Prototype Indications Adverse Effect Contraindications

Class

Chapter 23 Anti-Seizure
These medications
-Should not be combine with narcotics or anti-seizure /CNS Depression /& Evening Promise
-Wear med Alert ID (implement fall prevention)
-Monitor CBC Baseline
 -Children Need Higher does

Generalized Seizure Medication

 Phenytoin- hydantoin
 Phenobarbital- barbiturate
 Diazepam- benzodiazepine
 Ethosuximide- succinimide (absence seizures)
 Valproic acid- modulate GABA (absence seizures)
Partial

Class Prototype Indications: Adverse Effects: Contraindications

-Less Sedating -CNS depression -Cat.D Fetal Bleeding
-Tonic-clonic and -Hyperplasia (swollen -Elderly
Phenytoin psychomotor seizures bleeding gums) -Gingko
-Drug of choice for -GI
Hydantoins patients unable to -Severe Liver Tox
tolerate sedation & -BMS
drowsiness -Steve Johnsons Disease
- -nystagmus
-Cardi Arrhythmia
-Increases Blood Glucose
-Loss of libido

Class Indications: Adverse Effects Contraindications

-Tonic-clonic & Cortical
Barbiturates Focal seizures
(Parenteral)
Phenobarbital
Prototype

Same as phenytoin -Cat.D Fetal Bleeding

-Long duration &
-Low lipid solubility Nightmare
-Less teratogenicity Halluciantions
-RAS receptors Abuse increases
Severe sedation
 Prototype Indications Adverse Effects Contraindications
-Management of Anxiety -Urinary Retention
Diazepam disorders -GI -Cat.D Fetal Bleeding
-Muscle relaxant -Paradoxical Excitatory
Benzodiazepines Antidote= -Tetanus reactions
Flumazenil -Relives anxiety -Withdrawal syndrome
-Acute Alcohol
withdrawal
-Tonic-Clonic
Class

-Potentiate effects of
GABA
Prototype Indications Absence Adverse Effects Contraindications -
seizures -Few A/E compared OB/Lact
Succinimides

Ethosuximide w/other antiepileptic -Patients with intermittent

Class

(Vampire teeth) drugs porphyria

(Skin blisters gum
Decreases GI recedes)
Anorexia
Irritability
Indications Adverse Effects Liver Contraindications Cat. X
Valporic Absence seizures TOX Hepatic /Renal
Other Drugs for Treating Absence Acid GABA receptors CNS drowsy/dizzy
Seizures

Indications Adverse Effects Contraindications

Carbamazepine

Drugs for treating Partial Seizures Drug of choice for -Most CNS related -Decreased fertility with
Prototype

Partial Seizures/ tonic- -Ataxia males

clonic - Liver TOX/fail
-Bipolar disorder - Decreases BMS
-Trigeminal neuralgia -Risk for suicide
-Vision Changes
 -Stevens-Johnson
Syndrome

Chapter 30
Adrenergic Agonists
Know the Alpha and Beta page 492,493,know the Adrenergic =sympathetic (fight or flight)and parasympathetic(you give a sympathetic mimic
-Adrenergic drugs increase heart rate

Class: Prototype Indications Adverse Effect Contraindications

Class Prototype Indications: Adverse Effect Contraindications

Alpha & Beta Adrenegic -Stim both alpha beta - -increases HR -PVD
Dopanine naturally occurring -Decreases -Pheochromocytoma
-shock/heart stimulant -decrease V Fib -
(fast/irregular/dangerous)
-Hypovolemia
-tachyarrythmias
-peritheral vascular
disease CNS

Class Prototype Indications Adverse Effect Contraindications

-Shock SVT glaucoma Otitis media (topical) -OTC
Alpha Specific adrenergic Agonist PHENYLEPRIN -non drowsy sinus med can’t longer than 3 days CVD
E -Anxiety/ restlessness Thyrotoxicosis DM
OB/
Diabetes
Class Prototype Indications Adverse Effect Contraindications
-stimulates Beta -Increase Heart rate -
Beta Specific Adrenergic Agonist Lsoproerenol -hypovolemica -increase conductivity
-transplant heart cxns
-hyperkalemia bronchodilation
-rlx uterus
 Chapter 31
Adrenergic Antagonists
Beta ones end in LOL
-Beta blockers decrease heart rate
-history of smoking= atenolol

