kahoot bomb quiz.docx

Unit 3 Pharmacologic Drug Class Action Drug Examples Indication (Areas of Use) Adverse Reactions Side Effects Nursing Implications & Patient Education CNS Stimulant Amphetamine-Like Drug Review Nursing Process pg. 202 & Prototype pg. 201 Stimulate the release of the neurotransmitters norepin...

Unit 3 Pharmacologic Drug Class Action Drug Examples Indication (Areas of Use) Adverse Reactions Side Effects Nursing Implications & Patient Education CNS Stimulant Amphetamine-Like Drug Review Nursing Process pg. 202 & Prototype pg. 201 Stimulate the release of the neurotransmitters norepinephrine and serotonin from the brain; improves attention and ability to focus methylphenidate Used to treat Narcolepsy and ADHD Tachycardia Hypertension Seizures Growth Suppression Transient wt. loss in children Hepatotoxicity Insomnia Anorexia Dry Mouth Irritability NVDC Tremors Dizziness Monitor sleep patterns; height and wt.; VS; EKG and LFTs. Cautions: Use cautiously in patients with: Cardiac history, anxiety, glaucoma, psychosis, hyperthyroidism, and seizures. Patient Teaching: Monitor height and weight in children. Avoid caffeine and other CNS stimulants; Do not discontinue abruptly; Take in the morning and at least 6 hrs before bedtime. Nutritional supplementation – adequate caloric intake. Take at the same time daily. Read OTC labels of medication – cold medications. Dry mouth management – sugarless gum/candy; increased fluids. Educate risk for addiction and need to secure medication. Monitor BP and HR – report palpitation. Anticipate the need for a drug holiday (pediatrics). Valproate Review pg. 225 Suppress the calcium influx, which prevents the electric current generated by the calcium ions. CNS Depression valproic acid Used to treat Tonic-clonic, absence, and mixed-type seizures. Hepatotoxicity Drowsiness Sleep Disturbances Decreased RR GI Upset Dizziness Diplopia Thrombocytopenia *Monitor serum levels, CBC & LFTs.* Cautions: Avoid prescribing in pregnant women, patients with liver impairment, patients with history of alcoholism, and children under 2 years old. Patient Teaching: Avoid pregnancy – use a barrier method. Avoid other CNS depressants/ETOH. Anticipate routine lab monitoring. Do not discontinue abruptly – life long therapy. Report excessive bruising and bleeding. Do not drive. s/s of liver failure – jaundice, Right UQ ABD pain/tenderness, weakness. Safety precautions – change positions slowy. Take at the same time every day. Avoid 4 Gs. Medical Alert Bracelet. Plan for travel to ensure you have enough medication. Report any OTC medications. Barbiturate Review pg. 225 Enhance the activity of GABA, an inhibitory neurotransmitter. CNS Depression phenobarbital Used to treat tonic-clonic, myoclonic, and partial seizures Respiratory Depression Coma Sedation Dependence Anorexia Drowsiness Decreased RR Confusion Decreased LOC Headaches GI Upset Hypotension Dizziness High dosing may cause coma. Available IV. Monitor vital signs and LOC. Safety!! Patient Teaching: Avoid ETOH and CNS depressants. Do not drive. Do not discontinue abruptly. Change positions slowly. Take w/food to decrease GI upset. Avoid pregnancy. Take at bedtime with daily dosing. Anticipate the need for Vitamin D, B12 and Folic acid supplementation. Medical Alert Bracelet. Plan for travel to ensure you have enough medication. Hydantoin Review Nursing Process pg. 223 & Prototype pg. 221 Inhibit sodium influx, stabilize cell membranes, reduce repetitive neuronal firing, and limit seizures. CNS Depression phenytoin Used to treat tonic-clonic seizures, and partial seizures Thrombocytopenia Leukopenia Liver/Renal impairment