Part 1 Neurological system ATI

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Terms in this set (...)

Acetylcholine
Cholinergic receptors
Epinephrine
Adrenegeric receptors
Norepinephrine
Adrenergic receptor
Dopamine
...
Cholinergic agonist
Enhances effects of acetylcholine
cholinergic antagonist
Blocks effects of acetylcholine
Anti- & -ase
Block degradation of transmitter
Cholinergic
nicotinic
Muscarinic
Adrenergic
Alpha 1 &2
beta 1 &2
Benzodiazepines and non-Benzodiazepines
Drugs that treat sleep disorders
Benzodiazepines
Orally 30 mins before bedtime
Older kind relieve insomnia, decrease anxiety, treat status epilepticus, Relaxed muscle spasms, Help with moderate sedation

CNS depressants inhibits GABA, promote sleep thru sedation
Non-Benzodiazepines
-pam (suffix)
Prototype: zolpidem (Ambien) Temazepram (Restoril)
Help with short-term treatment of insomnia, Sleep disorders
Enhance Inhibitory effects of GABA
Benzodiazepines side effect
Short term - dependence over weeks
Drowsiness, dizziness, confusion, anxiety
Withdrawl causes paranoia, panic attacks, muscle twitching, hallucinations, paradoxical effect (opposite reaction)
Gradually decrease use
Contraindication
Schedule 4 pregnancy and lactation
Glaucoma, children younger than 18 years old

Precautions include we know or hectic impairment, suicidal, alcohol, neuromuscular disorder, chronic respiratory disorders, sleep apnea*
Interactions with benzodiazepines
Other benzodiazepines, alcohol, opioids,
smoking decrease effects of benzodiazepines
Cimetinde increase of benzodiazepines level
Non-Benzodiazepines side effects
Drowsiness, headache, anxiety, dizziness, diplopia, confusion older adults
amnesia
Administration
Oral pill or oral spray
Administer just before bedtime for eight hours sleep, empty stomach for full effect
Non-benzodiazepines contraindications
Schedule 4 children younger than 18, suicidal, labor and delivery
Precautions for older adults, substance abuse, depression, respiratory disorders, sleep apnea, hectic or renal dysfunction
Interactions with other drugs
Empty stomach, effects decrease w/food

Do not take with alcohol and other CNS depressants
Drug therapy for muscle spasms two types
Centrally acting muscle relaxants
Peripherally acting relaxants
Centrally acting muscle relaxants
Prototype: Bacolfen (Lioresal)
Spinal cord injury
Multiple sclerosis
Cerebral palsy
Musculoskeletal injury or other disorders
Bacolfen (Lioresal)
Prototype Centrally acting muscle relaxants
Centrally acting muscle relaxants mechanism
Enhances inhibitory effects of GABA
Bacolfen (Lioresal) side effects
dizziness, nausea, constipation
Withdrawal symptoms (Seizures and hallucinations) only if abruptly discontinued
Centrally acting muscle relaxants administration
Oral or Intrathecal infusion do not stop abruptly
Centrally acting muscle relaxants contraindication
Allergy to drug, you said and I think precedents past two weeks, cerebral palsy
Precautions for older adults, children, severe mental illness, seizure disorders, cerebral vascular accident
Interactions
Alcohol, CNS depressants
Pts. W/diabetes require to increase their insulin
Centrally acting muscle relaxants administration
Start with Low dose, gradually increase (20mg, 3-4x/day) , with food, encourage liquids, increased fiber, discontinue use gradually 1-2 weeks
Peripherally acting muscle relaxants
Relax skeletal muscle spasms related to cerebrovascular accident
Spinal cord injury
Multiple sclerosis
Cerebral palsy
Treat and prevent malignant hyperthermia, a side effect of general anesthesia
Dantrolene (Dantrium)
Prototype Peripherally acting muscle relaxants
Mechanism of Peripherally acting muscle relaxants
Inhibit release of calcium, block contraction of muscles
Side effects of Dantrolene (Dantrium)
Muscle weakness (monitor muscle strength)
Drowsiness and dizziness
Diarrhea
Liver toxicity (order liver function test)

Report abdominal pain and jaundice, skin or square of eyes become yellow indicating liver failure
Dantrolene (Dantrium) forms/type
Oral: 1-2 days pre-op

IV : malignant hyperthermia
Dantrolene (Dantrium) contraindications
Liver disease
Caution: cardiac /pulmonary disease
Neuromuscular d/o & ppl 35+
Dantrolene (Dantrium) interactions
CNS depressant & alcohol
Females 35+ high risk of liver toxicity

