Class Prototype Indications Adverse Effect Contraindicati Drug Drug Route Nursing Teach

ons

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
Class Prototype Indications: Adverse Effects: Contraindications Drug-Drug Route Assess
-Less Sedating -CNS depression -Cat.D Fetal -Oral Contraceptives
-Tonic-clonic and -Hyperplasia Bleeding -Alcohol -Slurred speech /tremors
Phenytoin psychomotor (swollen bleeding -Elderly -Other Ant seizures -Take on a full stomach
seizures gums) - -Narrow therapeutic level 10-20
Hydantoins -Drug of choice -GI mg/mL
for patients -Severe Liver Tox -Check serum levels until stable
unable to tolerate -BMS -Children need a higher dose
sedation & -Steve Johnsons -Use a barrier method
drowsiness Disease
-nystagmus (Teach about liver toxicity)
-Cardi Arrhythmia
-Increases Blood
Glucose
-Loss of libido

Class Indications: Adverse Effects Contraindications Drug-Drug Route Assess

-Tonic-clonic & -First get level of Orientation and
Barbiturate Cortical Focal Taper Promote orientation (CNS)
seizures medication -Withdrawal (taper medication)
(Parenteral) so they -More likely to be used in
Same as phenytoin -Cat.D Fetal -Oral Contraceptives don’t have pregnancy
Phenobarbital

& Bleeding -Alcohol withdrawal -Check adequate urine output ->

Prototype

-Long duration Nightmare -Other Ant seizures -Takes a while to kick in and lasts
-Low lipid Hallucinations Therapeutic a long time.
solubility Abuse increases 15-40 Emergency cases-Status epileptic,
-Less Severe sedation mcg/ml tetanus, eclampsia,
teratogenicity
-RAS receptors Overdose=activated charcoal

(Can have my baby and play with

her Barbie’s)
 Prototype Indications Adverse Effects Contraindications Drug-Drug Route Assess
-Management of -Urinary Retention -Have been associated with
Diazepam Anxiety disorders -GI -Cat.D Fetal -Oral Contraceptives -Long dependency & withdrawals
-Muscle relaxant -Paradoxical Bleeding -Alcohol 18-50 hour
Antidote= -Tetanus Excitatory reactions -Other Ant seizures half life
Benzodiazepines

Flumazenil -Relives anxiety -Withdrawal Clonazepam =

-Acute Alcohol syndrome oral disintegrating tablet good
withdrawal for PT w/trouble swallowing
-Tonic-Clonic
Class

-Potentiate
effects of GABA
Prototype Indications Adverse Effects Contraindications Drug-Drug Route Nursing Considerations
Absence seizures -Few A/E compared -OB/Lact -Primidone -Take right after meal
Ethosuximide w/other -Patients with Dec serum levels -Use this drug first due to
Succinimides

(Vampire antiepileptic drugs intermittent A barb anti-seizure) lessened effects therapeutic drug
teeth) porphyria level
Class

Decreases GI (Skin blisters gum

Anorexia recedes) 1. ethosuximide less side effects
Irritability than
2. methsuximide lot more
adverse effects
Indications Adverse Effects Contraindications Drug-Drug Route Nursing Considerations
Valporic Absence seizures Liver TOX Cat. X -Phenobarbital -Assess liver enzymes/Renal tests
Other Acid GABA receptors CNS drowsy/dizzy Hepatic /Renal ^serum levels -Monitor Muscle Weakness
Drugs for -Other anti-seizure -Monitor serum levels of Valporic
Treating meds Acid
Absence ethosuximide
Seizures diazepam -ECG if necessary
primidone -Description of seizures including
zidovudine onset aura duration and recovery
 Indications Adverse Effects Contraindications Drug-Drug Route Nursing Considerations
Drugs for Drug of choice for -Most CNS related -Decreased fertility -Numerous check Metab by -Administer with food
treating Carbamazepine Partial Seizures/ -Ataxia with males drug guide liver -Caution with fertility with men
Prototype

