Term
| Antiepileptic 'Phenytonin' Mechanism of Action |
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Definition
| Inhibits influx of sodium ions thereby reducing excessive firing of cell |
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Term
| Antiepileptic 'Phenytonin' Indications |
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Definition
| Psychomotor seizures, status epilepticus |
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Term
| Antiepileptic 'Phenytonin' Contraindications |
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Definition
| Sinus bradycardia; SA block; 2nd or 3rd degree AV block |
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Term
| Antiepileptic 'Phenytonin' Serious Adverse Effects |
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Definition
| Life-threatening dermatologic reactions; Liver damage; Blood dyscrasias; Cardiovascular collapse if given too rapidly by IV push |
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Term
| Antiepileptic 'Phenytonin' Common Adverse Effects |
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Definition
| Dizziness, Ataxia, Blurred vision, Nausea, Gingival hyperplasia; Decreased effectiveness of oral contraceptives and warfarin, decreased blood levels during pregnancy |
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Term
| Antiepileptic 'Phenytonin' Preadministration assessment |
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Definition
| Type and frequency of seizure activity; Possibly EKG |
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Term
| Antiepileptic 'Phenytonin' Monitoring |
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Definition
| Drug levels (goal is 10-20mcg/ml) |
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Term
| Antiepileptic 'Phenytonin' Key Patient Education |
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Definition
| Avoid hazardous activity if CNS depression is significan; Don't stop abruptly (withdrawal seizures); Meticulous oral hygiene; Avoid alcohol/other CNS depressants; Check w/prescriber before starting any other meds |
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Term
| Antiepileptic 'Phenytonin' Notes |
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Definition
| Infant death from neonatal hemorrhage (when drug taken by mother)- can be avoided with vitamin K administration |
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Term
| Tricyclic antidepressant 'Amitriptyline' Mechanism of Action |
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Definition
| Blocks neuronal uptake of norepinephrine and serotonin |
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Term
| Tricyclic antidepressant 'Amitriptyline' Indications |
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Definition
| Depression, Bipolar, chronic pain syndrome, neuropathy, migraine headache, panic disorder, and OCD |
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Term
| Tricyclic antidepressant 'Amitriptyline' Contraindications |
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Definition
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Term
| Tricyclic antidepressant 'Amitriptyline' Serious Adverse Effects |
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Definition
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Term
| Tricyclic antidepressant 'Amitriptyline' Common Adverse Effects |
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Definition
| Drowsiness, Dry mouth, Constipation, Urinary hesitancy, Hypotension |
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Term
| Tricyclic antidepressant 'Amitriptyline' Preadministration assessment |
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Definition
| ECG- especially for patients over 40 years of age |
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Term
| Tricyclic antidepressant 'Amitriptyline' Monitoring |
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Definition
| Psych symptoms including suicidal ideation |
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Term
| Tricyclic antidepressant 'Amitriptyline' Key Patient Education |
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Definition
| Symptom relief not immediate; Change position slowly to minimize orthostasis; Avoid hazardous activities if sedation is significant; Take dose at bed-time to minimize daytime sedation; Avoid alcohol/other CNS depressants; and other anticholinergic agents |
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Term
| Tricyclic antidepressant 'Amitriptyline' Notes |
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Definition
| Initial response in 1-3 weeks; full effect over 1-2 months; Continue therapy at least 3 months to prevent relapse |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Mechanism of Action |
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Definition
| Inhibits CNS reuptake of serotonin, weak effect on dopamine or norepinephrine |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Indications |
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Definition
| Major depression, OCD, panic disorder, PTSD |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Contraindications |
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Definition
| Caution in patients with compromised liver function, seizure disorders |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Serious Adverse Effects |
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Definition
| Seizure, Tachycardia, Bradycardia, AV Block, May increase risk of suicidal thinking or attempts (expecially in pediatric populations); Serotonergic Syndrome (2-72 hrs after treatment)- Agitation, confustion, anxiety, hallucinations, poor concentration, profuse diaphoresis, tremor, fever: resolves when drug discontinued |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Common Advers Effects |
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Definition
| Decreased libido, Nausea, Headache, Nervousness, Insomnia, Anxiety, Weight gain |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Preadministration Assessment |
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Definition
| History of seizures; Anxiety, nervousness, insomnia (may be exacerbated); Suicidal ideation |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Monitoring |
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Definition
| Compare mood to baseline, Assess for suicidal ideation |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Key Patient Education |
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Definition
| Effects may not be felt for 2-4 weeks; Take with food; Avoid ultraviolet light; Report development of suicidal thoughts or behavior changes; Avoid alcohol and other drugs; Do not stop taking abruptly |
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Term
| Selective Serotonin Reuptake Inhibitor 'Sertraline' Notes |
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Definition
| Reaches steady state in 7 days, 94% protein bound; Withdrawal syndrome (dizziness, HA, nausea, sensory disturbances, tremor, anxiety) can be minimized by tapering dose |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Mechanism of Action |
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Definition
| Inhibit MAO-A, thereby increasing availability of norepinephrine and serotonin (only partly explains effect- full explanation not yet known) |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Indications |
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Definition
| Atypical depression, depression refractory to other therapy, OCD, bulimia (Onset 2-3 weeks) |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Contraindications |
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Definition
| Patients taking SSRI's Pheochromacytoma, heart failure, liver disease, severe renal impairment, Cerebrovascular defect, cardiovascular disease, hypertension, age > 60 |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Serious Adverse Effects |
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Definition
