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ATI Pharmacology NIC
Chap 15 - 18
93
Pharmacology
09/15/2011

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Term

CHAPTER 15

Miscellaneous central nervous system medications

Definition
Term

MEDICATION CLASSIFICATION

Muscle Relaxants and antispasmodics

 

Definition
Term
Meds
Definition
  • Diazepam (Valium) - central acting
  • Dantrolene (Dantrium) - periphereal acting
  • Baclofen (Lioresal) - ca
    Cyclobenzaprine (Skelaxin) - ca
  • Tizanidine (Zanaflex) -ca
Term
Complications
Definition

All of the meds

  • CNS depression

Centrally Acting Agents

  • Hepatic Toxicity
  • Physical Dependance
  • Nausea, constipation, and urinary retention (Baclofen)

Peripherally Acting

  • Hepatic Toxicity
  • Muscle Weakness
Term
Contraindications
Definition

Baclofen and Dantrolene

preg risk C

Diazepam

Preg risk D

 

All Meds

use cautiously with impaired liver and renal function

other CNS Depressants

Term

MEDICATION CLASSIFICATION

Muscarine Agonists

Definition
Term
Med
Definition
Bethanechol (Urecholine)
Term
Uses
Definition
Nonobstructive urinary retention, usually post op or post partum
Term
Complications
Definition
Extrene muscarinic stimulation may result in sweating, tearing, urinary urgency, bradycardia, and hypotension
Term
Contraindications
Definition
contraindicated in clients with urinary or GI obstruction, peptic ulser disease, coronary insufficiency, asthma, and hyperthyroidism
Term

MEDICATION CLASSIFICATION

Muscarinic Antagonists

Definition
Term
Meds
Definition
  • Oxybutynin (Ditropan)
  • Oxybutynin transdermal system (Oxytrol)
  • Darifenacin (Enablex)
  • Tolterodine (Detrol)
Term
Uses
Definition
Overactive Bladder
Term
Complications
Definition
  • Anticholinergic effects
  • CNS effect - hallucinations, confusion, insomnia, nervousness
Term
Contraindications
Definition

glaucoma

GI or GU obstruction

urinary rentention

use cautiously in pts with GERD, heart failure, kidney or liver impairment

 

Term

Chapter 16

Sedative-Hypnotics

Definition
Term

MEDICATION CLASSIFICATION

Benzodiazepines

Definition
  • Diazepam (Valium)
  • Alprazolam (Xanax)
  • Lorazepam ( Ativan)
  • Chlordiazepoxide (Librium)
  • Temazepam (Restoril)
Term
Uses
Definition
  • Anxiety
  • Seizure disorders
  • Insomnia
  • Muscle Spasm
  • Alcohol Withdrawal
  • Panic Disorder
  • Induction of Ansthesia
Term
Complications
Definition
  • CNS Depression
  • Anterograde Amnesia
  • Paradoxical Response
  • Resp depression
  • Physical Dependance
  • AcuteToxicity
Term
Contraindications
Definition
  • preg risk D
  • sleep apnea, respiratory depression, organic brain disease, during lactation
  • hx of substance abuse use cautiously
  • other CNS depressants
Term

MEDICATION CLASSIFICATION

Nonbenzodiazepines

Definition
Term
Meds
Definition
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Eczopicone (Lunesta)
  • Trazadone
Term
Uses
Definition
Management of Insomnia
Term
Complications
Definition
  • Daytime Sleepiness
  • Lightheadness
Term
Contraindications
Definition

Preg risk B

breastfeeding pts

older clients use cautiously

Term

MEDICATION CLASSIFICATION

Melatonin Agonist

Definition
Term
Med
Definition
Ramelteon (Rozerem)
Term
Uses
Definition
Managment of Insomnia
Term
Complications
Definition
  • Sleepiness
  • Dizziness
  • Hormonal Effects
Term
Contraindications
Definition

Preg Risk C

Use cautiously in pts with liver disease

high fat foods

concurrent use of fluvoxamine (Luvox)