Partial tonic-clonic - Liver TOX/fail cyto450 Assess

Seizures -Bipolar disorder - Decreases BMS -Alcohol -History of BMS
-Trigeminal -Risk for suicide -Grapefruit -Ren/Hep function
neuralgia -Vision Changes -Cytochrome 450 -VS, Orientation, affect, reflexes
-Increase GABA -Stevens-Johnson grip
activity Syndrome -EEG if appropriate
Chapter 30
Adrenergic Agonists
-Adrenergic Agonists are Sympathomimetic drugs that mimic the effects of the SNS (fight or flight)
-Use- Varies from ophthalmic preparations for dilating pupils to systemic preparation for shock
Know the Alpha and Beta page 492,493, and parasympathetic (you give a sympathetic mimic to reverse it) responses block and
-Adrenergic drugs increase heart rate
Class: Prototype Indications Adverse Effect Contraindications Drug Drug Route Nursing Considerations

Class Prototype Indications: Adverse Effect Contraindications Drug Drug Route Nursing Considerations
-Stimulates both -Tachycardia -Hypovolema -Tricyclic -IV only -Sympathetic Response
(Treat first)
alpha beta -Hypotension -Pheochromocytoma antidepressants -Vital signs
Alpha & Dopamine -Naturally (causes over load of TCA -Vasoconstriction & ^ HR
Beta occurring catecholamine’s) -MAOI -Pupil Dilation
Adrenegic -Shock/heart -Peripheral (PVD) -Herbal OTC -Hypovolemia
-Tachyarrhythmia’s
Extravasation stimulant - Decrease V Fib -Assess for V fib and
antidote (fast/irregular/dangero Tachyarrhythmia’s
Phentolamine us) -ECG if appropriate
Class Prototype Indications Adverse Effect Contraindications Drug-Drug Route Nursing Teach
-Shock SVT STIM SNS -Severe hypertension -TCA -IV -Level of orientation
Alpha PHENYLEPRI -Glaucoma -Anxiety/ -OTC =antidepressants -Topical -Watch urinary output
-CVD/vasomotor
Specific NE -Non drowsy restlessness -MAOIs -Taper off over 2 to 4 days*
spasm
adrenergic sinus med Cold/F -Fear Thyrotoxicosis/DM
-Liver -VS (HR)/ECG
Agonist -Otitis media -Pallor -OB –Narrow-angle -Urine/bile -
topical Ø 3 + days -Nausea Glaucoma -Labs Ren/Hep
Class Indications Adverse Effect Contraindications Drug-Drug Route Nursing Teach
-Shock -MI -Pulmonary HTN -Sympathomimetic -Critical -Assess
Beta -Heart Transplant -Palpitations -Eclamspia drugs ^ effects Care -Pulmonary HTN
Specific -Stimulates Beta -Restlessness -Uterine Hem -IV only -Uterus Hemorrhage
Isoproterenol

Adrenergic -Bronchospasm -Anxiety -Intrauterine Death - Beta adrenergic -Intrauterine Death

Prototype

Agonist during anesthesia -Fear -OB/Lact blockers/ Ø last long -Diabetes, Thyroid
-Hyperkalemia -Angina Antagonist ˇ effect -VS, ECG
Stim beta adrenergic -Difficulty
receptors = Increase
Breathing
(Heart rate,
Conductivity,
contractility,
bronchodilation,
Blood flow to S.M.
-Relax Uterus
Chapter 31
Adrenergic Antagonists
Beta ones end in LOL
Alpha blockers are useful in the treatment of hypertension
-Beta blockers decrease heart rate
-History of smoking= atenolol

