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Pharm II unit 12
ANESTHETICS AND NEUROMUSCULAR BLOCKING AGENTS
54
Nursing
Undergraduate 1
11/29/2011

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Cards

Term
What type of drug is turbocurarine (Tubarine)
Definition
NONDEPOLARIZING- NEUROMUSCULAR BLOCKING AGENT 
Term
 What is turbocurarine (Tubarine) used for?
Definition

·        skeletal muscle relaxant

·        adjunct to general anesthetics

·        Minimized patient movement to conserve energy and agitation to prevent ICP increases in ICU’s.

·        Diagnose myasthenia gravis

Term
What types of pts should not use turbocurarine (Tubarine)
Definition

·        hypersensitivity

·        early pregnancy


Term
What types of pts need extra caution whlie on turbocurarine (Tubarine)
Definition

Caution with patients with pulmonary disease or cancer

·        May exacerbate asthma, hypotension and cardiac disease

·        Use cautiously in persons suffering from hypovolemia, acid/base imbalance and electrolyte imbalance.

Term
What are the common side effects of turbocurarine (Tubarine)
Definition

flushing

hypotension


Term

What are the serious side effects of turbocurarine (Tubarine)

Definition

  prolonged paralysis

 apnea

malignant hyperthermia

Term

A pt is on turbocurarine (Tubarine) the nurse knows to try and        Decrease ____ and ____.

 

Definition
anxiety, fear
Term
Your pt is on turbocurarine (Tubarine) what equipment/supplies do you need to have ready at bedside?
Definition

Have resuscitation equipment and cholinesterase inhibitor antidote at bedside

Term
What type of drug is succinylcholine (Anectine)
Definition

DEPOLARIZING 

NEUROMUSCULAR BLOCKING AGENT

Term
How does succinylcholine (Anectine) work?
Definition
Agonist at the cholinergic nicotinic receptors.  Produces repetitive excitation of the motor end plate which causes rapid contractions followed by flaccid paralysis.
Term
What is succinylcholine (Anectine) used for?
Definition

·        IV or IM administration for rapid endotracheal intubation

·        endotrachial procedures

Term
What type of pt should youo question an order of succinylcholine (Anectine)
Definition

·        hypersensitivity

·        familial hx of malignant hyperthermia

·        open eye injury

·        acute narrow-angle glaucoma

·        clients who have or who are at risk for hyperkalemia

Term

What are the common side effects of  

succinylcholine (Anectine) 

Definition

·        Increased ocular pressure

·        histamine release,

·        muscle pain (this is due to the rapid cycling at the beginning of induction)

Term

What are the serious side effects of  

succinylcholine (Anectine) 

Definition
Prolonged paralysis and apnea
Term
What equipment will a nurse need to have at the bedside when giving succinylcholine (Anectin)
Definition

 Have resuscitation equipment at the bedside

Have oxygen available.


Term
What type of drug is Propofol (Diprivan)
Definition
PARENTERAL ANESTHETIC AGENT
Term
What is Propofol (Diprivan) used for
Definition

Induction and maintenance of general anesthesia

sedation in ICU

Term
How fast does Propofol (Diprivan) work?
Definition

·        IV administration

·        Rapid onset- 40 seconds

·        rapid recovery with minimal psychomotor impairment

Term
What types of pts should not be given Propofol (Diprivan) 
Definition

·        Hypersensitivity

·        Pregnancy and lactation

·        seizure disorders

·        Caution with patients who have cardiac or PVD

·        Increased ICP


Term
What are the common side effects of Propofol (Diprivan) 
Definition

·        nausea and vomiting

·        involuntary muscle movement

·        Hypotension

·        Pain at injection site


Term

What are the serious side effects of Propofol (Diprivan) 

Definition

·        Apnea

·        Anaphylaxis


Term
A pt is to have Propofol (Diprivan) what type of inviroment should you provide 
Definition

Low stimulus environment

Term
What should the nurse assess for befor giving Propofol (Diprivan) r/t condition of the medication.
Definition
Observe for particles or discoloration prior to administration- if separated emulsion do not use
Term

Why should a nurse limit duration of administration of 

 Propofol (Diprivan)

Definition

to avoid bacterial growth

Term

What vitalsings need to wached closly while on

Propofol (Diprivan)

Definition
BP, Respirations
Term
What type of drug is carbidopa-levodopa (Sinemet)
Definition
ANTIPARKINSON- DOPAMINERGIC
Term
What does carbidopa-levodopa (Sinemet) treat?
Definition

