Pain
What assessments are important prior to administering opioid medications? What are some examples of opioid medications?
Pain, RR, LOC
Morphine
Codeine
Tramadol
Fentanyl
What are important patient education topics for patients on phenytoin?
Dental care important for gingival hyperplasia
Albumin and drug levels are important for monitoring
Sedation/cognitive impairment possible
Take with meals
Report rash right away
Don't double doses
What medication used for general anesthesia induction/maintenance usually has an onset within 40 seconds and duration 5-10 minutes?
Diprivan (Propofol)
What foods should be avoided for patients taking phenelzine? What drug class is this?
Avoid foods high in tyramine: aged, smoked, pickled foods, aged cheese, sausage, salami, fava beans, yogurt, buttermilk
MAOI
•Do not take following high fat meal – delays onset of action
•Rapid onset of action – take immediately before bed
•Anterograde amnesia (short term memory loss), unpleasant taste, reduced inhibition, aggression/bizarre behavior
What is the reversal agent for opioid medications? For benzodiazepines?
Naloxone
Flumazenil
What antiseizure medications are associated with bone marrow suppression. What are signs and symptoms of bone marrow depression?
Valproic Acid
Carbamazepine
Bleeding: Platelets
Fatigue, SOB: Anemia (RBCs)
Fever, Pain: Infections (WBCs)
What s an example of a drug used in anesthesia and intubation and is a paralytic agent? What does "paralytic agent" mean?
Vecuronium
Paralyzes muscles (like the ones used for respiration)
What drugs are contraindicated for patients taking SSRIs like FLuoxetine?
MAOIs (phenelzine)
Triptans (Sumatriptan)
Serotonergic drugs
What are stimulant medications for ADHD treatment?
What are nonstimulant medications for ADHD?
Vyvanse, Concerta, Ritalin
Atamoxetine
What are 2 examples of medications used to treat pain associated with muscle spasms? What would be the therapeutic goals of treatment?
Baclofen, Cyclobenzaprine
Reduced pain secondary to reduced muscle spasms
What are the signs and symptoms associated with lithium toxicity?
Cardiac: Bradycardia Central nervous system: Confusion, memory problems, new or worsening tremors, hyperreflexia, clonus, slurred speech, ataxia, stupor, delirium, coma Renal: Nephrogenic diabetes insipidus characterized by polyuria and polydipsia. Hematologic: Leukocytosis and aplastic anemia. Gastroenterology: Diarrhea and nausea.
What severe side effects can occur if isoflurane is used in anesthesia?
ileus, hypotension, profound respiratory depression
What are the goals for treatment for depression therapy? What drugs are used to treat depression?
Improved Mood
Improved Energy
Improved function
Fluoxetine, Venlafaxine, Imipramine, Phenelzine, Bupropion
What are side effects of stimulant meds used to treat adhd?
Insomnia, weight loss, appetite suppression, dysrhythmias
How does opioid toxicity present?
Respiratory depression, decreased LOC, respiratory arrest, emesis
What patient education is important for patients on benzodiazepines? What are the names of some benzodiazepines?
Diazepam, Midazolam
Avoid other CNS depressants (examples?)
Discontinue gradually if long term treatment
What is the reversal agent for Lithium? For Haldol? For phenobarbital? For phenytoin? For imipramine?
None
What are the signs and symptoms of serotonin syndrome? What drugs could cause this? How is it treated?
Agitation, hyperreflexia, hyperthermia, excessive sweating, poor coordination, confusion, hallucinations
SSRIs - Fluoxetine
SNRIs - Venlafaxine
TX: ECG, Cyproheptadine, Benzodiazepines
What is the example of an OTC product used to treat insomnia?
Melatonin
Which pain medications are used to treat mild pain? Which are used to treat moderate to severe pain?
Mild: Codeine, Alleve
Mod-Severe: Fentanyl, Morphine, Tramadol
What are examples of two drugs that are indicated for both seizures and pain?
Gabapentin and Pregabalin
What drugs studied require serum drug monitoring?
Lithium, phenytoin, Depakote (Valproic Acid)
What are some side effects associated with SSRI medications?
•Sexual dysfunction
•Nausea
•Headache
•CNS Stimulation
•Weight gain
What drug used to treat depression has a narrow therapeutic index and leads to cardiotoxicity in overdose?
Imipramine (TCAs)