Term
|
Definition
| It is a covering of astrocytes that encircle capillary walls of brain. Allows water, alcohol, oxygen, C02, glucose, gases and lipid soluble substances to penetrate |
|
|
Term
| OCD, PTSD, GAD, panic disorder and social phobia are all classified as what? |
|
Definition
|
|
Term
|
Definition
| Depresses activity in the limbic and hypothalamus/brainstem/thalamic areas. Increases GABA, all benzies are Schedule IV. Also causes muscle relaxation, analgesic effects, and anticonvulsant effects. Also can cause sedation and hypotension |
|
|
Term
| Benzodiazepines prototype |
|
Definition
|
|
Term
| What are the symptoms of Benzo overdoses? |
|
Definition
Lethargy
Confusion
Respiratory depression
Hypotension
Cardiac and respiratory arrest |
|
|
Term
| Treatment for benzo overdose |
|
Definition
treat symptoms
- supportive measures
- gastric lavage
- activated charcoal |
|
|
Term
| What is the antidote for benzodiazepines? |
|
Definition
| Antidote is flumazenil (romazicon) |
|
|
Term
| Nursing interventions for Benzos |
|
Definition
Safety
Side rails
Ambulation assistance
Fall prevention
Monitor for CNS depression
Assess LOC (level of consciousness)
Assess anxiety level
Monitor for abuse |
|
|
Term
| Patient teaching for Benzos |
|
Definition
Don’t double dose
Avoid other CNS depressant agents (ie: alcohol)
Avoid driving/using heavy machinery
Don’t stop abruptly. Need to taper doses. |
|
|
Term
|
Definition
| Anti-anxiety. Once commonly prescribed. Now benzos are preferred |
|
|
Term
| What is the MOA of Barbiturates |
|
Definition
| Nonselective depression of CNS, increased GABA |
|
|
Term
|
Definition
| Phenobarbital (luminal) which is long acting |
|
|
Term
|
Definition
Epilepsy
Insomnia
Short term
Lose effectiveness in about 2 weeks
Preanesthetic sedation
IV anesthetic |
|
|
Term
|
Definition
CNS depression
Respiratory depression
Hypotension |
|
|
Term
| Barbiturate adverse effects |
|
Definition
Tolerance
Physical dependence
Abrupt withdrawal can be fatal
Abuse
Barbiturates have a very narrow therapeutic index
Overdose can be fatal |
|
|
Term
| In order for a person to be diagnosed as having a major depression disorder, what must they present with? |
|
Definition
, the patient must exhibit 5 elements that are present most of the day, nearly every day for a period of at least two weeks out of the following two categories:
Depressed mood
Anhedonia |
|
|
Term
| Initial response to antidepressant medication |
|
Definition
|
|
Term
| Maximal response to antidepressant medication |
|
Definition
| might not be felt until 12 weeks into treatment |
|
|
Term
| A drug cannot be considered ineffective until what? |
|
Definition
| It has been taken for 1 month without pt improvement |
|
|
Term
| How long should antidepressant treatment last? |
|
Definition
| 4-9 months after symptoms are in remission |
|
|
Term
|
Definition
First available in Western medicine
Blocks serotonin and norepinephrine reuptake |
|
|
Term
|
Definition
Second or third-line antidepressants
Inhibits monoamine oxidase enzyme
Numerous drug and food interactions |
|
|
Term
|
Definition
Current first line therapy
Safer and as effective
Blocks reuptake of serotonin |
|
|
Term
|
Definition
Blocks reuptake of serotonin and norepinephrine
Side effects similar to SSRI’s |
|
|
Term
| Tryclic antidepressant prototype |
|
Definition
|
|
Term
| Is imipramine (tofranil) Often used as a first learn therapy? What are the side effects? |
|
Definition
RARELY used as first line. Significant anticholinergic effects
Dry mouth
Tachycardia
Urinary retention
Constipation
Blurred vision
Significant orthostatic hypotension
Sedation
Increased risk for seizures
Overdose can be fatal
Cardiac dysrhythmias |
|
|
Term
| Nursing assessments/interventions for tricylics |
|
Definition
Assess for effectiveness
Assess for compliance
Assess cardiovascular system
EKG before starting may be required
Monitor for side effects
Assess for suicide ideation |
