Term
| What adverse effects may occur with methylphenidate (Ritalin)? |
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Definition
| Adverse reactions of CNS stimulants include restlessness, insomnia, tachycardia, hypertension, anorexia, and diarrhea. Insomnia can be minimized by reducing the afternoon dose and giving it before 4:00 P.M. or using a long-duration preparation that is just given in the morning. Anorexia can cause weight loss and growth suppression. This can be minimized by administering stimulants during or after meals, which reduces the appetite suppression. When stimulants are discontinued, a rebound increase in growth will occur; therefore, adult height may not be affected |
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Term
| What instructions can the nurse give to the parents of a child taking amphetamine (Adderal) to help minimize insomnia and anorexia? |
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Definition
| Taking the medication before 4 pm or using a long acting medication once a day can reduce insomnia, and giving the medication before or with meals can reduce anorexia |
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Term
| What adverse effects may occur with atomoxetine (Strattera)? |
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Definition
| The most common adverse effects are dyspepsia, nausea and vomiting, anorexia, dizziness, mood swings, and insomnia. A small increase in blood pressure and heart rate may be seen, there is a small risk of severe liver injury so patient teaching should include signs of liver injury-jaundice, dark urine, light stool, abdominal tenderness, and unexplained flu-like symptoms |
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Term
| What adverse effects and drug interactions can occur with modafinil (Provigil)? |
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Definition
| has less abuse potential than other CNS stimulants and it is a Schedule IV drug. Physical dependence and withdrawal have not been reported. It is generally well tolerated with the most common side effects being headache, nausea, nervousness, diarrhea, and rhinitis. It has been linked to serious skin reactions such as Stevens-Johnson syndrome and patients should be instructed to report swelling or rash, especially if accompanied by fever or changes in the oral mucosa. Modafinil induces CYP3A4 liver enzymes and may accelerate the metabolism of oral contraceptives and cyclosporine, thus reducing their effectiveness. |
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Term
| What is doxapram (Dopram) used for? |
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Definition
a CAN and respiratory stimulant that is used to treat respiratory depression caused by drug overdose, anesthesia, or chronic obstructive pulmonary disease (COPD).
It is given IV as an infusion or injection. Adverse reactions are uncommon, usually due to overdose, and may include hypertension, tachycardia, tremors, spasticity, and hyperactive reflexes. |
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Term
| Which barbiturates are used to induce sleep and which are used to sustain sleep? |
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Definition
Phenobarbital – controls seizures
Butabarbital (butisol) – intermediate-acting, used to sustain sleep, taken about one hour for the onset of sleep (not for those who have trouble falling asleep)
Secobarbital (Seconal) & pentobarbital (Nembutal) – short-acting barbituates are used to induce sleep for those who have difficulty falling asleep
Thiopental sodium (pentothal) – ultrashort-acting barbiturate, used as a general anesthetic to induce unconsciousness for surgery |
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Term
| What drug interactions can occur with the barbiturates? |
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Definition
| Barbiturates and other CNS depressants intensify each other’s effects if used together. This can result in fatal CNS depression; patients should be warned against the combination of barbiturates with alcohol or other CNS depressants. Barbituates induce hepatic enzymes causeing an acceleration in metabolism and a reduction in effect of some drugs. Increased metabolism is a particular concern with warfarin (an antiboagulant), oral contraceptives, and phenytoin (an antiseizure drug). If taken concurrently w/ barbiturates, the dosages of these drugs will need to be increased. |
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Term
| What adverse effect can occur if alprazolam is combined with morphine or alcohol? |
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Definition
| Combining other CNS depressants (alcohol, barbiturates, or opioids) with oral benzodiazepines can result in significant respiratory depression. Patients taking benzodiazepines may have complex sleep-related behaviors with no memory of their actions. These can include sleep driving, preparing and eating meals, making phone calls, and having sexual intercourse. These behaviors tend to occur with higher doses and when benzodiazepines are combined with alcohol or other CNS depressants. |
