Neuro pt 1

what is Benztropine

anticholinergic

Benztropine pharmacological action

Decreases the effects of acetylcholine which results in a decrease \n in tremors and muscle rigidity

Benztropine Therapeutic use

\-Treats Parkinson’s disease for tremors & Muscle rigidity \n -Also for acute dystonic reactions

Benztropine complications

\-If decrease in urinary output = need to stop \n -Dry mouth, constipation, worsening of mental symptoms when starting meds, decreasing sweating, blurred vision

Benztropine contraindications/ precautions

no one under 3yrs old

no alcohol

Benztropine med admin

\-do not give within 2 hours of antacids and antidiarrheals

Benztropine nursing interventions

* encourage fluids
* no one under 3 yrs old
* no admin within 2 hrs of antacids and antidiarrheals

Benztropine patient education

no alcohol

drink lots of fluids

avoid hot weather- can cause hyperthermia

Benztropine effectiveness evaluation

* decrease in tremors
* decrease in muscle rigidity

What is Cyclobenzaprine?

central acting muscle relaxant

Cyclobenzaprine pharmacological action

Enhance inhibitory effects of GABA in the spinal column

Cyclobenzaprine therapeutic use

Relief of muscle spasms do to MSK injury

Cyclobenzaprine complications

CNS effects- drowsiness, dizziness, decreased bp, nausea, constipation

Cyclobenzaprine contraindications/predictions

\-Previous allergy to the drug,

\-Use of MAOI antidepressants within 2 wks can cause: \n Cerebral palsy, severe renal impairment, older adults & children

Cyclobenzaprine interactions

\-avoid alcohol, CNS depressants \n -Use with MAOI can cause HTN crisis

Cyclobenzaprine med admin

oral- start with low dose and gradually increase, give w food/milk

Cyclobenzaprine nursing interventions

\-Start with low dose & gradually increase \n -Give with food or milk \n -encourage fluids, increase fiber

\- careful to discontinue

\-do not give with other CNS depressants/ sedatives

Cyclobenzaprine patient education

\-CNS effects will subside over time \n -Increase fluids & fiber \n -Do not drive if drowsy \n -Change positions slowly \n -No alcohol

\-do not take w sedatives \n -Take with food or milk

Cyclobenzaprine effectiveness evaluation

relief of muscle spasms

What is levodopa/carbidopa

dopamine replacement

\n levodopa/carbidopa pharmacological actions

\-Levodopa can cross blood brain barrier, gets taken up by \n dopaminergic nerves and converts to dopamine.

\-Carbidopa helps levodopa get to the brain, helps minimize side effects by preventing the levodopa that remains in the periphery from converting to dopamine.

\n levodopa/carbidopa therapeutic actions

Relieves symptoms of parkinson’s disease

\n levodopa/carbidopa complications

\-Nausea & vomiting, orthostatic hypotension, darkening & sweeting of urine

\-dykenesia’’s, tremors, twitching, other movements

\-symptoms of psychosis-hallucinations & paranoia

\n levodopa/carbidopa contraindications

\-Narrow angle glaucoma

\-history of melanoma

\-history of psychosis/ or suicidal thoughts.

levodopa/carbidopa precautions

\-Older adults

\-Existing renal, hepatic, resp. or endocrine disorders \n -Wide angle glaucoma

\-peptic ulcers,

\-depression, bipolar disorder

\n levodopa/carbidopa med admin

\-Start low dose, gradually increase \n -can take up to 6 months for full response \n -monitor for on/off episodes \n -immediate release work fast but wears off \n -extended release works longer but takes longer to start working

\n levodopa/carbidopa nursing interventions

\-Combination drug \n -GI disturbances: carbidopa helps \n -Dyskinesia: decrease levodopa, or give amantadine

\- Give antipsychotics for psychosis

\-watch for OH

\n levodopa/carbidopa patient education

\-Take with food \n -Avoid high protein foods \n -Move slowly from sitting to standing

\n levodopa/carbidopa effectiveness evaluation

Decrease in parkinson’s disease symptoms

What is Baclofen?

\n central acting muscle relaxant

Baclofen pharmacological actions

Enhance inhibitory effects of GABA in the spinal column

Baclofen therapeutic actions

Relieve muscle spasticity due to cerebral palsy, spinal cord injury, multiple sclerosis

Baclofen complications

\-CNS effects: drowsiness, dizziness, decreased b/p

\-Nausea, constipation

\-Withdrawal symptoms can occur if stopped abruptly

Baclofen percautions/contraindications

\-Previous allergy to the drug, \n -severe renal impairment,

\-older adults & children

Baclofen med admin

Oral: start in low dose & gradually increase

\-give with food/milk

\-Can also be intrathecal (directly into spine)

\-do not stop abruptly

Baclofen nursing interventions

\-Start with low dose & gradually increase \n -Give with food or milk \n -encourage fluids, increase fiber

\-caution discontinuing

\-do not give with other CNS depressants or sedatives

Baclofen patient education

\-CNS effects will subside over time \n -Increase fluids & fiber \n -Do not drive if drowsy \n -Change positions slowly \n -Do not drink, no sedatives \n -Take with food or milk \n -Do not stop abruptly, taper off

Baclofen effectiveness evaluation

Relief of muscle spasticity