Hyperglycemia Stevens-Johnson Syndrome BP/HR Changes Dizziness Drowsiness Gingival hyperplasia Headaches GI Upset Urine Discoloration Tinnitus Suicidal Ideation Ataxia Fatigue Monitor for Toxicity: Monitor Serum values & CBC; Signs of toxicity: Increased sedation; Nystagmus; Tremors; Vision Changes; Safety; Available IV. Cautions: Patients with thyroid disease, Diabetes; cardiac disease; renal and liver disease. Pregnancy/Breastfeeding Patient Teaching: Diligent oral hygiene (soft bristle toothbrush) and routine dental f/u. Do not discontinue abruptly. Diabetics – need to monitor BG readings. Report mood and behavior changes. Do not drive. Avoid ETOH or other CHS depressants. Monitor for bleeding and bruising – bleeding prevention. Pregnancy prevention. Monitor and report changes in BP and HR. Report changes in skin. Take as directed at the same time daily. Medical Alert Bracelet. Plan for travel to ensure you have enough medication. Anticipate lab monitoring, routine appointments and vitamin supplementation. s/s of toxicity. s/s of infection and infection prevention. Non-phenothiazine Antipsychotic Review Nursing Process pg. 260 & Prototype pg. 259 Blocks dopamine receptors in the brain. haloperidol Used to treat psychosis and schizophrenia Tachycardia EPS/TD NMS Orthostasis Seizures Blood Dyscrasias Drowsiness Photosensitivity Hypotension Cardiac Rhythm Changes Euphoria Anticholinergic: Constipation; Urine Retention; Dry Mouth; Vision Changes Monitor CBC and orthostatic v/s, periodic EKG. Monitor EPS/TD: Dystonia; Akathisia; Pseudo-parkinsonism; rhythmic muscle activities. Cautions: Renal and hepatic dysfunction, vascular disease; Avoid medication in those with dementia or PD; glaucoma. Patient Teaching: Avoid ETOH, and other CNS depressants. Change positions slowly. Sun protection – sunscreen, long sleeves, etc. Monitor urine output. No driving. Constipation prevention and management. Dry mouth – increase fluid. Anticipate routine f/u for labs and assessment for EPS/TD/NMS. s/s EPS/TD – notify provider. Monitor BP and HR – report palpitations. Do not discontinue abruptly. Report high fevers – NMS. Atypical Antipsychotic Review Nursing Process pg. 260 & Prototype pg. 263 Blocks serotonin and specific (D2) dopamine receptors in the brain aripiprazole Used for the treatment of schizophrenia, bipolar disorder & depression Tachycardia Hyper or Hypotension EPS/NMS Blood Dyscrasias Drowsiness NVCD Weight Changes Memory Loss Tremor Headaches Monitor CBC, weight and v/s. Cautions: Patients with CNS depression; ETOH; PD; dementia; seizures Patient Teaching: May take 6 wks to see effect. Monitor weight. Strategies for improving memory. Monitor BP and HR. Avoid grapefruit juice and St. John’s Wort. Selective Serotonin Reuptake Inhibitor (SSRI) Review Nursing Process pg. 272 & Prototype pg. 270 Block the reuptake of serotonin into the nerve terminal of the CNS. First-line fluoxetine Used for the treatment of depression, panic disorders, PTSD and OCD Seizures Angioedema Osteoporosis Suicidal Ideations Serotonin Syndrome Stroke Drowsiness Dizziness Insomnia Headaches Palpitations NVDC Weight Changes Erectile Dysfunction Safety Precautions Assess for suicidal ideation (children) Cautions: Patients with a hx of MI; CVA; Breastfeeding women; Patients with glaucoma Patient Teaching: Avoid St. John’s Wort. Report increases in suiddal thoughts depression and anxiety. Avoid ETOH or other CNS depressants. Takes 3-4 wks to take effect. Take with food to decrease GI upset. Educated family on the need to monitor for suicidal thoughts. Do not combine with MAOIs. Take as prescribed – do not increase. Do not discontinue