Neurological Medications – Flashcards

Therapeutic: Antiepileptic drug IV with NS because of precipitate Has to be diluted and pushed slow because it can cause cardio collapse! ***Does not work prophalytically on absence seizures. Can treat ventricular tachycardia, off label. A/E: Suicidal thoughts, lethargy, headache, drowsinesss, dizziness, nystagmus, confusion, ataxia, coma, and seizures. Cardio Effects: bradycardia, v-fib, hypotension, phlebitis. Heart monitoring constantly. ORAL HYGIENE important! Do not stop abruptly, taper off Contraindications: those who have experience seizures due to hypoglycemia, those with blood dyscrasias. Nursing Implications: Shake the suspension well prior to administration. Serum therapeutic concentration at 10-20 mcg/mL. Toxi levels is 30-50mcg/mL. Monitor diabetic patients carefully because this med can affect glucose levels.

Therapeutic: Antiepileptic drug PO or IV given over at least an hour IV A/E: N/V, diarrhea, abdominal pain, and diminished appetite. Suicidal thoughts Hepatotoxicity risk... monitor liver enzymes! Skin rash possibility Do not stop abruptly, taper off

Therapeutic: Antiepieptic drug ONLY PO but a lot like Dilantin A/E: drowsiness, dizziness, ataxia, and nausea, and vomiting. Confusion, blurred, vision, lethargy, and visual disturbances, myalgia, leg cramps, and suicidal thoughts. Can cause SLE. Contraindications: Pts with increased intraocular pressure, sle, cardiac disease, hepatic disease, liver disease, HTN. Monitor CBC, wear sunscreen, I&Os due to urinary

Therapeutic: Antianxiety & Antiepileptic drug, skeletal muscle relaxant PO or IV (IV in Status Epilepticus, SLOW push) A/E: Droswiness, sedation, lethargy, ataxia, dizziness, headache, confusion, paradoxical excitation, hypotension, respiratory depression, cardiovascular collapse Contraindications: depressed vital signs, those in shock, narrow-angle glaucoma, cautiously used in patients with depression, and myasthenia gravis, reduce dose for those with hepatic disorders. ***Monitor COPD patients closely due to increase respiratory depression.

Osmotic Diuretic (used with high ICP) Monitor perfusion! IV PB over 30-60 minutes w/ filter! Should see increased output Serum Osmo 275-300, monitor Monitor fluid and electrolytes Monitor everything like a diuretic

Steroid (decreases inflammation) Monitor for infection because of lowered immunity! Monitor glucose (hyperglycemia, up to 200 okay) Sodium and water retention PO or IV (with fluids, slow push) IV with Craniotomy Do not stop abruptly, taper off

Prophylactic Treatment of Seizures Skeletal muscle relaxant PO Suicidal thoughts, seizure precautions ADMINISTER WITH FOOD Short term use Do not stop abruptly, taper off

Parkinson's Treatment (lack of dopamine) PO Liver function tests, Hepatotoxicity (dark urine and sweat) Take with meals Oral Hygiene, Dry mouth treat

Parkinson's Treatment (improves physical mobility) PO Mydriasis, drowsiness, blurred vision, dry mouth After meals, if dry mouth occurs before Do not stop abruptly, taper off

Therapeutic: AchE Inhibitors for Myasthenia Gravis PO, IM, and IV Seizures, bronchospasms, bradycardia can occur. Atropine is the antidote Give with milk Do not stop abruptly, taper off **This drug is used to reverse the actions of neuromuscular blockers following surgery.

Therapeutic Class: Muscle Relaxant and used in treatment of Multiple Sclerosis Treats spasticity of muscles in MS or spinal cord issues. PO Seizures, drowsiness, ataxia , weakness, headache, fatigue, urinary frequency, constipation, nausea, vomiting *prolong QT prolongation, dysrhythmias Take with meals or *milk Do not stop abruptly, taper off

Therapeutic: Antiepileptic drug Treats partial seizures, neuropathic pain, spasticity, ocular ataxia PO A/E: drowsiness, fatigue, nystagmus, and dizziness. The administration can lead to frequency viral infections, weight gain, and gastric upset. Contraindications: Pregnancy, hypersensitivity, and cautiously in renal impairment patients, status epilepticus, or the elderly. Treatment for overdose: renal dialysis. Signs of overdose: dyspnea, sedation, double vision, and slurred speech. **Report any visual changes, suicidal thoughts, bruising or bleeding, swelling of the feet or ankles, or increased seizure activity.