|
|
Term
| Tricylic nursing teaching |
|
Definition
Takes 1-3 weeks to see benefit
anticholinergic effects
Avoid Use of hard candy, gum
Good oral care
Rise slowly to avoid orthostatic BP effects
Treatment will continue for 4-9 months |
|
|
Term
|
Definition
| tranylcypromine (Parnate) |
|
|
Term
|
Definition
| Inhibits MAO enzyme in the liver, intestinal walls and ends of some neurons |
|
|
Term
| How long does it take an MAOI to take effect? Is it a first choice med? |
|
Definition
| 1-3 weeks. Considered a THIRD choice after SSRI and TCA. |
|
|
Term
| What are MAOIs effective in treating and what are their side effects? |
|
Definition
Effective in treating atypical depression
Side effects:
Orthostatic hypotension
CNS stimulation
Hypertensive crisis |
|
|
Term
|
Definition
| Hypertensive crisis as a result of interaction with tyramine containing foods |
|
|
Term
| What foods contain tyramine? |
|
Definition
| cheese, smoked/pickled meats, aged/fermented meats, yeast. sauerkraut, beer/chianti wines |
|
|
Term
| What are the symptoms of an MAOI hypertensive crisis? |
|
Definition
| Tachycardia, palpitations, headaches, sweating, Nausea/vomiting |
|
|
Term
| What do we teach pts with MAOIs |
|
Definition
Orthostatic hypotension
Dietary restrictions
Provide specific list
Signs of hypertensive crisis
Avoid all other drugs/supplements (including OTC)
unless approved by provider |
|
|
Term
| What do we assess with MAOIs? |
|
Definition
| effectiveness, med and diet compliance, cardio system, side effects, suicide ideation |
|
|
Term
| Can a TCA be given with an MAOI? How about an MAOI with a TCA? |
|
Definition
| You can give a TCA with an MAOI, but not the other way around |
|
|
Term
| When you start an MAOI and TCA at the same time, what dose do you give? |
|
Definition
|
|
Term
| If the decision is made to switch from an MAOI to a TCA, how long is the wash-out period? |
|
Definition
| 2 weeks between the drugs |
|
|
Term
| If the decision is made from switching to an SSRI from an MAOI? |
|
Definition
| 2-5 weeks between the drugs |
|
|
Term
| Can you use an MAOI and SSRI at the same time? |
|
Definition
| No. They are contraindicated |
|
|
Term
| What is the prototype of SSRIs? |
|
Definition
|
|
Term
|
Definition
| Selective serotonin Reuptake Inhibitors |
|
|
Term
| How long does it take for an SSRI to be effective? |
|
Definition
| Takes up to 4 weeks for effectivness |
|
|
Term
| Do SSRIs have a long or short half life? |
|
Definition
| Long, which allows for daily doses |
|
|
Term
| Is fluoxetine highly protein bound? |
|
Definition
| Yes, it binds at a high rate |
|
|
Term
| Which has fewer anticholinergic and cardiac effects, TCA's or SSRI's? |
|
Definition
| SSRI's. Death by overdose is rare. |
|
|
Term
|
Definition
| Nausea, Sexual dysfunction, Insomnia, weight gain, serotonin syndrome (SES) |
|
|
Term
|
Definition
| Take in morning to reduce insomnia, take for 4 weeks to see benefits, sexual dysfunction, weight gain, tx is 4-9 months |
|
|
Term
|
Definition
| Seratonin/Norepinephrine reuptake inhibitors |
|
|
Term
|
Definition
| Venlafaxine (Effexor) very similar to SSRI's. equally effective and similar side effects |
|
|
Term
|
Definition
Characterized by mood swings from depression to euphoria. Drugs used to treat this disorder are called “mood stabilizing drugs”
Is chronic condition requiring life-long treatment |
|
|
Term
|
Definition
Inflated self esteem/grandiosity
Speech hyperactivity
Motor hyperactivity
Decreased sleep requirements
Flight of ideas
Poor judgment
Inappropriate social behavior
Possible aggression and hostility
Involvement in reckless behaviors
Impulsive shopping
Hypersexual activity |
|
|
Term
| Antimania Agents prototype |
|
Definition
|
|
Term
| What does lithium affect which decreases neurotransmitter release? |
|
Definition
|
|
Term
| Lithium "Facts" need to know |
|
Definition
Exact mood stabilizing mechanism is unknown
