3) pharm- muscle relaxants/parkinsons/alzheimers/anti-epilectic

Antispasmodics are

muscle relaxants

centrally acting muscle relaxants

diazepam, baclofen, cyclobenzaprine, methocarbamol

peripherally acting muscle relaxant

dantrolene

dantrolene used for

malignant hyperthermia (2-3 min IV)

baclofen enhances _______

GABA

baclofen produces __________ _______ and depressess _________ __________ __ ____________

sedative effect, hyperactive spasticity of muscles

cyclobenzaprine IV used after

back surgery

muscle relaxants complications

CNS depression, nausea, constipation, generalized weakness, orthostatic hypotension

muscle relaxants nursing considerations

take with meals, increase fiber if constipation occurs

diazepam complication

hepatic toxicity

parkinsons meds do NOT _______ disease progression

halt

parkinsons meds relieves

dyskinesias (bradykinesia, resting tremors, muscle rigidity)

parkinsons meds mainain balance between ________ and ___________

dopamine, acetylcholine

parkinons meds inc ______ levels

dopamine

parkinsons meds only works for

several years (then switch meds)

parkinsons meds

levodopa, carbidopa

levodopa is converted to

dopamine

carbidopa inc amounts of _________ reaching the CNS

levodopa

levodopa/carbidopa: must give at _________ times

scheduled

levodopa/carbidopa: avoid

protein, pyridoxine (vit B6)

levodopa/carbidopa: side effects

dyskinesias, tachycardia, palpitations, dyrhythmias, psychosis, eye spasms

pramipexole/ropinirole ________ dopamine receptors

activates

pramipexole/ropinirole: used as ________ early in disease

monotherapy

pramipexole/ropinirole: late in disease used as adjunct with _____________________

levodopa/carbidopa

dopamine agonist meds

pramipexole, ropinirole, selegiline, rasagiline, amantadine

pramipexole and ropainirole side effects

daytime drowsiness, postural hypotension

ropinirole can damage

fetus

selegiline/rasagiline: prevents dopamine ________

breakdown

selegiling/rasagiline works with ________________ to decrease “wear-off” effect

levodopa/carbidopa

selegiline/rasagiline only works for about

2 y

amantidine prevents dopamine

reuptake

dopamine agonists nursing considerations

eventual loss of effects, initially no effects, medication holidays, avoid high protein, do not stop abruptly

alzheimers meds

donepezil, memantine, rivastigmine

alzhiemer meds improve

cognition, behavior, ability to do ADLs

rivastigmine decreases ________ side effects

nausea/vomiting

donepezil increases level of

acetylcholine

meds for advanced alzheimers

memantine, rivastigmine

med for all stages of alzheimers

donepezil

anti-epileptic actions

slows entrance of Na and Ca back into neuron, suppresses neuron firing, enhances inhibitory effects of GABA

traditional anti-epileptic meds

phenobarbital, primidone, phenytoin, carbamazepine, valproic acid

new anti-epileptic meds

lamotrigine, levetiracetam, topiramate, oxycarbazepine, gabapentin, pregabalin

traditional anti-epileptic complications

CNS effects, gingical hyperplasia, blood dyscrasias

newer anti-epileptic complications

CNS effects, skin disordeers, sedation, dizziness, vision problems

anti-epileptic nursing considerations

controls seizures, no sudden cessation, therapeutic plasma levels drawn

phenobarbital used for _________ __________ in kids

febrile seizures

phenytoin: __________ TI

narrow

phenytoin: dont give more than ______ mg per min

50 (bradycardia)

phenytoin: dont mix with __________ _________ bc it dec effectiveness and absorption of med

tube feeding

phenytoin: interacts with

heparin

phenytoin: side effect

enlargement of gums

phenytoin: risk for

bleeding, anemia, infection

phenytoin: __________ for OB patients

iaratogenic

levetiracetam side effect

suicidal ideations

levetiracetam: caution with

mental disorders