Pharmacology-review-for-nurses.pdf

P PHARMACOLOGY DRUGS AFFECTING THE NERVOUS SYSTEM ANTICONVULSANTS/ANTISEIZURE MEDICATIONS Prototype : a. Hydantoins - phenytoin (Dilantin) b. Barbiturates - phenobarbital ( Luminal) Adverse effects : - sedation & drowsiness, gingival hyperplasia - diplopia, nystagmus, vertigo, dizziness - thrombocytopenia, aplastic anemia Nursing considerations : 1. Advise female clients to use contraceptives. 2. Inform clients taking phenytoin that harmless urine discoloration is common. 3. Warn clients with diabetes that hydantoins may increase blood sugar level. 4. Reassure that barbiturates are not addictive at a low dosage. 5. Avoid taking alcohol with barbiturates. 6. Administer IV phenytoin slowly to avoid cardiotoxicity. 7. Avoid mixing other drugs in same syringe with phenytoin. ANTIPARKINSONIAN AGENTS Prototype : a. Anticholinergic agents - trihexyphenidyl (Artane), benztropine (Congentin) b. Dopaminergic agents - Levodopa, carbidopa-levodopa (Sinemet), amantidine (Symmetrel) Adverse effects of dopaminergic agents: a. levodopa–nausea, vomiting, anorexia, orthostatic hypotension, dark-colored urine and sweat b. amantidine – ankle edema, constipation Nursing considerations: 1. Give dopaminergic agents after meals to reduce GI symptoms. 2. Reassure client that levodopa may cause harmless darkening of urine and sweat. 3. Avoid taking Vit B6 (pyridoxine) because it reverses effects of levodopa. 4. Change positions slowly to avoid orthostatic hypotension. 5. Elevate leg to reduce ankle edema. DRUGS AFFECTING MENTAL FUNCTIONING SEDATIVES, HYPNOTICS, AND ANXIOLYTICS – induce sleep, sedate & calm clients Prototype: a. Benzodiazepines (end with –epam) - diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), flurazepam (Dalmane) b. Barbiturates - phenobarbital, Adverse effects: - hangover-effect, dizziness, CNS depression - respiratory depression, drug-dependenc