Dosing is individualized to patient
Short half-life
Administered several times a day
Metabolized/excreted via kidneys
Narrow therapeutic index |
|
|
Term
|
Definition
|
|
Term
| Signs of lithium toxicity (late to early) |
|
Definition
| Fine motor hand tremors, NVD, Muscle weakness, slurred speech, drowsiness, blurred vision, seizures |
|
|
Term
| Nursing Assessments for Lithium |
|
Definition
| Assess history/frequency of manic. Moniter serum lithium levels |
|
|
Term
| When should lithium be administered and why? |
|
Definition
| After meals to decrease GI upset |
|
|
Term
| When do we monitor serum lithium levels? |
|
Definition
| Weekly until stabilized. Drawn in am before morning dose |
|
|
Term
| What do we educate with serum lithium? |
|
Definition
| Compliance, regular drug levels, toxicity symptoms, increased fluids, maintain consistent sodium intake |
|
|
Term
|
Definition
| A term used to describe a loss of contact with reality. Can be acute or chronic. Characterized by delusions, hallucinations, lack of insight and judgement, inappropriate mood an affect |
|
|
Term
| Positive psychotic symptoms |
|
Definition
| symptoms reflect an increase in the presence of abnormal behaviors. These active, abnormal symptoms are hallucinations, delusions, thought disorders and movement disorders |
|
|
Term
| Negative psychotic symptoms |
|
Definition
| an absence of normal behaviors found in healthy individuals. They may appear months of years before positive symptoms. They are loss of interest, lacking motion, reduced ability to carry out activities, neglect of personal hygiene, social withdrawal, loss of motivation |
|
|
Term
| Cognitve psychosis symptoms |
|
Definition
| problems with thought processes, these might be the most disabling in schizophrenia, because they interfere with the ability to perform ADLS. 1. problem w/ making sense of information 2. Difficulty paying attention 3. memory problems |
|
|
Term
| First generation conventional Antipsychotics |
|
Definition
|
|
Term
|
Definition
| EPS (extrapyramidal symptoms) dystonia, akathesia, parkinsonian, tardive dyskinesia, NMS (Neuroleptic malignant syndrome 4% risk of death) agranulocytosis, sedation, orthostatic hypotension, sexual dysfunction, anticholinergic effects |
|
|
Term
| Second Generation "atypical" antipsychotics |
|
Definition
|
|
Term
|
Definition
| Agranulocytosis, orthostatic hypotension, weight gain, type II diabetes, dysplidemia, lower risk of EPS, NMS |
|
|
Term
| Risperidone (Risperdal) MOA |
|
Definition
| Blocks dopamine and serotonin receptors |
|
|
Term
| How long does it take for Risperdal to take effect? |
|
Definition
| 1-2 days, significant improvement in 1-2 weeks |
|
|
Term
|
Definition
| Weight, vitals, ADLS, Labs (CBC, Drug Levels, Renal/Liver studies), behavior, emotional, medication compliance, therapy compliance |
|
|
Term
|
Definition
whatever the patient says it is
whenever the patient says it exists
an unpleasant sensory and emotional experience
associated with actual or potential tissue damage
a personal and individual experience |
|
|
Term
|
Definition
| to maintain a patient pain level that is acceptable to the patient and allows for self-care and ADL’s” |
|
|
Term
|
Definition
The patient is the expert of their pain
Pain management is a patient right
Non drug interventions should be routinely utilized
Dosing should be individualized
Adverse effects should be actively and proactively managed
Preventative round the clock dosing for moderate to severe pain should be implemented |
|
|
Term
| Pain Transmission Gate Theory |
|
Definition
Tissue injury causes the release of Bradykinin, Histamine, Potassium, Prostaglandins, Serotonin
stimulate “A” fibers or “C” fibers of nerves, starting the pain process
These pain fibers enter the spinal cord and travel up to the brain through a “gate”
This gate regulates the flow of sensory impulses
Closing the gate stops the impulses