Class Prototype Indications Adverse Effect Contraindications

Alpha Beta -Nonselective -asthma(bronchiapsam ) -
Adrenergic Blacking -HTN -shock
Labetalol pheochromaocytoma -diabetes
-clonidire withdrawals -chf pregnancy
Class Prototype: Indications: Adverse Effect : Contraindications:
Alpha Adrenergic Blocking Agent - Heart:
-Antidote for dopamine Hypotension CAD
Phentolamine norepine -orthostatic hypertension MI
-midigates Angina CVA
pheochmyytoma effects MI
-Blacks alpha one CVA
receptors causing Arythmia
vasodialation and Flushing
lowering BP Weakness
Dizzy
Headache
Class: Prototype : Indications: Adverse Effect Contraindications
Alpha 1 Selectibve Adrenergic
Blockers Doxazosin -Txurine and Kidney
stones
-benign prostatic
hypertrophy
HTN tx
Black smooth musle in
bladder/
Class Prototype: Indications:Stage Fright Adverse Effect: Contraindications:
Beta Adrenergic Blacking Agent and Cardiovascular -Pulmonary Edema -diabetes
problems -Sleep disturbances -heart
Propranolol -Prophylaxis for -Decreased libretto
migraines
-Essential Tremors
Class: Prototype: Indications Adverse Effect : Contraindications :
Beta One Selective Adrenergic -preferred with people
Blocking with reparatory CNS= Bradycardia Low cardiac Output
Atenolol (smoking/asthma/COPD) CHF lowers CO Bradycardia
because it doesn’t block HTN
the bronco #$$# Sleep Disturbances -COPD
- -Pulmonary at high Diabetes
levels -Thyroid
heartblack CHF
sinus bradycardia lower
CO

Chapter 57

Histamine 2 Antagonist ch57 Cimetidine -First class developed LT-Gynecomasty -OB/L

Prevents Gastrin release Galactoria -
-Decreases pepsin HCL -Low BP
/Histamine -Arrrythmias
-Zollinger Elli
-Duod ulcer prophylactic
Surgery –
Lt-
gynecomasty/galactoria
- aspiration

Antacids Sodium -Upset Stomach -Caution GI Obstruction

Ch 57 Bicarbonate -Hyperacidity -
(neutralized)
Sodium is an -
electrolyte make
sure they are
doing
good/Problems
with acids an
acids
Proton Pump Inhibitors OMEPRAZOLE -Suppress HCL to GI Elderly
neutralize Blocks the -Tounge Atrophy -If their hemoglobin is low
final step in acid -Dizziness Vertigo and OB
production Insomnia
-Peptic Ulcers
-GERD

Antipeptic Agents Sucralfate -Cotes and Protects GI -Dizziness -Renal Failer and Dialisis
-Ulcer Healing -vertigo -
-GI
Dry mouth injestion rash
back pain
Prostaglandin Misoprostol -Prevent NSAID induced -Flatulent Pregnancy abortion
G/U potential category X
-

Digestive Enzyme Suppliments Pancrelipase -Produces Pancreatic Hyperuricouria (urine Allergy to pork
Enzymes crystals kidney stone ) -OB/Lact

Saliva Mouth Kote Stroke CHF

Gland HTN
Surgery (head and neck) Renal Failure
Chemo radiation
-abnormal electrolytes
Chapter 58

LT =Long term
Bulk Stimulants Magnesium Citrate Increases Fluid /Saline -Diarrhea in kids During -Acute abdominal
into intestines lactation Disorders
-Clears the bowel for -GI Chathartic -Pregnancy Stimulates
Diagnostic Tet/exams dependance Become Labor
- Get Rid Poison in dependent on it causes
Overdose chronic Constipation
-GI
-CNS
-Cardiovascular
Lubricating Stimulant Mineral Oil Hemorrhoids -Fainting
-Recent rectal surgery -Leaking and Staining
-Safe for infants GI
(suppository form) CNS (less likely)
Cardio’

Chemical Stimulants Caster oil Evacuates Intestins LT-Cathartic dependence OB /Lact

-BG-blood glucose Acute abd
-GI
CNS
Cardio (loss of fluid
electrolytes
GI Stimulant Metoclopramide -Causes low blood -Peg crosses placenta
-GI motility after surgery pressure -Gi obstruction perforation
-Parkinson like
symptoms
-Stimulates -
Parasympathetic NS