Therapeutic: Anticholinesterase Agents, Edrophonium (Tensilon) is the test for myasthesia gravis IV or IM Routes Involuntary contraction or twitching of muscles, nausea,vomiting, miosis,and increased salivation. Potentially serious side effects: bradycardia, hypertension, dysnea, and death due to paralysis of respiratory muscles.

Therapeutic: Immunomodulators(drugs that affect body defenses) for MS Subcutaneous, once daily dose. A/E: Local reactions, arthralgia, back pain, flulike symptoms, infection, anxiety,vasodilation, chest pain, palpitations, rash, pruritus, diarrhea, nausea, dyspnea, rhinitis ***Asthenia, lymphadenopathy

Therapeutic: Immunomodulators for MS: subcutaneous, three times a week. IM: 30 mcg/week available too. A/E: Myalgia, upper respiratory tract infection, flulike symptoms, local reactions, depression, headache, **Hepatotoxicity, anemia, myelosuppression

Therapeutic: Immunomodulators for MS and Antitumor IV Route A/E nausea, vomiting, diarrhea, cough, headache, abdominal pain, fever, alopecia, **Myleosuppression, renal failure, hepatotoxicity, cardiotoxicity (heart failure, MI, fetal harm)

Therapeutic: Direct-acting skeletal muscle relaxant It is the drug of choice when treating malignant hyperthermia. Routes: PO, IV A/E: muscle weakness, drowsiness, hepatotoxicity, other side effects: xerostomia, dizziness, nausea, photosensitivity, diarrhea, tachycardia, erratic blood pressure, and urinary retention. Contraindications: preexisting hepatic diseases, and liver functions should be monitored regularly. Drug Interaction: Do not use alcohol with drug due to its additive sedation. Overdose results in : muscle weakness, lethargy, and coma. Educate patients about the signs of liver dysfunction. Do not drive until the effects of the drug are known because this drug may cause drowsiness or dizziness.

Therapeutic: Antiparkinson agent Routes: PO, IM, IV A/E: sedation, constipation, blurred vision, dry mouth, decreased sweating, urinary retention, and confusion. Paralytic ileus is the only identified life-threatening adverse reaction. Contraindications: closed-angle glaucoma, myasthenia graves, tardive dyskinesia, GI or urinary obstruction, prostatic hypertrophy, peptic ulcers, tachycardia, and children under 3 years old. Treatment of Overdose: Physostigmine Nursing Implications: Monitor I&Os, check bowel sounds, avoid strenuous activity due to the inability to sweat which can lead to heat stroke.

Therapeutic Class: Antimigraine Agent Route: PO, Intranasal, SQ A/E: mild and transient dizziness or nausea, diarrhea, myalgia, and inflammation, and pain at the subcutaneous injection site. Rare but serious cardiac events include coronary artery vasospasm, MI, dysrhythmias, and myocaridial ischemia. Contraindications: CAD, PVD, HTN uncontrolled, hypercholesterolemia, those with strong family CAD history. Pt's with a history of epilepsy have an increased risk for seizures when taking this med.

Therapeutic Class: Corticosteriods Route: PO A/E: Mood swings, weight gain, acne, facial flushing, hyperglycemia, nausea, insomnia, sodium and fluid retention, impaired wound healing, menstrual abnormalities, **Peptic ulcer, hypocalcemia, osteoporosis with possible bone fractures, loss of muscle mass, decreased growth in children, possible masking of infections. Contraindications: Treat cautiously in HTN, Heart Failure, liver disease pts, diabetics, psychoses, hypothyroidism, if taken longer than 2 weeks, it must be tapered down. Cautiously in peptic ulcers or ulcerative colitis because it could worsen these conditions. Use with potassium wasting drugs can cause hypokalemia. Diabetic patients blood glucose levels should be monitored due to the affects of the drugs. Nursing Implications: Obtain electrolytes levels, hematocrit, and hemoglobin levels, blood glucose levels, BUN, and creatinine levels. Recommend opthalmoscopic examinations every 2 to 3 months for those receiving opthalmic steroid therapy. Monitor for persistent backache or chest pain. Education: Expect a slight weight gain with improve appetite. Report any weight gain increase of 5lbs per week or greater. Avoid alcohol or caffeine because it can increase the chances of peptic ulcer. Eat a high protein, calcium, and vitamin D rich diet to reduce the risk of osteoporosis.

Therapeutic Class: Antiviral for influenza**Drug is used off label to benefit Parkinson's Patients Route: PO A/E: insomnia, dizziness, light-headness, nervousness, loss of concentration, and mental confusion. **Dysrhythmias, leukopenia (rare), heart failure. Pts with renal impairment are at increased risk of toxicity. Contraindications: CNS disease, suicidal ideation, or psychiatric disorders, including seizures or psychoses, as the antiviral may worsen the condition. Use cautiously in renal impairment patients. The drug is excreted by the kidney, so renal impairment can also cause toxicity. Toxic symptoms: visual or auditory hallucination, seizures, coma, or dysrhythmias. Taper off in Parkinson patients or symptoms may drastically worsen. Overdose can be treated with Physostigmine.