If no impulses are transmitted to higher centers in the brain, there is no pain perception |
|
|
Term
| Factors that lower pain threshold |
|
Definition
| Anxiety, sleeplessness, tiredness, anger, fear/fright, depression, discomfort, pain, isolation |
|
|
Term
| Factors that raise pain threshold |
|
Definition
| Sleep, rest, diversion, empathy, analgesics, anti-anxiety agents, antidepressants |
|
|
Term
| JCAHO pain management standards/appropriate documentation |
|
Definition
| assessment, management, education and evaluation |
|
|
Term
|
Definition
| Aka opioid agonists. Derived from poppy. |
|
|
Term
|
Definition
| Morphine sulfate, used for moderate to severe pain, do not use abbreviation MS04, easily confused with MgSO4 |
|
|
Term
| What class is Morphine sulfate? |
|
Definition
| Schedule II. Pregnancy category D |
|
|
Term
| What is Morphine Sulfate's action |
|
Definition
| Stimulates specific opiate receptors in the brain to alter pain preception |
|
|
Term
| How can you give Morphine Sulfate? |
|
Definition
| Route: IV, SQ, PO, PR, Inhaled |
|
|
Term
| Morphine what is onset, peak, and uration? |
|
Definition
| onset 20 min, peak 1 hr, duration 3-7 hours. Given pre-anesthesia, adjunct to mech ventilation |
|
|
Term
| Morphine sulfate side effects |
|
Definition
CNS depression
Respiratory depression
Pupil miosis
Orthostatic hypotension
Constipation
Nausea and vomiting
Facial flushing
Urinary retention |
|
|
Term
| Morphine sulfate contraindications |
|
Definition
Known drug allergy
Pregnancy
Severe asthma or other respiratory insufficiency
Elevated intracranial pressure
Trauma
Disease |
|
|
Term
| Morphine Sulfate: toxicity/overdose management prototype |
|
Definition
| Opioid antagonists, naloxone (Narcan) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 60-100 min, may need more than one dose |
|
|
Term
| What does Narcan reverse? |
|
Definition
| Respiratory depression, sedation, pain control |
|
|
Term
| Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) |
|
Definition
Subclass: salicylate
acetylsalicylic acid (Aspirin)
Subclass: Propionic acid
ibuprofen (Motrin) |
|
|
Term
| NSAIDs have what properties? |
|
Definition
Analgesic
Anti-inflammatory
Antipyretic
Anti-rheumatic |
|
|
Term
|
Definition
Analgesia (mild to moderate)
Anti-inflammatory effects
Antipyretic effects
Antigout effects
Relief of vascular headaches
Platelet inhibition (aspirin only)
Osteoarthritis, rheumatoid arthritis |
|
|
Term
| NSAIDs side effects Gastrointestinal |
|
Definition
Dyspepsia, heartburn, epigastric distress, nausea
GI bleeding
Mucosal lesions (erosions or ulcerations) |
|
|
Term
|
Definition
| Reductions in creatinine clearance, acute tubular necrosis with renal failure |
|
|
Term
| NSAIDs Cardiovascular side effects |
|
Definition
|
|
Term
| NSAID sublass Salicylates |
|
Definition
| acetylsalicylic acid (Aspirin) |
|
|
Term
| acetylsalicylic acid (Aspirin) |
|
Definition
Affects platelet aggregation
Analgesic
Antipyretic
Anti-inflammatory
Anti-thrombotic effect: used in the treatment of MI and other thromboembolic disorders |
|
|
Term
| Aspirin Contraindications |
|
Definition
| GI lesions/peptic ulcer disease, bleeding disorders |
|
|
Term
| Lab studies for Salicylates |
|
Definition
| Cardiac, renal, liver studies, CBC, platelet count |
|
|
Term
| Salicylates drug interactions |
|
Definition
| alcohol, herapin, phenvtoin, oral anticoagulants, steroids, sulfonamides |
|
|
Term
| Why are Salicylates not given to children under the age of 12? |
|
Definition
| The risk of Reye's syndrome (sudden (acute) brain damage and liver function problems of unknown cause) |
|
|
Term
|
Definition
| "Non-Narcotics" such as acetaminophen (Tylenol) |
|
|
Term
|
Definition
| Analgesic/antipyretic effects, little to no anti-inflammatory effects, available OTC and in combo products with opioids |
|
|
Term
| Acetaminophen/Tylenol MOA |
|
Definition
| Similar to salicylates, blocks pain impulses peripherally by inhibiting prostaglandin synthesis |