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Term
| Which drugs will increase the amount of anesthetic needed and which will decrease the amount needed? |
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Definition
| Opioids reduce the amount of anesthetic needed by producing analgesia so the inhalation agent doesn't have to produce analgesia by itself. CNS depressants (barbiturates, benzodiazepines, alcohol) add to the depressant effects of the anesthetic; therefore, less anesthetic is needed. Conversely, CNS stimulants (amphetamines) increase the required dose of anesthetic. Neuromuscular blocking agents (muscle relaxants) reduce the amount of anesthetic needed because high doses of anesthetic are required to produce muscle relaxation. Neuromuscular blocking agents prevent contraction of all skeletal muscles, including the diaphragm. Therefore, patients require mechanical ventilation during surgery when these agents are used. Pancuronium,atracurium (Tracrium), and vecuronium (Norcuron) are nondepolarizing neuromuscular blockers because they relax the muscles without first causing depolarization. |
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Term
| What drug will be used to reverse the effects of pancuronium? |
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Definition
| a nondepolarizing neuromuscular blocker; it can be reversed with cholinesterase inhibitors, such as neostigmine (prostigmin) |
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Term
| What drug is used to treat a patient who becomes very hyperthermic (108 degrees F) after receiving succinylcholine and enflurane (Ethrane)? |
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Definition
| Dantrolene (Dantrium) acts by reducing the metabolic activity of skeletal muscles. |
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Term
| Which intravenous anesthetic agent should not be used for a patient with a history of schizophrenia because of possible adverse effects of hallucinations and delirium? |
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Definition
| Ketamine (Ketalar) is an intravenous agent that produces dissociative anesthesia in which the patient feels dissociated from his or her environment. It produces sedation, immobility, analgesia, and amnesia. Ketamine is used for short-term surgery or diagnostic procedures. It increases salivation, heart rate, and blood pressure. Adverse psychological reactions can occur during recovery from ketamine; including hallucinations, disturbing dreams, and delirium. These can be minimized by keeping the patient in a soothing stimulus-free environment until recovery is complete. Children under 15 years and adults older than 65 years are least likely to experience adverse psychological reactions. |
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Term
| Which drugs are used for epidural anesthesia? |
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Definition
| Lidocaine (xylocaine) and bupivacaine (Marcaine) |
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Term
| What adverse effects may occur with phenytoin (Dilantin)? |
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Definition
Above 20 mcg/ml, toxicity may occur with nystagmus (continuous back and forth movements of the eyes), ataxia, sedation, and double vision. Bone marrow suppression can occur with resultant thrombocytopenia and leukopenia. During phenytoin therapy, platelet and white blood cell counts should be monitored. Gingival hyperplasia causing swelling, tenderness, and bleeding of gums can occur; but may be minimized by good dental hygiene, dental flossing, and gum massage. Skin rash occurs rarely (2 to 5% of patients), but it may progress to severe life-threatening skin conditions such as Stevens-Johnson syndrome. If a rash develops, phenytoin should be discontinued. During pregnancy, phenytoin can cause birth defects including cleft palate and heart defects. It should be used during pregnancy only if the benefits of seizure control outweigh the risks to the fetus (pregnancy category D).
Phenytoin interacts with a large number of drugs. By inducing hepatic enzymes, phenytoin decreases the effects of oral contraceptives, warfarin (Coumadin), and glucocorticoids. Some drugs can increase phenytoin levels by reducing its metabolism; these include diazepam (Valium), cimetidine (Tagamet), and alcohol (if taken acutely). Another antiseizure drug, valproic acid, increases phenytoin levels by displacing it from protein binding sites. Drugs that decrease phenytoin levels are carbamazepine (antiseizure drug), phenobarbital, and alcohol (if used chronically). CNS depressants such as alcohol and barbiturates will add to the depressant effects of phenytoin. |
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Term
| Which lab tests should be monitored in a patient taking carbamazepine (Tegretol)? |
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Definition
Therapeutic serum range is 5-12 mcg/ml should be monitored. Bone marrow suppression can occur causing leukopenia, anemia and thrombocytopenia; complete blood cell counts should be drawn before therapy and periodically during therapy.