CNS Depressants

Term
Chapter 17 - Airflow Disorders
Definition
Term

MEDICATION CLASSIFICATION

Beta2 - Adrenergic Agonists

Definition
Term
Meds
Definition
  • Albuterol (Proventil, Ventolin)
  • Formoterol (Foradil Aerolizer)
  • Salmeterol (Serevent)
  • Terbutaline (Brethine)
  • Levalbuterol (Xopenex)
Term
Uses
Definition
long term control of asthma
Term
Complications
Definition
  • inhaled agents have minimal adverse effects
  • oral agents can cause tachycardia and angina
  • Tremors
Term
Contraindications
Definition

Preg Risk C

pts with tachydysrhythmias

use cautiously pts with diabetes, hyperthyroidism, hypertension, and angina

use of propranolol

MAOIS and Tricyclic antidepressants

Term

MEDICATION CLASSIFICATION

Methylxanthines

Definition
Term
Meds
Definition
Theophylline
Term
Uses
Definition

Long term control for chronic asthma (oral)

 

Term
Complications
Definition
  • Mild toxicity
  • dysrhythmias and seizures
Term
Contraindications
Definition
  • Preg risk C
  • Use cautiously in children and older adults
  • Caffeine can increase med
  • Phenobarbital and Phenytoin decrease med
  • Cimetidine (Tagamet), ciproflaxin (Cipro) and other Fluoroquinolone abx's increase drug 
Term

MEDICATION CLASSIFICATION

Inhaled Anticholenergics

Definition
Term
Med
Definition
  • Ipratropium (Atrovent)
  • Tiotropium (Spiriva)
Term
Uses
Definition
  • relief of bronchospasm associated with COPD
  • Allergen and exercise induced ashtma
  • Inhalation
Term
Complications
Definition
Local anticholenergic effects
Term
Contraindications
Definition

Preg Risk  B

pts who have allergies to peanuts

 

Term

MEDICATION CLASSIFICATION

Glucocorticoids

 

Definition
Term
Meds
Definition

Inhalation

  •  Beclomethasone (QVAR)
  • Budesonide (Pulmicort Flexhaler)
  • Fluticasone ( Advair, Flovent)
  • Triamcinolone acetonide (Azmacort)

Oral

  • Prenisone (Deltasone)
  • Prednosolone (Prelone)

IV

  • Hydrocortisone Sodium Succinate (Solu-Cortef)
  • Methylprednisone Sodium Succinate (Solu Medrol)
Term
Uses
Definition
depend on route pg 212
Term
Complications
Definition

Inhaled Glucorticoids

  • dificulty speaking, hoarsenss, and candidiasis

Prednisone (When used more than 10 days)

  • suppression of adrenal gland
  • bone loss
  • hyperglycemia and glucosuria
  • myopathy
  • peptic ulcer disease
  • Infection
  • Disturbances of fluid and electrolytes
Term
Contraindications
Definition
  • Preg Risk C
  • clients who have recieved a live virus vaccine
  • systemic fungal infections
  • use cautiously with NSAIDS
    concurrent use of K+
  • concurrent use of glucocorticoids and hypyglycemic agents
Term
Administration
Definition

consume a diet with sufficient calcium and vit D

 

Term

MEDICATION CLASSIFICATION

mast cell stabilizers (anti-inflammatories)

 

Definition
Term
Meds
Definition
Cromolyn Sodium (Intal)
Term
Uses
Definition
  • management of chronic asthma
  • prophylaxis of exercised - induced asthma
  • prevention of allergen - induced attack
  • allergic rhinitis by nasal route
  • inhalation route of admin
Term
Compications
Definition
  • Safest of all asthma medications
  • Safe to use for children
Term
Complications
Definition