Therapeutic Class: Dopamine Agonists Indications: Parkinson's Disease Route: PO A/E: Nausea, orthostatic hypotension *Shock, acute myocardial infarction (MI)

Therapeutic Class: Anticoagulants Route: IV infusion or SQ A/E Minor bleeding, nausea, vomiting, transient thrombocytopenia, anemia, **Hemorrhage, anaphylaxis

Therapeutic Class: Low Molecular Weight Heparins Route: Subcutaneous A/E: Minor bleeding, nausea, vomiting, hematoma, local pain, fever *Hemorrhage, thrombocytopenia, pancytopenia, anaphylaxis

...Therapeutic Class: anticonvulsant Indications: adunct treatment of partial onset seizures; primary generalized tonic-clonic seizures; myoclonic seizures - juvenile myoclonic epilepsy. A/E: dizziness, weakness, suicidal thoughts. **May cause decreased WBC and RBC and abnormal liver function tests. Assess for behavioral abnormalities (agitation, hostility, apathy, emotional lability, depression), and coordination difficulties (ataxia, abnormal gait).

Therapeutic Class: Anticoagulants Route: PO/IV based on target INR, which is usually within the range of 2-3 A/E Minor bleeding, nausea, vomiting, transient thrombocytopenia, anemia, **Hemorrhage, anaphylaxis

Therapeutic Class: Nonphenothiazines Route: PO A/E: Akathisia, sedation, transient drowsiness, EPS, tremor, orthostatic hypotension, weight changes, anticholinergic effects *TD, NMS, acute renal failure, respiratory depression, laryngospasm, hepatotoxicity, sudden unexplained death, agranulocytosis

Therapeutic Class: Antiepileptic Drugs Route: PO A/E Paresthesia, drowsiness, weight loss, **Depression, difficulty with memory, psychomotor slowing

Therapeutic Class: Antiplatelet agent Route: PO A/E: flulike symptoms, headache, diarrhea, dizziness, bruising, upper respiratory tract infection, and rash, or pruritus. **Excessive bleeding, risk for GI bleeding **Education: Immediately report signs of bleeding, tarry stools, blood in urine, bleeding with tooth brushing, nosebleeds, unusual bruising, bloody sputum, profuse menstrual bleeding, continuous headach, faintness, or dizziness.

Antibodies are administered to provide passive immunity. Route: IV or IM A/E: Local reactions at the injection site (pain erythema, myalgia, influenza-like symptoms (malaise, fever, chills) headache, joint stiffness *Anaphylaxis

Therapeutic Class: Dopamine Agonists for Parkinson's Disease Route: PO A/E: Fatigue viral infection, dizziness, somnolence, nausea, vomiting, dyspepsia, *Sleep attacks, syncope

Used to slow the progression of Lou Gehrig's disease or amyotrophic lateral sclerosis A/E: dizziness, tiredness, upset stomach, stomach pain, diarrhea, muscle weakness or aches, loss of appetite, headache. ***difficulty breathing, fever, depression

Therapeutic Class: Antihypertensive *Loop Diuretics Route: PO, IM, IV A/E: Minor hypokalemia, orthostatic hypotension, tinnitus, nausea, diarrhea, dizziness, fatigue *Serious hypokalemia, blood dyscrasias, dehydration, ototoxicity, electrolyte imbalances, circulatory collapse Nursing Implications: Monitor B/P, Monitor elderly closely, Monitor I&O's, check labs, weigh daily, eat potassium rich foods.

Therapeutic Class: None Pharmacologic: Thrombolytic Route: IV A/E: Bleeding, spontaneous ecchymoses, hematomas, or epistaxis should be reported to the healthcare provider immediately. Angioedema and IC bleeding are rare. Contraindications: History of CVA within the past 3 months, recent trauma, or surgery, active bleeding, severe uncontrolled HTN ***Should not be given to patient if on warfarin and INR is greater than 1.7 or PT is greater than 15 seconds.

Therapeutic Class: Benzodiazepines Route:IV inject it slowly Antianxiety and used for status epilepticus A/E: Sedation, headache, drowsiness, weakness, vertigo, ataxia, paradoxical excitement, short term amnesia, **Coma, respiratory depression, cardiac arrest, suicidal ideation, blood dyscrasias, physical dependence, cardiovascular collapse