Hepatic enzymes, and warfarin levels should also be monitored |
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Term
| What is the only indication for ethosuximide (Zarontin)? |
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Definition
| the drug of choice for absence seizures, the only indication for this drug. It works by inhibiting calcium influx. Therapeutic serum range is 40 to 100 mcg/ml. Adverse effects include drowsiness, dizziness, and lethargy; which usually decrease with continued use. Nausea and vomiting can be reduced by taking the drug with food. Rare but serious adverse reactions include systemic lupus erythematosus, leukopenia, aplastic anemia, and Stevens-Johnson syndrome. |
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Term
| What adverse effects may occur with levodopa (Dopar)? |
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Definition
| Adverse effects include nausea and vomiting. This occurs early in treatment and can be minimized by using lower dosages or taking with meals. Food delays absorption of levodopa so administration with meals should be avoided if possible. Dyskinesias (abnormal movements such as head bobbing, tics, grimacing) are another adverse effect. They can be managed by decreasing the dose of levodopa but that may cause symptoms of Parkinson's Disease to reappear. Orthostatic hypotension is common early in treatment. Dysrhythmias may occur due to beta 1 stimulation, especially in patients with heart disease. Psychosis develops in 20% of the patients with visual hallucinations, vivid dreams or nightmares, and paranoia. This can be treated with antipsychotic drugs. Levodopa can cause urine and sweat to darken. It can also activate malignant melanoma, so any suspicious skin lesions should be checked before starting levodopa. |
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Term
| What adverse effects and drug interactions may occur with selegiline (Eldepryl)? |
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Definition
| can cause insomnia, but this can be minimized by taking the last daily dose by noon. can inhibit MAO-A. This enzyme inactivates norepinephrine and serotonin; therefore, inhibition of MAO-A can cause vasoconstriction and a hypertensive crisis. Foods high in tyramine (aged cheese, red wine, and bananas) should be avoided because MAO-A also inactivates tyramine. Increased levels of tyramine cause vasoconstriction and hypertension. Selegiline can intensify adverse reactions to levodopa, such as orthostatic hypotension, dyskinesias, and hallucinations. These can be reduced by decreasing the levodopa dosage. Like other MAOIs, selegiline should not be used concurrently with meperidine (Demerol). The combination can cause stupor, rigidity, agitation, and hyperthermia. Selegiline and fluoxetine (Prozac) given in combination can cause fatal reactions. Fluoxetine should be withdrawn 5 weeks before starting selegiline. |
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Term
| What adverse effects can occur with benztropine (Cogentin)? |
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Definition
| Adverse effects are dry mouth, blurred vision, photophobia, urinary retention, constipation, and tachycardia. The elderly usually do not tolerate the CNS effects of sedation, confusion, delusions, and hallucinations, so younger patients with mild symptoms are the most appropriate candidates for anticholinergic therapy. |
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Term
| If edrophonium (Tensilon) increases the muscle weakness in a patient with myasthenia gravis, what can be given to relieve the weakness? |
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Definition
| To distinguish whether the patient is in cholinergic or myasthenic crisis, an ultrashort-acting cholinesterase inhibitor can be given,edrophonium (Tensilon). If edrophonium relieves the symptoms, the crisis is myasthenic. If the symptoms worsen, a cholinergic crisis is occurring and atropine, an anticholinergic, is given to relieve the symptoms. |
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Term
| Which adverse effects may occur with glatiramer (Copaxone)? |
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Definition
| Injection site reactions are the most common side effect with pain, redness, itching, and pitting occurring. A postinjection reaction lasting about 15 to 20 minutes occurs in about 10% of the patients- flushing, palpitations, severe chest pain, anxiety, laryngeal constriction, and urticaria. It is self-limiting and requires no treatment. |
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Term
| What irreversible adverse effect can occur with mitoxanthrone (Novantrone)? |
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Definition
can cause irreversible heart damage and the patient should be monitored for signs of heart failure (peripheral edema, fatigue, and shortness of breath).
It is toxic to rapidly dividing cells so GI symptoms and hair loss may occur. The drug may turn the urine, skin, and sclera a harmless blue-green tint. |
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Term
| What adverse effects may occur with rivastigmine (Exelon)? |
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Definition
| can cause cholinergic side effects of nausea, vomiting, dyspepsia, diarrhea, bradycardia, and bronchoconstriction. Dizziness and headache are common. Significant weight loss occurs in about one-fourth of the patients taking rivastigmine. Weight should be monitored frequently. |
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Term
| What adverse effects may occur if oral baclofen is abruptly stopped? |
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Definition
| Abrupt stoppage of oral baclofen can cause visual hallucinations, paranoid ideation, and seizures. Withdrawal should occur over 1 to 2 weeks. Abrupt stoppage of intrathecal baclofen is more dangerous and can cause high fever, altered mental status, exaggerated spasticity, muscle rigidity, and rarely, rhabdomyolysis (muscle breakdown), multiple organ system failure, and death. |
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Term
| What adverse effects and drug interactions may occur with buspirone (Buspar)? |
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Definition
| Adverse effects are dzziness, nausea, headache, nervousness, lightheadedness, and excitement. Drug interations can occur, buspirone levels can be elevated by taking erythromycin or ketoconazole (antimicrobial agents) and grapefruit juice concurrently |