Preg Risk B

use cautiously with pt with liver and kidney disease

Term

MEDICATION CLASSIFICATION

Leukotriene Modifiers

Definition
Term
Meds
Definition
  • Montelukast (Singulair)
  • Zileuton (Zyflo)
  • Zafirlukast (Accolate)
Term
Uses
Definition
long term therapy of asthma in adults and children 15 up
Term
Complications
Definition
liver injury with Zyflo and Zafirlukast
Term
Contraindications
Definition

cautiously in pts with liver dysfunction

Zileuton and Zafirlukat inhibit metabolism of coumadin

Zileuton and Zafirlukat inhibits metabolism of Theophylline

Term

Chapter 18 - Upper Respiratory Disorders

 

Definition
Term

MEDICATION CLASSIFCIATION

Antitussived -Opioids  

Definition
Term
Meds
Definition
  • Codiene
  • Hydrocodone
Term
Uses
Definition
Chronic Nonproductive Cough
Term
Complications
Definition

CNS Effect - dizziness, light headness, drowsiness, resp depression

GI Distress

Potential for Abuse

Term
Contraindications
Definition
  • Codiene is Preg Risk C
  • acute ashthma, head trauma, liver and renal dysfunction, and acute alcoholism
Term

MEDICATION CLASSIFICATION

antitussives - non-opoids

Definition
Term
Meds
Definition
  • Dextromethorphan - found in robitussin
  • Benzonatate (Tessalon)
  • Diphenhydramine (Benadryl)
Term
uses
Definition
Cough Suppressant
Term
Complicatons
Definition
  • Few adverse effects
  • mild nausea, dizziness, and sedation
  • some potential for abuse
Term
Contraindications
Definition
  • Preg Risk C
  • may cause high fever if used within 2 weeks of MAOI antidepressants
Term

MEDICATION CLASSIFICATION

Expectorants

Definition
Term
Meds
Definition
Guaifenesin (Mucinex)
Term
Definition
Term
Uses
Definition
  • increases cough production
  • often used with atitussives or a decongestant
  • relieve colds
  • rhinitis
Term
Complications
Definition
  • GI Upset
  • Drowsiness, dizziness
  • Allergic Reaction (rash)
Term
Contraindications
Definition
  • Preg Risk C
  • talk to MD before breastfeeding
  • may or may not be recommended for children
Term

MEDICATION CLASSIFICATION

Mucolytics

Definition
  • Acetylcysteine (Mucomyst, Acetadote)
  • Hypertonic Saline
Term
Uses
Definition
  • acute and chronic pulmonary disorders
  • cystic fibrosis
  • Acetylcysteine is the antidote for acetaminophen poisoning
Term
Complications
Definition
  • Preg Risk B
  • clients at risk for Gi Bleed

 

Term

MEDICATION CLASSIFICATION

Decongestants

Definition
Term
Meds
Definition

Phenylephrine

Ephedrine

Naphazoline

Phenylypropanolamine

Term
Uses
Definition
  • treat allergic rhinitis
  • sinusitis and common cold
Term
Complications
Definition
  • Rebound Congestion secondary to prolonged use of topical agents
  • CNS Stimulation
  • Vasoconstriction
Term
Contraindications
Definition
  • chronic rhinitis
  • caustiously with pts with coronary artery and hypertension
Term

MEDICATION CLASSIFICATION

Antihistamines

Definition
Term
Meds
Definition

1st generation h1 antagonists

  • Diphenhydramine (Benadryl)
  • Promethazine (Phenergan)
  • Dimenhydrinate (Dramamine)

2nd generation h1 antagonists

  • Loratadine (Claritin)
  • Cetirizine (Zyrtec)
  • Fexofenadine (Allegra)
  • Desloratadine (Clarinex)
Term
Uses
Definition

1st generation

  • mild allergic reactions
  • Anaphylaxis
  • Motion Sickness
  • Insomnia
Term
Complications
Definition
  • Sedation
  • Anticholinergic Effects
  • GI Discomfort
  • Acute Toxicity - children have symptoms of excitation and hallucinations
Term
Contraindications
Definition
  •  during third trimester of pregnancy
  • use cautiously in children
  • CNS Depressants
Term
Definition