Class Prototype Indications Adverse Effect Contraindications Drug-Drug Route Nursing Teach
Alpha Beta -Nonselective Dizziness/insomnia -Asthma - Anesthetic agents Assess
Adrenergic blocking agent –Arrhythmias (Could lose (halothane -Hypertension
Blocking Labetalol -HTN -Bronchospasm broncodilation /isoflurane) -Bradycardia or Heart Block, VS,
pheochromaocyt -Hypotension effects) -Enfurane level of orientation
oma -Diabetes -Bradycardia or -Diabetic agents -Asthma or Bronchospasm
-Clonidine -Congestive heart heart block -OTC cold drug -Shock or HF, ECG LABS
withdrawals (CHF) -Shock or CHF either ^ or ˇeffect -OB
-Block the effects -Pulmonary Edema -Bronchospasm -Calcium Channel -Diabetes
of -Diabetes Blockers
Norepinephrine OB
Class Indications: Adverse Effect: Contraindications Drug-Drug: Route: Nursing Teach
Alpha -Antidote for Heart: -Coronary Art Injection/a -Assess for any CV disease
Adrenergic dopamine Hypotension (CAD) Alcohol (lower BP bsorbed -Cardiac output levels
Blocking norepinephrine -Orthostatic -MI /Vasodilation) (IV/IM) -Pregnancy Lactation
Agent -Severe hypotension -CVA Urine -Orientation, Affect, Reflexes
hypertension -Angina -OB/Lact Ephedrine -VS, Peripheral perfusion and
Phentolamine

reactions caused -MI -Epinephrine cardiac output

Prototype:

by manipulation -Cerebrovascular (vasocxn)(^HTN)

of (CVA)
pheochromocyto -Arrhythmia
ma effects Flushing
(before and after Weakness
surgery) Dizzy
-Blocks alpha one Headache
receptors causing -MI
vasodilation and
lowering BP
Class: Prototype: Indications: Adverse Effect Contraindications Drug-Drug Route Nursing Teach
Alpha -Mild to Mod HTN -Arrhythmias -Lactation -Vasodilators -Hep/Ren Function
1-Selective Doxazosin -Benign prostatic -Edema -CHF -Antihypertensive Extensive -CV Disease
Adrenergic hypertrophy -GHF -Renal Failure drugs hepatic -Sexual Dysfunction
Blockers (Relaxes bladder -Angina Metabolism
and prostate also -GI
used for kidney -CNS
stones) -Hypotension
Class Prototype: Indications: Adverse Effect: Contraindications Drug Drug: Route: Nursing Teach:
Beta Stage Fright and -Decrease libido -Diabetes -Clonidine -Bradycardia, heart blocks, shock,
Adrenergic Cardiovascular -Pulmonary Edema -Bradycardia -NSAID heart failure
Blocking Propranolol problems -Sleep disturbances -Heart Block -Insulin/ant diabetic -Ren/Hep Dysfunction
Agent -Prophylaxis for - CNS -Shock CHF -COPD
migraines -GI -COPD -Acute Asthma
-Essential -Bradycardia -Asthma -Diabetes, Thyrotoxicosis, OB/L
Tremors -Bronchospasm -OB/Lact -Teach “This will decrease you
heart rate “
-May not be able to exercise due
to decrease exercise tolerance
Class: Prototype: Indications Adverse Effect Contraindications Drug-Drug: Route Nursing Teach
Beta 1- -Preferred with -CNS: Sleep Disturb - Sinus Bradycardia Assess:
Selective people with -Heart: Bradycardia -Heart Block -NSAIDS Bradycardia/Heart Blocks/shock
Adrenergic Atenolol reparatory CHF/ Hypotension -Cardiogenic Shock -IV Lidocaine or heart failure
Blocking (smoking/asth -Pulmonary at high -CHF Neuro/ cardiac status
ma/COPD/aller Respiratory track -Hypotension -VS,LS,ECG, LAbs
gies) because it ranges from rhinitis
doesn’t block the to bronchospasm -COPD Off Label Uses
bronco -Decrease Libido -Diabetes Migraine
-HTN and impotence -Thyroid Disease Prevents alcohol withdrawal
-Angina
-Cardiac -Preferred for Smoker
Arrhythmias