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Term
| What adverse effects may occur with amitriptyline? |
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Definition
| The most common side effect is orthostatic hypotension due to alpha 1 blockade on blood vessels. Other common side effects are sedation and anticholinergic effects (dry mouth, constipation, urinary retention, excessive perspiration, blurred visioin, and tachycardia) weight gain and sexual dysfunction can occur, most cause blood dyscrasias (leukopenia, thrombocytopenia, and agranulocytosis) requiring monitoring of blood cell counts. The most serious adverse effect is cardiac toxicity w/ an increased risk of dysrhythmias. |
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Term
| What patient teaching should be included for a patient taking doxepin (Sinequan)? |
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Definition
| Of possible side effects. To minimize side effects, initial doses should be low. Once an effective dose is determined the entire daily dose can be taken at bedtime. Get up slowly, avoid CNS depressants, report fever, sore throat, bruising; weigh weekly, initial response 1-3 weeks maximal 1-2 months |
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Term
| What side effects may occur with fluoxetine (Prozac)? |
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Definition
| Common side effects are agitation or insomnia, weight gain, and sexual dysfunction, bruxism (clenching and grinding of teeth) can be caused resulting in headache, jaw pain and dental problems hyponatremia, serotonin syndrome |
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Term
| What causes serotonin syndrome? What are the signs and symptoms? |
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Definition
| SSRIs increase serotonin’s effects they can cause serotonin syndrome. Signs and symptoms ususally begin 2-72 hours after initiation of treatment; include agitation, confusion, hallucinations, incoordination, hyperreflexia, excessive sweating, tremors, and fever. Death can occur, the syndrome resolves with discontinuation of the drug. |
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Term
| What adverse effects may occur with venlafaxine (Effexor)? |
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Definition
| Nausea is the most common side effect; sexual dysfunction and hyponatremia may occur. SNRIs should be tapered slowly when being discontinued to avoid withdrawal symptoms. Concurrent use with an SSRI or another SNRI should be done cautionusly; however MAOIs are contraindicated when taking an SNRI due to the risk of serotonin syndrome. |
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Term
| If a patient is taking a MAOI and is being switched to venlafaxine (Effexor), how many days should the MAOI be discontinued before starting the SNRI? |
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Definition
| MAOIs must be withdrawn at least 14 days before starting an SNRI |
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Term
| What food and drug interactions can occur with phenelzine (Nardil)? |
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Definition
| Foods rich in tryamine can cause a hypertensive cisis if taken with MAOIs. Tryamine promotes the release of norepinephrine sympathomimetics and TCAs can cause hypertensive crisis, SSRIs can cause serotonin syndrome |
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Term
| What drug or food interaction does not occur when selegiline (Emsam) is used at low dosages? |
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Definition
| There is little risk for hypertensive reactions to tryamine with the use of transdermal selegiline in low doses |
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Term
| When bupropion (Wellbutrin) is given with an SSRI, what adverse effect of the SSRI is counteracted? |
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Definition
| Bupropion increases sexual desire and pleasure and has been used to counteract sexual dysfunction in patients taking SSRIs |
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Term
| What adverse effects may occur with bupropion (Wellbutrin)? |
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Definition
| The most serious side effect is seizures, usually occurring when the dosage is too high. The most common adverse effects are agitation, headache, dry mouth, constipation, weight loss, GI upset, insomnia, and tachycardia. MAOIs can increase the risk of bupropion toxicity and patients should discontinue MAOIs at least 2 weeks before starting bupropion therapy. |
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Term
| What response occurs when dopamine receptors are blocked? |
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Definition
| Blockade of dopamine receptors produces movement disorders or extrapyramidal symptoms (EPS). |
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Term
| What response occurs when norepinephrine receptors are blocked? |
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Definition
| (apha-1 block) causes orthostatic hypotension and reflex tachycardia |
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Term
| What response occurs when histamine receptors are blocked? |
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Definition
| Histamine blockade causes weight gain and sedation. |
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Term
| What response occurs when acetylcholine receptors are blocked? |
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Definition
| Blocking acetylcholine receptors cause anticholinergic symptoms such as dry mouth, blurred vision, urinary retention, constipation, and tachycardia |
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Term
| Which symptoms will haloperidol (Haldol) improve? |
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Definition
| Improves the positive symptoms, but may have little effect on the negative symtoms. Initial effects may be seen in 1-2 days, but substantial improvement usually takes 2-4 weeks. Full therapeutic effects may not occur for several months. What are positive symptoms? Positive symptoms are exaggerated or distorted function while negative symptoms are loss of function. Positive symptoms include hallucinations, delusions, disordered thinking, disorganized speech, agitation, and paranoia. Negative symptoms include social withdrawal, emotional withdrawal, lack of motivation, poverty of speech, poor insight, poor judgment, and poor self-care. |
