Neuro Medication Chart PDF

1 Neuro Medication Chart Medication Why patient...

1 Neuro Medication Chart Medication Why patient Nursing implications How would nurse Important Information receiving med know if drug working? Disease Modifying For treatment of MS Assess LFT Patient will have ↓of s/s Immunomodulators are typically Drugs (DMD) Assess CBC MS safer than immunosuppressants. Use of disease- Meds should be started ASAP Immunomodulators are typically modifying drugs after DX made preferred for treatment. Immunomodulator  interferon beta-1a (DMD) can slow Instruct patient on S/S of liver Immunomodulators Assess for progression of MS, ↓ disease and to report new s/s of liver disease (Avonex) IM/SQ  dimethyl fumarate frequency & onset of these symptoms o Jaundice (Tecfidera) intensity of relapse Instruct patient on S/S of o Ascites  glatiramer acetate & delay permanent bone marrow impairment o Nausea/Vomiting (Copaxon) neurologic loss. and to report new onset of o Dark Urine  natalizumab (Tysabri) these symptoms o Pale Stool Color  fingolimod (Gilenya) Assess for hypersensitivity o Easy bruising/bleeding  teriflunomide (Aubagio) reaction (HSR). If a HSR BOTH: Assess for impairment of occurs, that DMD must be bone marrow Immunosuppressant discontinued and never used o Easy bruising or  Mitoxantrone again. bleeding o Pale Mitoxantrone only: If the o Frequent infections nurse notices extravasation o Fatigue while infusing, the nurse BOTH: Assess for should immediately hypersensitivity reactions discontinue the medication and restart it in another IV o Anaphylaxis site. ▪ Hives Mitoxantrone only: Educate ▪ Angioedema patient on signs/symptoms of Natalizumab only: At risk for heart failure (shortness of progressive multifocal breath, fatigue, peripheral leukoencephalopathy edema) and have patient (opportunistic viral infection report immediately leading to death or severe disability) o Monitor for sudden neurologic changes Mitoxantrone only: can cause irreversible cardiac damage,  2 Neuro Medication Chart produce fetal harm, and severe tissue injury with extravasation. RNs that are pregnant should be cautious about administering this medication. Immunosuppressant For acute Assess blood sugar Patient will have ↓ of s/s of Hyperglycemia (glucocorticoids) exacerbation of MS Assess for s/s of infection MS Increases risk of infection methylprednisolone Monitor wound healing May impair wound healing (Solumedrol) Fluid retention IVIG- IV For acute Administered IV over several Patient will have ↓of s/s Flu-like SX are likely with exacerbation of MS days. MS infusion. Immunoglobulin (intravenous immune May take 3-4 weeks to see Assess liver function globulin) IVIG can be used for improvement in SX.+ Adverse effects are mild and patients who cannot reversible use steroids. GG selectively stimulates certain parts of the immune system while suppressing others. Stool Softener To treat constipation Assess frequency of BM Patient will have more May cause diarrhea docusate sodium (Colace) Assess for s/s of GI distress frequent, &/or softer BMs Muscle Relaxer Anti-spasmodic; to Assess for s/s muscle spasm Patient will have ↓ in Avoid giving with CNS baclofen (Lioresal) prevent muscle Assess for respiratory muscle spasm depressants/alcohol spasms/pain depression/sedation.  3 Neuro Medication Chart Dopamine replacement For treatment of Combo drug carbidopa enhances Patient has ↓ S/S of PD Medicine is less effective on levodopa/carbidopa Parkinson’s the effects of Levodopa allowing symptom relief after about 5 (Sinemet) disease. more dopamine to reach the brain. years of therapy-may then have a drug free holiday & then Makes more restarted at a ↓dose. levodopa available Dopamine cannot be used to to CNS. treat PD patients because Dopamine does not cross the First line drug for blood brain barrier. PD Dopamine agonist For treatment of PD Assess for tremors, S/S of PD Patient has ↓ S/S of PD Used as a secondary drug after bromocriptine (Parlodel) levodopa/carbidopa loses its ropinirole (Requip) effectiveness. rotigotine (Neupro) MAO-B Inhibitor For treatment of PD Assess for tremors, S/S of PD Can be used alone, but mainly Inhibits dopamine breakdown used for managing off times during levodopa /carbidopa selegiline (Eldepryl) therapy. rasagiline (Azilect) Risk for hypertensive crisis if patient has increase in foods that contain tyramine. Foods that contain tyramine include aged, cured, or fermented foods. Avoid these foods while taking these meds and for 2 weeks after stopping. COMT Inhibitor For treatment of PD Assess for tremors, S/S of PD Patient has ↓ S/S of PD Used in managing off times during entacapone (Comtan) levodopa/carbidopa therapy. tolcapone (Tasmar) Must be used in conjunction with levodopa.