Milestone 3 Pharm HESI blueprint Study Guide
phenytoin - ANS-Dilantin
anticonvulsant
"phenyTOXIC" : can't talk, can't walk: push IV slow
TX: chronic seizures
Therapeutic Range: 10-20 (>20- hold RX)
*report ataxia, hand tremor, slurred speech*
*suicidal ideation, new rash (Steven Johnson)*
gingival hyperplasia expected! urine discoloration is common.
*alternative BC
phenytoin levels - ANS-10-20
trihexyphenidyl - ANS-Artane
TX parkinson sx, EPS
"tri hex"
orthostatic hypotension
ankle edema : elevate legs
can't see can't pee can't spit can't shit
benztropine - ANS-Cogentin
TX sx of Parkinson's
orthostatic hypotension
ankle edema : elevate legs
can't see can't pee can't spit can't shit
Levodopa/Carbidopa - ANS-Sinemet
Tx sx of parkinsons
-Increase dopamine to minimize tremors and rigidity.
-Do not use levodopa (Sinemet) within 2 weeks of MAOI use.
-High protein decreases absorption
admin after meals
dark colored urine/sweat is normal
AE: orthostatic hypo.
avoid B6
amantidine - ANS-Symmetrel
TX sx of parkinsons
AE ankle edema, constipation
* elevate legs
diazepam / lorazepam /
alprazolam / flurazepam - ANS-TX anxiety seizures insomnia alc withdrawal
"in a BENZ"
, § Dangerous, sedative
§ Acts fast, highly addictive, not long-term use
§ Side Effect: low and slow (CNS (fall risk) cardio resp)
§ Take at bedtime, do not skip doses or abruptly stop
§ Avoid valerian root, muscle relaxants
§ Report history of reaction to midazolam
§ Do not drink alcohol
§ Antidote for Benzos: Flumazenil
diazepam associated w cleft lip
phenobarbital - ANS-Luminal
TX anxiety insomnia sedative
§ Dangerous, sedative
§ Lasts longer in the body 3-5 days, so higher risk of toxicity
§***Patient on phenobarbital with low blood pressure and increased sedation: always
assess the patient first
§ low and slow (CNS (fall risk) cardio resp)
§ Withdrawal symptoms
no alcohol
amitriptyline - ANS-Elavil
TX depression
"Amy trips" : fall risk -Slow position changes
o Side Effects:
§dry: see, pee, spit, shit
§ Sweating
§ Seizures
§ Sedation
o Drink more fluids, eye drops o Orthostatic hypotension o Urinary retention
take w food
imipramine - ANS-Tofranil
TX depression, chronic pain
"inhibits pee"
Side Effects:
§ dry, see, pee, spit, poop
§ Sweating
§ Seizures
§ Sedation
o Drink more fluids, eye drops o Orthostatic hypotension o Urinary retention
take w food
phenelzine - ANS-Nardil
TX depression
AE hypo. crisis!!
§ Avoid calcium, antacids, Tylenol, NSAIDs
phenytoin - ANS-Dilantin
anticonvulsant
"phenyTOXIC" : can't talk, can't walk: push IV slow
TX: chronic seizures
Therapeutic Range: 10-20 (>20- hold RX)
*report ataxia, hand tremor, slurred speech*
*suicidal ideation, new rash (Steven Johnson)*
gingival hyperplasia expected! urine discoloration is common.
*alternative BC
phenytoin levels - ANS-10-20
trihexyphenidyl - ANS-Artane
TX parkinson sx, EPS
"tri hex"
orthostatic hypotension
ankle edema : elevate legs
can't see can't pee can't spit can't shit
benztropine - ANS-Cogentin
TX sx of Parkinson's
orthostatic hypotension
ankle edema : elevate legs
can't see can't pee can't spit can't shit
Levodopa/Carbidopa - ANS-Sinemet
Tx sx of parkinsons
-Increase dopamine to minimize tremors and rigidity.
-Do not use levodopa (Sinemet) within 2 weeks of MAOI use.
-High protein decreases absorption
admin after meals
dark colored urine/sweat is normal
AE: orthostatic hypo.
avoid B6
amantidine - ANS-Symmetrel
TX sx of parkinsons
AE ankle edema, constipation
* elevate legs
diazepam / lorazepam /
alprazolam / flurazepam - ANS-TX anxiety seizures insomnia alc withdrawal
"in a BENZ"
, § Dangerous, sedative
§ Acts fast, highly addictive, not long-term use
§ Side Effect: low and slow (CNS (fall risk) cardio resp)
§ Take at bedtime, do not skip doses or abruptly stop
§ Avoid valerian root, muscle relaxants
§ Report history of reaction to midazolam
§ Do not drink alcohol
§ Antidote for Benzos: Flumazenil
diazepam associated w cleft lip
phenobarbital - ANS-Luminal
TX anxiety insomnia sedative
§ Dangerous, sedative
§ Lasts longer in the body 3-5 days, so higher risk of toxicity
§***Patient on phenobarbital with low blood pressure and increased sedation: always
assess the patient first
§ low and slow (CNS (fall risk) cardio resp)
§ Withdrawal symptoms
no alcohol
amitriptyline - ANS-Elavil
TX depression
"Amy trips" : fall risk -Slow position changes
o Side Effects:
§dry: see, pee, spit, shit
§ Sweating
§ Seizures
§ Sedation
o Drink more fluids, eye drops o Orthostatic hypotension o Urinary retention
take w food
imipramine - ANS-Tofranil
TX depression, chronic pain
"inhibits pee"
Side Effects:
§ dry, see, pee, spit, poop
§ Sweating
§ Seizures
§ Sedation
o Drink more fluids, eye drops o Orthostatic hypotension o Urinary retention
take w food
phenelzine - ANS-Nardil
TX depression
AE hypo. crisis!!
§ Avoid calcium, antacids, Tylenol, NSAIDs