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Term
| Which type of EPS can produce severe spasms of the tongue, face, neck, or back and can cause joint dislocations? |
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Definition
| Acute dystonia develops within the first few days of therapy often within the first few hours. Severe spasms of the tongue, face, neck, or back can occur, laryngeal spasms can impair respirations and severe spasms of the trunk can cause joint dislocations. Intense spasms require an anticholinergic drug such as benztropine or diphenhydramine given IM or IV. |
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Term
| Which type of EPS is characterized by pacing and constant motion? |
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Definition
| Akathisia is an uncontrollable need to be in motion and is characterized by pacing and squirming. It usually developes within the first two months of therapy and may be treated with beta blockers, benzodiazepines, or anticholinergics. Reducing the dose of the antipscychotic or switching to another antipsychotic may be more effective. |
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Term
| Which type of EPS occurs after long-term treatment with antipsychotics and may be irreversible? |
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Definition
| Tardive dyskinesia develops in 15-20% of patients during long-term therapy (over one year) and, for many, symptoms are irreversible. It is characterized by twisting, writhing, worm-like movements of the tongue and face. Lip-smacking and flicking out of the tongue (fly-catching motion) may occur. Involuntary movements of the mouth and tongue can interfere with chewing, swallowing, and speaking. Malnutrition and weight loss can result. Involuntary movements of the limbs, toes, fingers, and trunk can follow. Some patients will have a decline in symptoms with a dosage reduction or discontinuation of the drug. In other patients the symptoms are irreversible. |
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Term
| What adverse effects may occur with haloperidol (Haldol), a typical antipsychotic? |
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Definition
| Adverse effects of a typical antipsychotic drug is neuroleptic malignant syndrome (NMS) which is rare, but serious, symptoms include “lead pipe” rigidity, sudden hyperthermia, sweating, dystrhythmias, blood pressure fluctuations, seizures and coma. Other adverse effects include seizures, sexual dysfunction, dermatologic symptoms, agranulocytosis, and dysrhythmias. |
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Term
| What drug interactions may occur with haloperidol (Haldol)? |
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Definition
| Typical antipschotis can lower the seizure threshold; therefore, patients on antiseizure medication smay need an increase in dose to control seizures. A dosage reduction or switching to a high-potency typical antipsychotic may reduce the effects. Sensitivity to ultraviolet light can occur and patients should be instructed to wear sunscreen and productive clothing. Agranulocytosis is rare but serious and necessitates instructing the patient to report signs of infection (fever, sore, throat) Potentially dysrhythmias can occur with some of the typical antipsychotics (chlorpromazine, thioridazine, haloperidol) anticholinergics intensify anticholinergic effects, CNS depressants intensify CNS depression, levodopa and dopamine decrease effects |
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Term
| What adverse effects may occur with clozapine (Clozaril)? |
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Definition
Can cause agranulocytosis in 1-2% of patients. White blood cell count and absolute neutrophil count is mandatory before treatment, then every two weeks for the next 6 months of treatment. Then every two weeks for the next 6 months and monthly therafter. Common side effects include sedation and weight gain (histamine blockade) and anticholinergic symptoms (acetylcholine blockade), Minimal interference with sexual function occurs. Very low risk of EPS because dopamine blockade is low.
High risk of metabolic effects; weight gain, diabetes and dyslipidemia; with clozapne |
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Term
| What adverse effects may occur with olanzapine (Zyprexa)? |
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Definition
| Common side effects include sedation (histamine blockade) constipation and other anticholinergic effects (acetylcholine blockade) and orthostatic hypotension (norepinephrine blockade) metabolic effects |
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Term
| Which atypical antipsychotic is least likely to cause adverse effects? |
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Definition
| Apripiprazole (Abilify) improves positive and negative symptoms in schizophrenia while posing little to no risk of EPS in contrast to other atypical antipscychotics it is unlikely to cause significant metabolic effects or orthostatic hypotension, and has no risk of anticholinergic effects or dysrhythmias. |
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Term
| What will happen to the serum lithium level if the serum sodium level is 128 mEq? |
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Definition
| Renal excretion of lithium is influenced by sodium levels; specifically, lithium excretion is reduced whn serum sodium levels are low. Dehydration and sodium loss (such as from diarrhea) can be sufficient to cause lithium toxicity. |
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Term
| What drug combinations are used to treat acute manic episodes in bipolar disorder? |
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Definition
With bipolar disorder antipsychotics are used during acute manic episodes even if psychotic symptoms are not present. They are usually used in combination with a mood stabilizer. Atypical antipsychotics are preferred over typical antipsychotics becaue they have a lower risk of extrapyramidal symptoms. The atypical antipsychotics approved for bipolar disorder include olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), aripiprazole (Abilify), andziprasidone (Geodon). They are all effective against acute mania, when used alone or in combination with lithium or valproic acid. Olanzapine is the only one approved for long-term maintenance therapy to prevent recurrence of mood episodes.
