Review of Exam 1 Prototype Meds

Levodopa (Stalevo), carbidopa (Sinemet), entacapone

For Parkinson’s Disease (PD)

Drug class: Dopaminergic Agent

MOA: ↑ dopamine in CNS

SE: Orthostatic hypotension, dyskinesia

Nursing Intervention:

Pt Education: take med in empty stomach or 2 or more hrs AFTER a meal containing protein & dark urine is NORMAL

benztropine (Cogentin)

For Parkinson’s Disease (PD) - EARLY stage of PD

Drug class: Anticholinergic Agent

MOA: Blocks acetylcholine inhibits overactivity in the brain -> allows dopamine levels to ↑

SE: confusion, delusion, hallucination, bradycardia, glaucoma, anticholinergic effect (dry mouth, blurred vision, dry eyes, constipation)

Nursing Intervention: docusate (Colace) is CONTRAINDICATED

• ANTIDOTE: Physostigmine (for anticholinergic toxicity)

Pt Education: take with food or milk, eat hard candy, drink fluids, AVOID alcohol & bright sunlight

donepezil (Aricept)

For Alzheimer’s Disease (AD)

Drug class: Cholinesterase Inhibitor

MOA: ↑ ACh levels

SE: bradycardia, N/V, diarrhea, severe abdominal pain, orthostatic hypotension

Nursing Intervention: ANTIDOTE: atropine

Pt Education: take med prior to bedtime

cyclobenzaprine (Amrix/Flexeril)

Drug class: Centrally Acting Muscle Relaxant

MOA: Inhibits upper-motor neuron activity - used for localized spasms

SE: drowsy, dizzy, urinary retention, constipation

Nursing Intervention: do NOT administer with other CNS depressants

Pt Education: take med with food & increase fiber

dantrolene (Dantrium)

Drug class: Direct-Acting Antispasmodics; calcium release blocker

MOA: Interferes with the release of calcium ions in skeletal muscle (Prevents calcium from being released into the muscles, if the release of Ca is blocked, muscle tension will be reduced) - used to treat muscle spasms

SE: Hepatic toxicity (↑ K+)

Nursing Intervention: used as an ANTIDOTE for Malignant Hyperthermia, do NOT administer with other CNS depressants OR calcium channel blockers & assess the IV site for infiltration

• CONTRAINDICATION: verapamil (Calan) & pts with cardiac, pulmonary, and hepatic (liver) problems

Pt Education: take med with food

desmopressin (DDAVP)

For Diabetes Insipidus (not enough ADH - Antidiuretic hormone secretion)

Drug class: ADH analog

MOA: ADH that acts on the kidneys to increase the reabsorption of water. 

SE: ↓ Na, water toxicity

Nursing Intervention: monitor I&O, Na level, Urine specific gravity, water intoxication, use HYPERTONIC saline

Pt Education: restrict fluids

levothyroxine (Synthroid)

For Hypothyroidism

Drug class: Thyroid hormone replacement

MOA: replaces T4, increases metabolic rate (Used to ↑ T3/T4)

SE: ↓ weight, palpitations, dysrhythmias

Nursing Intervention: monitor T4 & TSH level, HR, assess for altered SLEEP pattern

Pt Education: administer SAME TIME every day in the MORNING & take in EMPTY stomach & AVOID iron/Ca within 4 hrs & monitor sleep pattern (dose HIGH = HARD time sleeping but dose LOW = TOO much sleep)

methimazole (Tapazole)

For Hyperthyroidism

Drug class: Antithyroid drug

MOA: inhibits thyroid hormone synthesis (Used to ↓ T3/T4)

SE: hepatotoxicity, agranulocytosis, ↓ HR, aplastic anemia

Nursing Intervention: monitor T4 & TSH level, monitor WBC, liver

Pt Education: take med with food & report sore throat/fever

hydrocortisone (Cortef)

For Addison’s Disease

Drug class: Corticosteroid

MOA: mimics cortisol

SE: monitor for signs of Cushing’s

Nursing Intervention: monitor for infection

Pt Education: take med with food SAME TIME every day & if taken LONGER than 2 weeks then it needs to be discontinued gradually