| Potential for hypertensive crisis (pootentially fatal)- interacts with dietary tyramine, indirect acting sympathomimetic drugs and tricyclic antidepressants; Serotonergic syndrome with SSRIs; Meperidine causes hyperpyrexia |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Common Adverse Effects |
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Definition
| Edema, orthostatic hypotension, restlessness, mania or hypomania, blurred vision |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Preadministration assessment |
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Definition
| Willingness and ability to adhere to diet and med restrictions; Do not take any Rx or OTC meds w/out consulting w/HCP; Suicidal ideation |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Monitoring |
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Definition
| Face to face contact w/patient at least weekly for initial 4 wks; Liver function and CBC every 6 months (leukopenia rare side effect) |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Key Patient Education |
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Definition
| S/S of orthostatic hypotension; Risk of hypertensive crisis; Dietary and medication restrictions (required for duration of therapy and 2 weeks after); Do not stop taking abruptly |
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Term
| Monoamine Oxidase Inhibitor 'Phenelzine' Notes |
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Definition
| Requires a compliant patient to avoid serious adverse reactions |
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Term
| Mood stabilizer 'Lithium' Mechanism of Action |
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Definition
| Unknown, possibly decreases release of norepinephrine and dopamine |
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Term
| Mood stabilizer 'Lithium' Indications |
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Definition
| Manic phase of bipolar disease |
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Term
| Mood stabilizer 'Lithium' Contraindications |
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Definition
| Severe debilitation, dehydration, sodium depletion, significant CV, renal disease, diurecic use, pregnancy, lactation |
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Term
| Mood stabilizer 'Lithium' Serious Adverse Effects |
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Definition
| Toxicity (>1.5 mEq/L)- starts with slurred speech, unsteady gait, weakness, drowsiness, vomiting, diarrhea- can progress to seizure, stupor, irregular heart rhythm and death |
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Term
| Mood stabilizer 'Lithium' Common Adverse Effects |
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Definition
| Increased thirst, Frequent urination, Nausea, Fine hand tremor, Hypothyroidism |
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Term
| Mood stabilizer 'Lithium' Preadministration assessment |
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Definition
| Fluid and electrolyte balance, Renal function, CV function |
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Term
| Mood stabilizer 'Lithium' Monitoring |
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Definition
| Serum lithium levels every 2-3 days during initiation and every 1-3 months during therapy; Annual: CBC, electrolytes, renal function, thyroid function |
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Term
| Mood stabilizer 'Lithium' Key Patient Education |
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Definition
| Avoid major changes in sodium and fluid intake, Drink 8-12 glasses of fluid daily; Consult with prescriber before using any other drug- even OTC (especially NSAIDs) |
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Term
| Mood stabilizer 'Lithium' Notes |
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Definition
NSAIDs can increase lithium levels by up to 60%!
Levels for acute therapy 0.8-1.4 mEq/L, Levels for maintenance 0.4-1.0 mEq/L) |
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Term
| Benzodiazepine 'Lorazepam' Mechanism of Action |
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Definition
| Increase effects of GABA (which has inhibitory effect on CNS) |
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Term
| Benzodiazepine 'Lorazepam' Indications |
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Definition
| Anxiety, insomnia, seizures, muscle spasms, alcohol withdrawal, anesthesia induction |
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Term
| Benzodiazepine 'Lorazepam' Contraindications |
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Definition
| Psychoses, Acute narrow-angle glaucoma, Children <6 months |
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Term
| Benzodiazepine 'Lorazepam' Serious Adverse Effects |
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Definition
| Withdrawal symptoms if stopped suddenly; Combining with other CNS depressants can cause respiratory depression, hypotension, bradycardia, altered LOC (can be fatal) |
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Term
| Benzodiazepine 'Lorazepam' Common Adverse Effects |
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Definition
| Drowsiness, Ataxia and confusion particularly in older adults, Adverse effects related to CNS depression |
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Term
| Benzodiazepine 'Lorazepam' Preadministration assessment |
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Definition
| Fluid and electrolyte balance; Renal function; CV function |
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Term
| Benzodiazepine 'Lorazepam' Monitoring |
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Definition
| Tolerance can develop if used longterm (Reversal agent for benzodiazepine is flumazenil- if patient has developed physical dependence could cause acute withdrawal) |
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Term
| Benzodiazepine 'Lorazepam' Key Patient Education |
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Definition
| Daily dose split into 2-3 doses for sustained effect. Avoid alcohol, Avoid driving, etc until effects are known; Drowsiness decreases with use |
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Term
| Benzodiazepine 'Lorazepam' Notes |
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Definition
| Schedule IV; Effects are limited by intrinsic amount of GABA; Paradoxical reactions of excitement, stimulation and acute rage |
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Term
| Anxiolytic 'Buspirone' Mechanism of Action |
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Definition
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Term
| Anxiolytic 'Buspirone' Indications |
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Definition
| Short-term treatment of anxiety |
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Term
| Anxiolytic 'Buspirone' Contraindications |
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Definition
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Term
| Anxiolytic 'Buspirone' Serious Adverse Effects |
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Definition
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Term
| Anxiolytic 'Buspirone' Common Adverse Effects |
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Definition
| Dizziness, Nausea, Headache, Nervousness, Light-headedness, Excitement, Tachycardia |
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Term
| Anxiolytic 'Buspirone' Preadministration assessment and Monitoring |
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Definition
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Term
| Anxiolytic 'Buspirone' Key Patient Education |
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Definition
| Avoid driving, etc if dizzy or drowsy, Do not stop taking abruptly |
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Term
| Anxiolytic 'Buspirone' Notes |
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Definition
| Initial response in 1 week, full effect takes several weeks |
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