During a depressive episode, antidepressants may be used but are always given with a mood stabilizer. The antidepressants used most often for bipolar disorder are bupropion (Wellbutrin), venlafaxine (Effexor), fluoxetine (Prozac), and sertraline (Zoloft). |
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Term
| methylphenidate (Ritalin) |
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Definition
| Other stimulant drug used to treat ADHD; stimulates the CNS heightening alertness and increase focus by regulating the levels of norepinephrine and dopamine |
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Term
|
Definition
| amphetamine drugs used to treat ADHD; stimulates the CNS heightens alertness and increase focus by regulating the levels of norepinephrine and dopamine |
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Term
|
Definition
| first non-stimulant drug approved for ADHD; inhibits the reuptake of norepinephrine, causing it to accumulate at the synaptic junction |
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Term
|
Definition
| a stimulant drug approved for promoting wakefulness in patients with excessive sleepiness such as narcolepsy or shift-work sleep disorders. Mechanism of action unknown, some evidence suggests blocking the reuptake of norepinephrine. |
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Term
|
Definition
| a CNS and repiratory stimulant that is used to treat respiratory depression caused by drug overdose, anesthesia, or chronic obstructive pulmonary disease. |
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Term
|
Definition
| intermediate-acting barbiturate; used to sustain sleep |
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Term
|
Definition
| most widely used antiseizure drug; blocks sodium influx into the cell suppressing hyperactive neurons and preventing action potentials; used to treat all forms of seizures; sedation and other CNS effects are mild |
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Term
|
Definition
| short acting barbiturate used to induce sleep for those who have difficulty falling asleep |
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Term
|
Definition
| benzodiazepine; treat anxiety and insomnia; induce general anesthesia and treat seizures, muscle spasms, panic disorder, and alcohol withdrawl |
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Term
|
Definition
| neuromuscular blocking agent (muscle relaxant) prevents contraction of all skeletal muscles requires ventilation in anesthesia; nondepolarizing neuromuscular blockers because they relax the muscles without first causing depolarization. |
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Term
|
Definition
| cholinesterase inhibitor; causes a buildup of acetylcholine at the neuromuscular junction by inhibiting cholinesterare the enzyme that breaks it down; reverses non depolarizing neuromuscular blockers |
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Term
| succinylcholine (Anectine) |
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Definition
| depolarizing neuromuscular blocking agent (causes contraction of muscles before relaxation) paralysis is brief because it is metabolized by the enzyme pseudocholinesterase; primarily used for muscle relaxation during endotracheal intubation for short procedures; adverse effects include prolonged apnea in patients who have low levels of pseudocholinesterase, malignant hyperthermia can be triggered – treated by ice packs, cold IVs and dantrolene (Dantrium) |
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Term
|
Definition
| general anesthetics administered by inhalation; used to induce general anesthesia and to maintain general anesthesia; adverse effects include respiratory and cardiac depression requires mechanical ventilation |
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Term
|
Definition
| use to treat hyperthermia from succinylcholine, acts by reducing the metabolic activity of skeletal muscles |
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Term
|
Definition
| an intravenous agent that produces dissociative anesthesia in which the patient feels dissociated from his or her environment; produces sedation, immobility, analgesia, and amnesia; used for short-term surgery of diagnostic procedures; increases salivation, heart rate, and blood pressure; adverse psychological reactions can occur during recovery including hallucinations, disturbing dreams and delirium; this can be minimized by keeping the patient in a soothing stimulus-free environment until recovery is complete. |
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Term
|
Definition
| local anesthetic commonlay used for infiltration; infiltration anesthesia involves injection the local anesthetic directly into the immediate area where the procedure will be performed; anesthesia can be prolonged using epinephrine to constrict blood vessels keeping it in the desired area longer |
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Term
|
Definition
| effective against partial seizures and tonic-clonic seizures; blocks the influx of sodium into the cell (the same as phenytoin). Therapeutic serum range is 5-12 mcg/ml; has minimal effect on cognitive function but can cause many neurologic effects; nystagmus, blurred vision, diplopia, ataxia, vertigo, unsteadiness, and headache occur in 35-50% of patients during the first weeks of treatment; tolerance usually develops. Side effects can be minimized by starting doses low and giving the highest doses at bedtime; bone marrow suppression can occur causing leukopenia, anemia, and thrombocytompenia (CBC periodically) Birth defects; decrease in concentration of body fluids (hypo-osmolality) from increased ADH secretion can be harmful to heart failure patients test serum sodium levels; associated w/ severe skin reactions (stevens-Johnson syndrome |