-drug of choice for

anistigiologistes
 -drug of choice for
diabetic gastropareisis
Antidiarrheal Loperamide Drug of choice 2 -12 -Causes Constipation -hepatic impar(carefully)
years -abd pain
-GI Muscle decrease -distention
peristalsis
-diarrhea chronic acute
-ileostomy

Chapter 59 Antiemetic’s

Phenothiazine Prochlorperazine Antianxiety blacks -urinary

response of CT Z retention
(chemo trigger -tachycardia
zone) in an area of blurry vision
the medulla -acute
communicates with confusion
the hormones all dystonia
antemetics
-2 Years olf for
vomiting after 24
hours
Nonphenothiazines Metoclopramide Decreases -CTZ Restlessness
response drowsy
-prophylactic -
cancer extrapyramidcu
/postoperative symptoms
-fatigue

(5-HT3) Receptor Blockers Ondansetron Blocks receptors -hedaches

CTZ and loaal 5- -drowsyness
(put dan on block) HT3 -renal liver
function
-constipation
-myalgia
-pain at
injection site
Substance p/Neurokin 1 Receptor Aprepitant -Nausea and Anorexia
Antagonist vomiting -fatigue
-Combo drug used -constipation
in Chemo and -dehydration
highly potent drugs -liver enzymes
(with dextomisisol)

Marinol (CBD)

Chapter 32 Cholinergic Agonists

-A cholinergic crisis is characterized by: Excessive stimulation of the Parasympathetic Nervous System
  EX: sweating, heavy salivation, and bronchospasm
-Decreased acetylcholine levels are characteristic of: Alzheimer’s Disease
 Degeneration of cholinergic pathways
 Acetylcholine transmitter in the cholinergic neuropathways appear insufficient

-Neostigmine
Antidote =Atropine
 It stimulates the parasympathetic nervous system.
 Treats Myasthenia gravis
 If the pulse drops =administer Atropine
o Atropine reverses only the muscarinic effects of cholinergic drugs, primarily in the heart, smooth muscle, and glands.

-Cholinergic Drugs increase smooth muscle strength

-All anticholinesterase drugs should be taken with food or milk to decrease the risk of gastric distress and ulceration

Class: Prototype Indications Adverse Effec

-Urinary Retention
Bethanechol -paralytic ileus
Direct-Acting Cholinergic (no bowel sounds)
Agonists

Class: Prototype Indications Adverse Effec

Indirect-Acting Cholinergic Agonists -myasthenia Insomnia,
Agents for Myasthenia Gravis gravis fatigue, rash,
pyridostigmine -Alzheimer's nausea,
vomiting,
disease diarrhea,
dyspepsia,
abdominal
pain, muscle
cramps.
 Agents for Alzheimer’s disease Prototype Indications Adverse
-Alzheimer’s Effects
donepezil -Increase in the
level of
acetylcholine in
CNS

Chapter 33 Anticholinergic Agents

Nursing Considerations
-can’t see can’t pee can’t spit can’t shit
-To decrease secretions, GI secretions
Nursing Diagnosis
-Constipation

Dicyclomine= Orally
Propantheline = Orally

Scopolamine= Patch Changed Every 3 Days/ Transdermal

Hyoscyamine =PT feels like heart will jump out of chest

Glycopyrrolate= Dries up secretions

Class: Prototype Indications Adverse Effec

-To dry up -Pupil D
Anticholinergics/Parasympatholytics respiratory -Dry Mouth
secretions to -Constipation
Atropine prevent aspiration
during surgery
Antidote =Physostigmine -Bradycardia
<0.5mg

Action
 It blocks the
parasympathetic
vagal
stimulation.

Chapter 24 Anitparkinsonism Agents

-The three major features of Parkinson's include: Rigidity, bradykinesia, and tremors.
 Characterized by abnormalities in Posture
-Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to: decrease salivation, spasticity, and tremors.
-Teach: Drugs do not cure these disorders; they instead enhance quality of life.
-Rasagiline + St John’s Wort =hyperpyrexia and death

On-off phenomenon

Class Prototype Indications Adverse

Dopaminergic Agents Effect
levodopa
Class Prototype Indications Adverse
Anticholinergic Agents Effect
benztropine

Class Prototype Indications Adverse

Adjunctive Agents (COMT) Inhibitor Effect
entacapone selegiline
tolcapone