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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...

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.