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Term
|
Definition
| drug of choice for absence seizures, the only indication for this drug; works by inhibiting calcium influx; adverse effects include drowsiness, dizziness, and lethargy which usually decrease w/ continued use. N&V can be reduced by taking w/ food, rare but serious adverse reactions include systemic lupus erythematosus, leukopenia, aplastic anemia, and stevens-johnson syndrome |
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Term
|
Definition
| one of the most effective drugs for Parkinson’s Disease; is converted to dopamine after entering the brain; adverse effects include N&V, symptoms may be well controlled for the first two years of use, but by the end of 5 years the disease tends to progress further reducing its effectiveness |
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Term
|
Definition
| type B monomine oxidase inhibitors (MAO-B) can be used or with levodopa for parkinson’s disease; selectively inhibits the enzyme that inactivates dopamine in the brain; can cause insominia, but this can be minimized by taking the last daily dose by noon. High doses can inhibit MAO-A; this enzyme inactivates norepinephrine and serotonin; inhibition of MAO-A can cause vasoconstriction and hypertension; can intensify adverse reactions to levodopa such as orthostatic hypotension, dyskinesias, and hallucinations. Should not be used with meperidine (Demerol), or within 5 weeks of fluoxetine (Prozac) |
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Term
|
Definition
| anticholinergic; inhibits the release of acetylcholine,reduces the rigidity and some of the tremors, but not the bradykinesia; this is one of the commonly used agent; adverse effects are dry mouth, blurred vision, photophobia, urinary retention, constipation, and tachycardia; the elderly usually do not tolerate the CNS effects of sedation, confusion, delusions and hallucinations so younger patients with mild symptoms are the most appropriate candidates for anticholinergic therapy |
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Term
| pyridostigmine (Mestinon) |
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Definition
| cholinesterase inhibitor prevents the breakdown of acetylcholine, cholinesterase inhibitors increase the effect of acetylcholine at the motor junction and relieve muscular weakness used to treat myasthenia gravis; side effects include N&V, diarrhea, abdominal pain, increased salivation and tearing, miosis, blurred vision, bradycardia and hypotension |
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Term
|
Definition
| used to distinguish wheter the patient is in cholinergic or myasthenic crisis, this ultrashort-acting cholinesterase inhibitor can be given, if it relieves the symptoms, the crisis is myasthenic. If the symptoms worsen a cholinergic crisis is occurring and atropine, and anticholinergic is given to relieve the symptoms |
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Term
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Definition
| immunomodulator used in the treatment of MS; works by reducing the number of proinflammatory T cells and increasing the number of anti-inflammatory T cells; doesn’t cause flu-like reactions, bone marrow suppression, or liver injury; injection site reactions are the most common side effect w/ pain, redness, itching, and pitting occurring; postinjection reaction lasting 15-20 minutes occurs in 10% of patients includes flushing, palpitations, severe chest pain, anxiety, laryngeal constriction, and urticarial it is self-limiting and requires no treatment |
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Term
| mitoxantrone (Novantrone) |
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Definition
| immunosuppressant; more toxic than immunomodulators, produces greater immune suppression. Bone marrow suppression reduces all blood cell types and leukopenia puts the patient at risk for severe infection; can cause irreversible heart damage and the patient should be monitored for signs of heart failure (peripheral edema, fatigue, and shortness of breath), toxic to rapidly dividing cells so GI symptoms and hair loss may occur, may turn the urine, skin and sclera a harmless blue-green tint |
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Term
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Definition
| cholinesterase inhibitor; prevents the breakdown of acetylcholine enhancing transmission by central cholinergic neurons that have not been destroyed by the disease; may slow progression of alzheimer’s disease by a few months, but does not stop progression; indicated for mild to moderate disease; can cause cholinergic side effects of N&V, dyspepsia, diarrhea, bradycardia, and bronchoconstriction. Dizziness and headache are common, significant weight loss occurs in about one-fourth of patients |
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Term
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Definition
| centrally acting muscle relaxant, used to treat muscle spasms; can cause CNS depression w/ drowsiness, dizzieness, and lightheadedness being the most common symptoms Chronic high-dose therapy can result in physical dependence d/c slowly |
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Term
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Definition
| used to treat anxiety; not a CNS depressant, no abuse potential, does not intensify effects of CNS depressants; effects develop slowly; most common adverse effects are dizziness, nausea, headache, nervousness, lightheadedness, and excitement, drug interactions including increased busipirone levels with erythromycin or ketoconazole (antimicrobial agents) grapefruit juice also increases |
