NU 578 UNIT 2 EXAM
Donepezil Side Effects
bradycardia, diarrhea, GI upset,
Donepezil
cholinesterase inhibitor. causes reversible inhibition. used for mild to moderate AD.
PO. Highly protein bound and has prolonged hold life (60 hours). takes 15 days to
achieve steady state. can cause peripheral cholinergic SE. initial dose for 1-3 mo to
avoid SE.
Cholinesterase inhibitors for AD
DO not use if patient has hx of respiratory or PUD. caution with patients with
bradycardia and heart block. watch for falls, encourage snacks to prevent weight
loss.
-At each visit: assess cognition, orientation, functional status. weight, respiratory
status, heart gi status.
Rivastigmine side effects
nausea, vomiting, abdominal pain, diarrhea, tremors, anorexia, Gi upset, weight loss
form GI upset. bradycardia, dizziness, fainting, available in patch! no drug
interactions bc no drug metabolizing enzymes.
,Rivastigmine
approved for AD and dementia of PD. causes irreversible inhibition.
Memantine
NMDA receptor antagonist. modulates the effect of glutamate at the NMDA
receptors, reducing the destructive effect of this neurotransmitter in the brain.
Reserved for Moderate to severe AD.
-usually used in combination with Donepezil.
-MOA: blocks calcium influx when extracellular glutamate is low permits calcium
influx when extracellular glutamate is high.
Memantine Side Effects
Taken PO. Dizziness, headache, confusion. Dosage low and then build up.
Sodium bicarb and other drugs that alkalinize the urine can great decrease renal
excretion of drug.
Caution when prescribing to its with heart dz, hepatic or renal impairment, and
opthalmic dz.
What drug is used to treat Parkinsons?
,Anticholinergic drugs or drugs with anticholinergic side effects (like
antidepressants). The goal is to increase dopamine in the brain. Treatment palliative,
not curative.
Levodopa
Crosses the BBB and is converted to dopamine. no longer sold as a single
formulation drug. always combined with Carbidopa. Combined because levodopa is
rapidly metabolized.
Selegeline
treats Parkinson's. Prevents dopamine breakdown by blocking MAO-B. causes
agitation and insomnia
Pramipexole
used for parkinsons and other movement disorders. used alone in early stages or
combined with levodopa in later disease.
Side Effects: Sleep attacks, impulse control problems. Dopamine receptor agonist.
do not depend on enzymatic conversion to become activated. used alone in early
stages and used with levodopa in advanced stages. takes several weeks to develop.
also used for restless leg
Morphine
, pure opioid agonist. causes analgesia, sedation, euphoria, respiratory depression,
cough suppression, suppression of bowel motility, urinary retention, emesis, miosis,
biliary colic. 11 formulations of drug. extensive first pass effect. Schedule II drug
Morphine Use and Adverse Effects
Use: moderate to severe pain. best for dull constant pain
Adverse Effects: respiratory depression, constipation, Orthostatic hypotension,
urinary retention, emesis, sedation, neurotoxicity, tolerance and physical
dependence.
Fentanyl
strong opioid analgesic with high milligram potency. can be used for surgical
anesthesia, chronic pain control, control of break through pain on other opioids.
schedule II
Fentanyl adverse effects
respiratory depression, hypotension, urinary retention, constipation, nausea,
sedation. It is metabolized by CYP3A4 isoenzyme and can be increased by those
inhibitors
Transdermal fentanyl
Donepezil Side Effects
bradycardia, diarrhea, GI upset,
Donepezil
cholinesterase inhibitor. causes reversible inhibition. used for mild to moderate AD.
PO. Highly protein bound and has prolonged hold life (60 hours). takes 15 days to
achieve steady state. can cause peripheral cholinergic SE. initial dose for 1-3 mo to
avoid SE.
Cholinesterase inhibitors for AD
DO not use if patient has hx of respiratory or PUD. caution with patients with
bradycardia and heart block. watch for falls, encourage snacks to prevent weight
loss.
-At each visit: assess cognition, orientation, functional status. weight, respiratory
status, heart gi status.
Rivastigmine side effects
nausea, vomiting, abdominal pain, diarrhea, tremors, anorexia, Gi upset, weight loss
form GI upset. bradycardia, dizziness, fainting, available in patch! no drug
interactions bc no drug metabolizing enzymes.
,Rivastigmine
approved for AD and dementia of PD. causes irreversible inhibition.
Memantine
NMDA receptor antagonist. modulates the effect of glutamate at the NMDA
receptors, reducing the destructive effect of this neurotransmitter in the brain.
Reserved for Moderate to severe AD.
-usually used in combination with Donepezil.
-MOA: blocks calcium influx when extracellular glutamate is low permits calcium
influx when extracellular glutamate is high.
Memantine Side Effects
Taken PO. Dizziness, headache, confusion. Dosage low and then build up.
Sodium bicarb and other drugs that alkalinize the urine can great decrease renal
excretion of drug.
Caution when prescribing to its with heart dz, hepatic or renal impairment, and
opthalmic dz.
What drug is used to treat Parkinsons?
,Anticholinergic drugs or drugs with anticholinergic side effects (like
antidepressants). The goal is to increase dopamine in the brain. Treatment palliative,
not curative.
Levodopa
Crosses the BBB and is converted to dopamine. no longer sold as a single
formulation drug. always combined with Carbidopa. Combined because levodopa is
rapidly metabolized.
Selegeline
treats Parkinson's. Prevents dopamine breakdown by blocking MAO-B. causes
agitation and insomnia
Pramipexole
used for parkinsons and other movement disorders. used alone in early stages or
combined with levodopa in later disease.
Side Effects: Sleep attacks, impulse control problems. Dopamine receptor agonist.
do not depend on enzymatic conversion to become activated. used alone in early
stages and used with levodopa in advanced stages. takes several weeks to develop.
also used for restless leg
Morphine
, pure opioid agonist. causes analgesia, sedation, euphoria, respiratory depression,
cough suppression, suppression of bowel motility, urinary retention, emesis, miosis,
biliary colic. 11 formulations of drug. extensive first pass effect. Schedule II drug
Morphine Use and Adverse Effects
Use: moderate to severe pain. best for dull constant pain
Adverse Effects: respiratory depression, constipation, Orthostatic hypotension,
urinary retention, emesis, sedation, neurotoxicity, tolerance and physical
dependence.
Fentanyl
strong opioid analgesic with high milligram potency. can be used for surgical
anesthesia, chronic pain control, control of break through pain on other opioids.
schedule II
Fentanyl adverse effects
respiratory depression, hypotension, urinary retention, constipation, nausea,
sedation. It is metabolized by CYP3A4 isoenzyme and can be increased by those
inhibitors
Transdermal fentanyl