|
|
Term
| Indications of Acetaminophen |
|
Definition
| Mild to moderate pain, fever, alternative for those who cannot take aspirin products |
|
|
Term
|
Definition
| Potentially lethal agents! Healthy adult limit is 4000 mg/day, monitor ALL sources |
|
|
Term
| What does acetaminophen toxicity cause? |
|
Definition
| Causes hepatic damage, long term use of large doses can also lead to nephropathy |
|
|
Term
| What is the antidote of acetylcysteine (mucomyst) |
|
Definition
|
|
Term
|
Definition
Medicate patients before the pain becomes severe
Offer/administer at regular intervals
Offer before planned painful activity
Dressing change
Ambulation
Pain management includes pharmacologic and nonpharmacologic approaches |
|
|
Term
|
Definition
| A drug induced state in which the CNS is altered to produce varying degrees of pain relief, depression of consciousness, skeletal muscle relaxation, and diminished or absent reflexes |
|
|
Term
|
Definition
| Agents that induce the loss of sensation throughout the entire body and includes loss of consciousness . This is necessary for major surgical procedures |
|
|
Term
|
Definition
| Agents that result in a loss of sensation to a limited body region. Does not cause loss of consciousness. |
|
|
Term
|
Definition
| Similar to local anesthesia, except that it involves a larger body area - such as an entire limb |
|
|
Term
| MAC anesthesia (monitored anesthesia care |
|
Definition
| Anesthesia that use sedatives, analgesics and other low-dose drugs during diagnostic procedures and minor surgery that allow patients to be responsive and breath without assistance |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Relieve anxiety/relax muscle groups |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Block reflexes that may be affected by procedure |
|
|
Term
|
Definition
| Life threatening. Caused by failure of Ca+ reuptake into the muscles. |
|
|
Term
| Malignant hyperthermia Symptoms |
|
Definition
| Usually within 30 mi of induction. Tachycardia, arrhythmias, prolonged/intense muscle contractions, elevated temperature (>104), flushing, cyanotic skin, hyperkalemia, cardiovascular and respiratory collapse |
|
|
Term
| Prognosis/prevention of malignant hyperthermia |
|
Definition
| fatal 10-20 percent of the time. Check family history |
|
|
Term
| Treatment of Malignant hyperthermia |
|
Definition
| Give dantrolene (dantrole), give sodium bicarbonate, decrease temp |
|
|
Term
| General Anesthesia pre-procedure pt teaching |
|
Definition
What procedure is being done
When to check in at the hospital
When to stop eating and drinking fluids
When (and if) to stop taking medications
Refrain from drinking alcohol for 24 hours prior to surgery
Stop any herbal supplements 2-3 weeks prior to surgery or per MD instruction |
|
|
Term
| post-op nursing assessment general anesthesia |
|
Definition
Maintain patient safety
Monitor vital signs
Evaluate LOC
Monitor recovery from anesthesia/procedure
Evaluate for nausea/vomiting
Assess for shivering
Evaluate pain |
|
|
Term
| local anesthesia: surface |
|
Definition
| Applied or sprayed directly on skin or mucous membranes. Does not penetrate deeper skin layers |
|
|
Term
| Local anesthesia: infiltration |
|
Definition
| Injected into deeper skin layers and affects surrounding region |
|
|
Term
| Local anesthesia: Nerve Block |
|
Definition
| Injected by surrounding a peripheral nerve and impacts all regions served by that nerve |
|
|
Term
| local anesthesia: Epidural |
|
Definition
| Injected into the epidural space surrounding the spinal cord |
|
|
Term
|
Definition
| Injected into cerebrospinal fluid, usually in the lumbar region |
|
|
Term
| Effect of local Anesthetics |
|
Definition
| Sense of pain affected first, followed by sensations of cold, heat, touch and pressure. Recovery is in reverse order! |
|
|
Term
| prototype of local anesthetics |
|
Definition
|
|
Term
| Lidocaine onset of action, duration |