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Term
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Definition
| tricyclinc antidepressant; blocks reuptake of norepinephrine and serotonin at the synaptic junction prolongin and intensifying their effects; takes 1-3 weeks to take maximal effect, most common side effect is orthostatic hypotension due to alpha 1 blockade on blood vessels also sedation anticholinergic effects |
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Term
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Definition
| tricyclinc antidepressant; blocks reuptake of norepinephrine and serotonin at the synaptic junction prolongin and intensifying their effects; takes 1-3 weeks to take maximal effect, most common side effect is orthostatic hypotension due to alpha 1 blockade on blood vessels also sedation anticholinergic effects |
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Term
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Definition
| selective serotonin reuptake inhibitor; blocks reuptake of serotonin at the synaptic junction; side effects are agitation or insomnia, weight gain, and sexual dysfunction |
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Term
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Definition
| selective serotonin reuptake inhibitor; blocks reuptake of serotonin at the synaptic junction; side effects are agitation or insomnia, weight gain, and sexual dysfunction |
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Term
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Definition
| Serotonin/norepinephrine reuptake inhibitor; blocks reuptake of serotoinin and norepinephrine w/ minimal effects on the other neurotransmitters; Nausea is most common side effect, sexual dysfunction and hyponatremia may occur taper slowly |
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Term
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Definition
| Monoamine oxidase inhibitor (MAOI); enzyme inactivates the neruotransmitters norepinephrine serotonin and dopamine; generally reserved for patients who have not responded to TCAs or SSRIs |
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Term
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Definition
| Monoamine oxidase inhibitor (MAOI); enzyme inactivates the neruotransmitters norepinephrine serotonin and dopamine; generally reserved for patients who have not responded to TCAs or SSRIs |
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Term
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Definition
| only MAOI administered by transdermal patch |
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Term
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Definition
| SSRI blocks reuptake of serotonin treats depression |
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Term
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Definition
| a unique antidepressant similar in structure and some actions to amphetamine (has stimulant properties and suppresses appetite); full effects in 1-3 weeks, does not cause weight gain or sexual dysfunction, increases sexual desire and pleasure |
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Term
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Definition
| Typical antipsychotic, high-potency, improves exaggerated or distorted function including hallucinations, delusions, disordered thinking, disorganized speech, agitation, and paranoia; has little effect on social withdrawal, emotional weithdrawal lack of motivation poverty of speech poor insight poor judgment and poor self-care |
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Term
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Definition
| low-potency typical antipsychotic takes higher doses to achieve affect; improves positive symptoms but not negative symptoms |
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Term
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Definition
| most effective drug for schizophrenia; can cause agranulocytosis in 1-2% of patients; should be reserved for thos who have not responded to other antipsychotics; monitor WBC, sideffects: sedation, wight gina, orthostatic hypotension, anticholinergic symptoms |
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Term
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Definition
| blocks serotonin, dopamine, histamine, acetylcholine and norepinephrine receptors; low risk of EPS, higher risk for metabolic effects |
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Term
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Definition
| improves positive and negative symptoms of schizophrenia while posing little to no risk of EPS; unlikely to cause significant metabolic effects or orthostatic hypotension, no risk of anticholinergic effects or dysrhythmias |
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Term
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Definition
| mood stabilizer; relieves symptoms during manic and depressive episodes, prevent recurrence of manic and depressive episodes and do not worsen symptoms of mania or depression; has a low therapeutic index |
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Term
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Definition
| controls sympotoms of acute manic episodes and helps prevent recurrence of mania and depression; higher therapeutic index than lithium and causes fewer side effects |
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Term
| chlorpromazine (Thorazine) |
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Definition
| used to treat schizophrenia, nausea, and hiccups that have lasted longer than a month; CNS depressant |
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