NUR 545 Advanced Pharmacology Exam 1

bethanechol type of drug

cholinergic agonist, direct-acting

bethanechol stimulates which nervous system?

parasympathetic

bethanechol adverse effects

abdominal cramps, diarrhea, nausea, sweating, flushing, and increased salivation

bethanechol reversal agent

atropine

how to prevent nausea with bethanechol

take 1 hour before or 2 hours after meal

atropine type of drug

cholinergic antagonist

atropine is listed on _______ criteria for older adults

BEERS

atropine given in what environemnt to reduce secretions?

pre-op

atropine adverse effects

dry mouth, dry eyes, constipation, photophobia, visual disturbances, elevated intraocular pressure and urinary retention

Atropine Contraindications

preexisting tachycardia (increases HR), angle-closure glaucoma, GI obstruction, and severe myocardial ischemia

vecuronium medication type

anti nicotinic medication

vecuronium use

muscle relaxation during surgery

vecuronium side effects

hypotension, respiratory arrest, muscle weakness, altered heart rate

pyridostigmine type of medication

cholinesterase inhibitor

adverse effects of pyridostigmine

stomach cramps, diarrhea, nausea, excessive saliva, sweating and muscle twitching

pyridostigmine reversal agent for overdose

atropine

carbidopa-levodopa mechanism of action

levodopa crosses BBB and converts itself into dopamine. carbidopa inhibits breakdown

carbidopa levodopa administration

oral, inhalation, or enteral formulations

carbidopa-levodopa adverse effects

N/V, dizziness, orthostatic hypotension, drowsiness, dark/concentrated body fluids

carbidopa-levodopa patient education

change positions slowly, iron can decrease absorption, high protein binds to levodopa (space away from drug use)

memantine mechanism of action

blocks influx of calcium ions caused by excess glutamate

memantine administration

oral

memantine type of drug

NMDA receptor antagonist

memantine serious adverse effects

SOB, hallucinations, seizures, anaphylaxis

memantine other considerations

lower dose for renal failure/CKD/liver dz, combining with DXM can increase risk for neuropsychiatric effects, avoid use with hx of CHF and uncontrolled HTN

meantine common adverse effects

dizziness, HA, confusion, constipation, HTN

phenytoin mechanism of action

binds and inactivates sodium channels to block hyperactive neurons from over-firing

phenytoin type of drug

anticonvulsant

phenytoin administration and use

oral or injection (IV or IM)

phenytoin adverse effects

dizziness, drowsiness, unsteady gait, nystagmus, slurred speech, gingival hyperplasia

phenytoin other considerations

avoid alcohol, speeds up liver breakdown of oral contraceptives (leads to lower levels in blood), monitor blood for therapeutic levels

multiple sclerosis treatment

disease-modifying therapies (slows progression) and acute flare management

baclofen type of drug

muscle relaxant

baclofen mechanism of action

GABA agonist to relieve muscle tightness (blocks calcium and prevents build up)

baclofen administration and use

oral or injection (intrathecal)

baclofen adverse effects

drowsiness, fatigue, dizziness, HA, insomnia, N/V, constipation, upset stomach

baclofen other considerations

do not stop abruptly (can cause seizures, hallucinations and mood changes), monitor for hypotension and excessive sedation. test doses via pump for intrathecal

haloperidol/haldol type of drug

antipsychotic

haloperidol/haldol mechanism of action

blocks dopamine receptors in brain (reduces positve symptoms of schizophrenia)

haloperidol/haldol administration and use

oral or injection (standard IM or extended release IM)

haloperidol/haldol adverse effects

dizziness, drowsiness, weight gain, insomnia, constipation, dry mouth, prolonged QT interval

haloperidol/haldol other considerations

monitor tele, monitor for any EPS symptoms, fall precautions and seizure protocols

All antipsychotic drugs can lead to _______ symptoms

extrapyramidal

extrapyramidal symptoms

bradykinesia, spasms, shuffling gait, poor posture, akathisia