Nursing exam 3 pharmacology

Glatiramer acetate

for prevention, reducing MS relapses over time

teach site rotation (arms, hips, thighs), first dose administered under medical supervision, site reaction (redness, pain, swelling, and itching), small percentage experience flushing, chest pain, rapid heartbeat after injection

Mitoxantrone

immunosuppressant MS, risk is cardiotoxicity (irreversible congestive heart failure), ALL patients must have their left ventricular ejection fraction evaluated before the first dose, causes bone marrow suppression (monitor CBC), extravasation (causes tissues damage if leaks out of fine), medication turns urine blue green for 24 hours

Neostigmine

used for myasthenia gravis, increase acetylcholine to improve muscle strength, administer meds exactly on time, assess for therapeutic effects,

Pyridostigmine

used for myasthenia gravis, improves muscle strength and reduces symptoms, highest priority is respiratory

Dopamine agonists (pramipexole, ropinirole)

used in younger patients to delay need for levodopa, side effects can include impulse control disorders, sleep attacks or orthostatic hypotension

MAO-B inhibitors (selegiline, rasagiline)

allows the dopamine that is present to last longer, AVOID tyramine high levels can cause a hypertensive crisis, avoid aged cheeses, cured meats, fermented foods, blocks enzyme that breaks down dopamine

Catechol O-Methyltransferase (entacapone)

helps levodopa work longer, enhances levodopa but can worsen side effects (urine may turn orangish brown), only used with levodopa

Anticholinergics (benztropine)

restore the dopamine-acetylcholine balance, side effects (cant see, pee, spit or poop), contraindicated in patients with glaucoma

carbidopa levodopa

levodopa (gets converted to dopamine), carbidopa (protects levodopa from being broken down), “on/off”, high protein can decrease absorption, take on empty stomach

benzodiazepines (lorazepam)

GABA enhancer used during prolonged seizure, given through an IV, respiratory depression is more adverse effect, antidote is flumazenil

Phenytoin

tonic-clonic and partial seizures, 10-20mcg/mL therapeutic range, only mixed with NS, requires filter

Cholinergic (bethanechol)

stimulates the receptors on the muscle of the bladder, treats non obstructive urinary retention, , (wet side effects), can cause bradycardia or hypotension

interferon

FOR MULTIPLE SCLEROSIS, reduces immune system inflammatory response, decrease number of cells that attack the myelin in the CNS

Corticosteroids

reduce inflammation, monitor blood glucose (hyperglycemia), infection signs and GI symptoms, fluid retention

Corticosteroids (long term)

osteoporosis (decease calcium absorption), adrenal suppression (cause adrenal glands to stop producing their own cortisol), cushing disease apperance, cataracts and glaucoma, muscle wasting