·        Parkinson disease

·        restless-leg syndrome


Term
How does carbidopa-levodopa (Sinemet) work?
Definition
Dopamine does not cross the BBB so precursor levodopa is used.  Due to high level of destruction of levodopa before absorption, carbidopa is added
Term

What types of pts should not be on

carbidopa-levodopa (Sinemet)

Definition

·    hypersensitivity

·        can activate malignant melanoma

·        closed-angle glaucoma

·        cannot be administered concurrently with MAOI’s


Term

What types of pts should be monitored while on

carbidopa-levodopa (Sinemet)

Definition
patients with cardiac disease, peptic ulcer disease and diabetes must be monitored closely
Term

What are the common side effects of

carbidopa-levodopa (Sinemet)

Definition

·        abnormal movements

·        orthostatic hypotension

·        GI effects


Term

What are the serious side effects of

carbidopa-levodopa (Sinemet)

Definition

·        neuroleptic malignant syndrome with abrupt cessation

·        assess for psychosis and suicidal thoughts


Term
How should carbidopa-levodopa (Sinemet) be given in relation to food.
Definition

Take on an empty stomach

Term
What diet would you give a pt on carbidopa-levodopa (Sinemet)
Definition

·        reduce protein and pyridoxine in diet

Term

What should a nurse know about

carbidopa-levodopa (Sinemet) r/t Titration

 

Definition

Titrate drug up to avoid GI effects

Titrate drug down to discontinue to avoid neuroleptic 

Term
Your pt is on carbidopa-levodopa (Sinemet) what should you teach them about thair BP
Definition
Teach client about hypotension associated with bradykinetic episodes or “on-off “syndrome.
Term
What type of drug is riluzole (Rilutek)
Definition

ANTI-AMYOTROPHIC

LATERAL SCLEROSIS

Term
What is riluzole (Rilutek) used to treat?
Definition
Treatment of ALS- slows disease’s progression
Term
How does riluzole (Rilutek) work?
Definition

Possible inhabitation of glutamate release- not really known


·        50mg doses orally every 12 hours

slow onset- duration 3-5 days

Term
What types of pts should not use riluzole (Rilutek)
Definition

·        hypersensitivity

·        Pregnancy category C


Hepatic disease, renal disease can affect clearance of drug

Term
What are the common side effects of riluzole (Rilutek)
Definition

·        May be confused with s/s of disease

·        Muscle fatigue

·        nausea and vomiting

·        anorexia,

·        vertigo and somnolence


Term

What are the serious side effects of riluzole (Rilutek)

Definition
neutropenia:  ask client about sore throat
Term

What type of history will you need on a pt taking 

riluzole (Rilutek)

Definition

Elicit careful renal and hepatic history

Term

If your pt is on riluzole (Rilutek)

what labs should you moniter

Definition

·        Monitor CBC and hepatic enzyme studies before therapy, monthly for 3 months, and then every 3 months.

Term

If your pt is on riluzole (Rilutek) what

diet restictions should they fallow

Definition

·        Monitor diet for caffeine and high fat as these affect drug utilization. 

Encourage high protein diet

Term
When should riluzole (Rilutek) be given in r/t food
Definition
Take drug on an empty stomach
Term
Your pt is going to start taking riluzole (Rilutek), what activitys should you caution against
Definition

Refrain from driving and tasks that require concentration till effects of drug known.

Term
What type of drug is glatiramer (Copaxone)
Definition
ANTI-MULTIPLE SCLEROSIS
Term
What is glatiramer (Copaxone) used for 
Definition
Reduce frequency of attacks in relapsing-remitting MS
Term
How does glatiramer (Copaxone) work
Definition
Synthetic chemical similar to myelin basic protein. May act as a decoy to locally generated auto-antibodies
Term
What types of pts should not use glatiramer (Copaxone)
Definition

·       those that need IV administration

·        hypersensitivity to Mannitol

·        Caution in immunocompromised patients or clients receiving vaccinations


Term

What are the Serious Adverse Effects

of  glatiramer (Copaxone)

Definition

·        chest pain or tightness

·        breathing difficulties

·        rash, hives


Term
Your pr tells you she has an OBGYN apointment and is on glatiramer (Copaxone). What eduation should you give this pt.
Definition

Can alter results of pap smear

Term
How should glatiramer (Copaxone) be stored?
Definition

·        Keep medication refrigerated,


reconstitute medication using sterile water.

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