abruptly. Report erectile dysfunction. Serotonin & Norepinephrine Reuptake Inhibitors Review Nursing Process pg. 272 Inhibit the reuptake of serotonin and norepinephrine venlafaxine Used to treat depression, anxiety, and panic disorders Tachycardia Hypertension Seizures Suicidal Ideation Palpitations Drowsiness Dizziness Insomnia Weight Changes Dry Mouth Erectile Dysfunction Look at other meds. Monitoring of BP and HR Cautions: Closely monitor Pregnant women, patients on anticoagulants, renal impairment, cardiac history, and glaucoma. Patient Teaching: Monitor BP and HR. Notify prescriber of med changes. Avoid St. John’s Wort. Report increases in suiddal thoughts depression and anxiety. Avoid ETOH or other CNS depressants. Takes 3-4 wks to take effect. Take with food to decrease GI upset. Educated family on the need to monitor for suicidal thoughts. Do not combine with MAOIs. Take as prescribed – do not increase. Do not discontinue abruptly. Report erectile dysfunction. Tricyclic Review Nursing Process pg. 272 Block the uptake of the neurotransmitters epinephrine, norepinephrine and serotonin in the brain. (Antihistamine) amitriptyline Used to treat depression Used to treat insomnia Suicidal Ideations Orthostatic hypotension Seizures Paresthesia Drowsiness Dizziness Weight Gain Anticholinergic: Blurred Vision Constipation Urine Retention Dry Mouth Assess vitals (B/P); Monitor bowel and bladder pattern. Safety precautions – assess for suicidal ideation. Patient Teaching: Avoid ETOH other CNS depressants or herbal meds for sleep. Constipation management, monitor urine output and report retention. Dry mouth management. Change positions slowly. Do not drive. Take at bedtime. Takes 3-4 wks to take effect. Educated family on the need to monitor for suicidal thoughts. Do not combine with MAOIs. Take as prescribed – do not increase. Do not discontinue abruptly. Monoamine Oxidase Inhibitors (MAOIs) Review Nursing Process pg. 272 Inhibits MAO, allowing the levels of norepinephrine, dopamine, epinephrine, and serotonin to rise. phenelzine sulfate Used to treat severe depression Hypertensive crisis Suicidal Ideations Dizziness Headaches Insomnia Dry Mouth Changes in Weight Monitor for suicidal ideations. Ensure patient is on no other antidepressants. Last resort!! Cautions: Cardiac History Patient Teaching: Avoid tyramine containing food: aged cheseses; aged/smoked or processed meats. Monitor vital signs. Family to monitor for suicidal idation – consider managing medication. Avoid St. John’s Wort. Read OTC labels – cough and cold remedies. Mood Stabilizers Review Prototype & Nursing process pg. 274 -275 Alters sodium transport to increased receptor sensitivity to serotonin. lithium Used to treat Bipolar Disorders, manic episodes Hyponatremia Suicidal Ideations Urinary Frequency Seizure Cardiac dysrhythmias Diabetes Insipidus GI Upset Dry Mouth Metallic Taste Edema Toxicity: Blurred Vision Memory Impairment Thirst Tremors Monitor lithium & sodium levels Monitor Urine output & weight and hydration status; EKG and HR; LOC **Monitor for Toxicity – Pg 277** Cautions: Pregnancy; Cardiac disorders. Patient Teaching: Maintain adequate fluid and sodium intake. Anticipate routine lab monitoring. s/s of toxicity – report changes to provider. Avoid pregnancy – use contraceptives. Take with food to decrease GI upset. Avoid St. John’s Wort. Take as prescribed – do not discontinue abruptly. Monitor breastfed infants for toxicity. Monitor heart rate – report any signs of irregularity. Report changes in weight and sudden increase in urine output. Discuss use of OTC meds with provider and any other medication changes.