IV: calcium blockers increase risk for Dysrhythmias
Therapy for seizure disorders
Antiepileptic drugs (eight ED)
Hydantoin
Iminostilbenes
Valproic acid
Other new drugs
Hydantoin
Tonic and clonic seizures
Partial seizures
Phenytoin (Dilantin)
Hydantoin prototype
Mechanism
Inhibit influx of sodium sodium channels, decreased discharge of neurons around areas of increased activity
Phenytoin (Dilantin)/Hydantoin side effects
Mild drowsiness and other CNS effects
Gingival hyperplasia
Skin rash
Withdrawal symptoms
Phenytoin (Dilantin) administration
W/meals
inject IV slowly
Monitor vitals
Monitor plasma- Nystagmus, ataxia, sedation, blurred or double vision
Phenytoin (Dilantin)/ Hydantoin contraindications
Pregnancy risk the
Skin rash
Bradycardia or heart block
Previous allergy
Caused by low blood sugar
Precautions for liver or kidney disease, cardiac function, diabetes mellitus
Older adults, alcoholism, debilitated patients, respiratory dysfunction
Phenytoin (Dilantin)/ Hydantoin interactions w/other drugs
IV # dextrose
Diazepam ect.
Alcohol, CNS depressants, Phenytoin, phenobarbital
Can prevent effectiveness of birth control
Iminostilbenes
Treat:
partial seizures
Tonic clonic seizures
Mood stabilizer for Bipolar disorder
Trigeminal neuralgia
Carbamazepine (Tegretol) and mechanism
Prototype Iminostilbenes
Inhibit the influx of sodium through sodium channels
Decrease the discharge of neurons around areas of increased activity
Iminostilbenes side effects
Visual disturbances with heavy, ataxia
Decreased excavation of water, fluid retention
Skin rash, Steven Johnson syndrome
Bone marrow suppression
administration
Oral with food
Or suppression
Iminostilbenes contraindications
Pregnancy risk D
Myoclonic seizures
Hematologic disorders
Heart failure
Precautions for cardiac or have the disease
1502 Gene
Alcoholism
Iminostilbenes interactions w/ other drugs
Grapefruit juice, BC
Anti fungals
And drugs that decrease plasma levels
Valproic acid (3rd type)
Oh seizure types
Mania associated with bipolar disorder
Prevent migraines
Valprotic acid ( Depacon, Depakote) & mechanism
Prototype drug
inhibits the influx of sodium channels
Enhances the Inhibitory effects of GABA
Valprotic acid s/e & adverse effects
Gastrointestinal upset
Bruising, bleeding , decreased platelets new light skin rash
Liver toxicity, possibly fatal
Hyperammonemia
Valprotic acid
IV dilute with 50mL or oral with food
Valprotic acid side contraindications
Pregnancy D
Liver disorders
Thrombocytopenia
Hyper ammonia
Other anticonvulsants
Precautions for kidney disease, older adults, age 10 and below
Valprotic acid interactions with other drugs
Phenobarbital
Topamax
Local anesthesia prototype
Cylocaine , Lidocaine"aimde"
Anesthesia / barbiturates
15 min +sodium thiopental (Pentothal)
General Anastasia / benzodiazepines Proto type
Midazolam ( versed)
Diazepam (Valium)
General anesthesia opioids prototype
Fentanyl (sublimaze) naxlone reverses respiratory depression seclude 2
Immunodulators s/e
Flu like symptoms
Bone marrow suppression
Liver toxicity
Pain and redness at subcutaneous injection site

Report jaundice skin Ulcers anorexia or ab pain
Immunodulators special instructions
Start with low dose and then Gradually increase

Monitor WBc
Immunodulators administration
B1a IM weekly
b1A rebif SC 3x week
Late in day
48 hr b-w injections

Beta-1 bravo gift subcutaneously every other day use within three hours after reconstituting
Hepatotoxicity
Abdominal tenderness, anorexia, Jandus all signs of toxicity to the liver
Migraine
Serotonin agonist
Sumatriptan (imitrex)
Prototype
Sumatriptan (imitrex) side effects
Heaviness or Chest pain so monitor vitals first
Coronary vasospam
CNS effects such as tingling sensation and vertigo
Administration
Oral one pill then repeat every two hours no more than 200mg in 24hrs
Spray nasally once in each nostril then repeat 2hours
SC once then repeat in 1 hr not more than 2 in 24 hrs
Contraindications
Vasoconstriction or cerebrovascular accident
Hypertension or peripheral vascular disease
Coronary artery disease, and anGina

precautions to kidney or liver
Interactions with other drugs
mAO inhibitors w/in 2 weeks
Another tripton=angina
Serotonin agonist = serotonin syndrome
St. John's wort may cause toxicity