|
Definition
| 2-5 minutes, effects last 10-90 minutes |
|
|
Term
|
Definition
| Surface and infiltration. Never given PO because it is inactivated by GI acids. Available in several strengths |
|
|
Term
| Lidocaine with epinephrine (a vasoconstrictor) |
|
Definition
The addition of a vasoconstrictor extends the action of the lidocaine.
The vasoconstrictor also decreases bleeding into the laceration while suturing.
Cannot use on nose, ears, hands/fingers, feet/toes or penis (use plain lidocaine) |
|
|
Term
| Lidocaine nursing implications |
|
Definition
Assess for allergies prior to administration
Understand use of plain lidocaine vs lidocaine with epi
Read label carefully
Many strengths available!!
Evaluate for pain sensation prior to starting procedure
Assess for gag reflex prior to offering oral fluids/food or medications after oral procedures
Protect anesthetized area from injury
Monitor for systemic effects |
|
|
Term
|
Definition
Lidocaine solution for throat or mouth pain should be swished and spit out
Do not consume hot foods/beverages until full sensation returns following oral procedures
Do not chew gum following oral procedure until sensation returns
Protect local area from injury until sensation returns
Discard of lidocaine patches safely |
|
|
Term
| RN considerations for Lidocaine |
|
Definition
Topical – wear gloves when applying
Oral – avoid providing patient with food and water till gag reflex is present
Epidural/spinal – safety precautions, watch for return of motor function, monitor respiratory status
If mixed with epinephrine, avoid ischemic tissues
Carefully check vial (color coded) for correct strength, route and presence of preservatives
Check for allergies |
|
|
Term
| General Anesthesia Prototype |
|
Definition
|
|
Term
| What is the most widly used IV anesthetic? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Does propofol have analgesic properties, onset/duration? |
|
Definition
| Rapid onset (60 secs) short duration (3-5 min) and no analgesic properties |
|
|
Term
| When do open propofol vials need to be discarded? |
|
Definition
|
|
Term
|
Definition
| for extended sedation, needs to be continuous infusion, can cause profound respiratory depression,hypotension. Has a narrow therapeutic range. Can cause propofal infusion syndrome, has an abuse potential |
|
|
Term
| Propofal infusion syndrome |
|
Definition
| to cardiac failure, rhabdomyolysis, metabolic acidosis, and renal failure, and is often fatal. |
|
|
Term
|
Definition
Progressive, neurodegenerative disorder
Usual age of onset is 40-70 years old
Caused by a lack of production of dopamine |
|
|
Term
| What are the 4 cardinal symptoms of Parkinson's |
|
Definition
Tremor
Muscle rigidity
Bradykinesia
Postural instability |
|
|
Term
| Is there a cure for Parkinson's? |
|
Definition
| NO. Only symptom alleviations |
|
|
Term
|
Definition
| Directly activate the dopamine receptors |
|
|
Term
|
Definition
| Levopoda. A precursor to the synethesis of dopamine |
|
|
Term
|
Definition
| Benztropine (Cogentin). Blocks acetylcholine effects, thus allowing for dopamine to have a greater influence |
|
|
Term
|
Definition
Drug of choice for Parkinson’s
Can cross blood-brain barrier
Undergoes conversion to dopamine
Nearly always combined with carbidopa
Enhances effect of levodopa |
|
|
Term
|
Definition
| Carbipoda and levodopa combined |
|
|
Term
| Levodopa effect, onset, half life |
|
Definition
| 2-3 weeks until effect is noticed, onset of action 1-3 hours, short half life (1 hour) need to take several times per day, take on empty stomach (food delays absorption, high protein decreases absorption) |
|
|
Term
| What happens with prolonged levodopa therapy? |
|
Definition
| May cause weaning effect, which makes it less effective. Need to increase frequency of dosing. Add another type of med to regime |
|
|
Term
|
Definition
Orthostatic hypotension
Nausea/vomiting
Dyskinesias
Postural hypotension
