma

·        clients who have or who are at risk for hyperkalemia

What are the common side effects of  

succinylcholine (Anectine) 

·        Increased ocular pressure

·        histamine release,

·        muscle pain (this is due to the rapid cycling at the beginning of induction)

 Have resuscitation equipment at the bedside

Have oxygen available.

Induction and maintenance of general anesthesia

sedation in ICU

·        IV administration

·        Rapid onset- 40 seconds

·        rapid recovery with minimal psychomotor impairment

·        Hypersensitivity

·        Pregnancy and lactation

·        seizure disorders

·        Caution with patients who have cardiac or PVD

·        Increased ICP

·        nausea and vomiting

·        involuntary muscle movement

·        Hypotension

·        Pain at injection site

·        Apnea

·        Anaphylaxis

Low stimulus environment

Why should a nurse limit duration of administration of 

 Propofol (Diprivan)

to avoid bacterial growth

What vitalsings need to wached closly while on

Propofol (Diprivan)

·        Parkinson disease

·        restless-leg syndrome

What types of pts should not be on

carbidopa-levodopa (Sinemet)

·    hypersensitivity

·        can activate malignant melanoma

·        closed-angle glaucoma

·        cannot be administered concurrently with MAOI’s

What are the common side effects of

carbidopa-levodopa (Sinemet)

·        abnormal movements

·        orthostatic hypotension

·        GI effects

·        neuroleptic malignant syndrome with abrupt cessation

·        assess for psychosis and suicidal thoughts

Take on an empty stomach

·        reduce protein and pyridoxine in diet

What should a nurse know about

carbidopa-levodopa (Sinemet) r/t Titration

Titrate drug up to avoid GI effects

Titrate drug down to discontinue to avoid neuroleptic 

ANTI-AMYOTROPHIC

LATERAL SCLEROSIS

Possible inhabitation of glutamate release- not really known

·        50mg doses orally every 12 hours

slow onset- duration 3-5 days

·        hypersensitivity

·        Pregnancy category C

Hepatic disease, renal disease can affect clearance of drug

·        May be confused with s/s of disease

·        Muscle fatigue

·        nausea and vomiting

·        anorexia,

·        vertigo and somnolence

What type of history will you need on a pt taking 

riluzole (Rilutek)

Elicit careful renal and hepatic history

If your pt is on riluzole (Rilutek)

what labs should you moniter

·        Monitor CBC and hepatic enzyme studies before therapy, monthly for 3 months, and then every 3 months.

If your pt is on riluzole (Rilutek) what

diet restictions should they fallow

·        Monitor diet for caffeine and high fat as these affect drug utilization. 

Encourage high protein diet

Refrain from driving and tasks that require concentration till effects of drug known.

·       those that need IV administration

·        hypersensitivity to Mannitol

·        Caution in immunocompromised patients or clients receiving vaccinations

What are the Serious Adverse Effects

of  glatiramer (Copaxone)

·        chest pain or tightness

·        breathing difficulties

·        rash, hives

Can alter results of pap smear

·        Keep medication refrigerated,

reconstitute medication using sterile water.