Psychosis
Agranulocytosis |
|
|
Term
|
Definition
A neuropsychiatric condition
Presents before age 7
Occurs in 3-7% of all children
More males than females
Characterized by:
Impulsive behavior
Lack of attention
hyperactivity |
|
|
Term
|
Definition
| Methylphenidate (Ritalin) |
|
|
Term
| Methylphenidate (Ritalin)M MOA |
|
Definition
| Promotes norepinephrine and dopamine release |
|
|
Term
| Who is Methylphenidate (Ritalin) contraindicated in? |
|
Definition
|
|
Term
| Adverse effects of Ritalin? |
|
Definition
| Insomnia, reduced appetite, growth suppression |
|
|
Term
|
Definition
Obtain baseline height and weight
Monitor height/weight at each follow-up appointment
Review activity log of symptoms |
|
|
Term
|
Definition
Take am dose after breakfast
Don’t take PM dose after 4pm
Minimize caffeine intake
Don’t stop abruptly
Notify MD: tachycardia/palpitations/angina |
|
|
Term
| Ritalin prescription restrictions |
|
Definition
Need written prescription
No refills can be indicated on written Rx
Limited quantities
Parents should be aware of school policies |
|
|
Term
|
Definition
May or may not involve loss of consciousness
Simple partial
Complex partial |
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Term
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Definition
Loss of consciousness
May be convulsive or non-convulsive
Absence
Tonic-clonic
Atonic |
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Term
| What does phenytoin (Dilantin) do? |
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Definition
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Term
| What does acetazolamide (Diamox) do? |
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Definition
| Suppresses calcium influx |
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Term
| What does phenobarbital (luminal) or diazepam (valium) do? |
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Definition
| They potentiate GABA, which is an inhibitory neurotransmitter |
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Term
| what is the most widely used antiepileptic drug? |
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Definition
| Phenytoin (Delantin). it was the first drug to suppress seizures without suppressing entire CNS |
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Term
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Definition
| Selective inhibition of sodium channels |
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Term
| What type of seizure does Dilantin treat? |
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Definition
| All except absence. Especially effective for tonic-clonic seizures. Affects CYP450 enyzmes |
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Term
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Definition
Dosing is highly individualized
Initial doses usually given twice a day
Has a narrow therapeutic index!
NEVER EVER stop abruptly. Do not use during pregnancy. May use once a day extended capsule when stable dose is determined |
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Term
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Definition
| Levels need to be between 10-20mcg/mL |
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Term
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Definition
CNS
Lethargy
Confusion
Cognitive impairment
Gingival hyperplasia
Decreases effectiveness of birth control |
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Term
| Pt Education for Dilantin |
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Definition
Good oral hygiene
Seizure frequency chart
Date, time, nature of seizures
Reason for plasma drug levels
Avoid potentially hazardous activities
Wear Medic Alert
Never stop medication abruptly
Notify MD if female and becomes pregnant
Don’t change brands without MD approval
Promote patient adherence to therapy |
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