Drugs affecting the Central Nervous System
Sedative have the inhibitory effect on CNS to reduce nervousness, excitability and irratability
Hyponotics can cause sleep and have much more potent effect on CNS than sedative
Name 3 indications for use of Antiepileptics
Overactive brain
Mood disorders
Epilepsy, generalized seizures, partial seizures
Parkinson disease is associated with decreased levels of this neurotransmitter in the brain.
What is dopamine?
These two substances should be avoided with muscle relaxants due to added CNS depression.
benzodiazepines and alcohol
What are the A-B-U-S-E signs of benzodiazepine overdose
Altered mental status, Bradycardia, Unable to walk (ataxia), Slurred speech, Eyes blurred, ↓ respirations
This muscle relaxant is used IV to treat malignant hyperthermia.
Dantrolene (Dantrium)?
Only muscle relaxant used for this emergency.
A patient taking phenytoin should be taught to perform good oral hygiene because this adverse effect can occur.
What is gingival hyperplasia?
Antiparkinson therapy attempts to restore the balance between dopamine and this neurotransmitter.
What is acetylcholine?
The nurse should teach a patient beginning an SSRI that improvement in depression may not occur immediately and usually requires this.
What is several weeks of consistent therapy?
Ms. L., 48 years old, complains of chronic insomnia. She says she “can’t shut her brain off.”
Her provider prescribes zolpidem (Ambien), a nonbenzodiazepine hypnotic.
Two weeks later, her husband reports that she was found cooking in the kitchen at 2 AM with no memory of it.
This patient’s behavior is a known and serious adverse effect of zolpidem. What is it called?
sleepwalking or other sleep-related behavior
This hypnotic has a BLACK BOX WARNING for sleepwalking and dangerous behaviors.”
zolpidem (Ambien)
risk for sleep relate injury
A patient who has been seizure-free suddenly stops taking an antiepileptic medication. This potentially life-threatening seizure emergency may occur.
What is status epilepticus?
This medication crosses the blood-brain barrier and is converted to dopamine in the brain.
What is levodopa?
A patient taking an MAOI should avoid foods containing this substance because the combination can cause a hypertensive crisis.
What is tyramine?
A patient receiving an anticholinergic develops tachycardia, dilated pupils, hot dry skin, urinary retention, and acute confusion. This complication should be suspected.
What is anticholinergic toxicity?
A patient taking a CNS stimulant reports chest pain and develops significant tachycardia and hypertension. These findings indicate the nurse should take this priority action.
What is hold the medication and notify the healthcare provider/seek prompt evaluation?
The nurse should teach a patient taking antiepileptic medication never to do this suddenly, even if the patient has been seizure-free.
What is abruptly stop taking the medication?
This medication is combined with levodopa to decrease levodopa's breakdown before it reaches the brain.
What is carbidopa?
The nurse should closely monitor a patient beginning antidepressant therapy for the emergence or worsening of this serious behavioral concern.
What are suicidal thoughts or behaviors?
This cholinergic-blocking medication increases heart rate and is used to treat symptomatic bradycardia.
What is atropine?
A child taking methylphenidate should have this physical measurement monitored because stimulant medications may decrease appetite and affect growth.
What are height and weight?
The nurse should monitor these laboratory values in a patient taking carbamazepine because of the risks for blood dyscrasias, hepatic effects, and hyponatremia.
What are CBC, liver function tests, and serum sodium?
A patient taking carbidopa/levodopa experiences dizziness when standing. The nurse should provide this safety instruction.
What is change positions slowly to prevent falls from orthostatic hypotension?
Mr. J., 62 years old, is scheduled for a colonoscopy. He has severe anxiety and keeps shaking his leg and hyperventilating. The provider orders midazolam (Versed) IV for procedural sedation.
His wife reports he sometimes gets confused at night and he has a history of alcohol use.
Mr. J suddenly becomes extremely confused and agitated after the medication. What is happening?
paradoxical reactions
Benzodiazepines can cause agitation, restlessness, or increased anxiety especially in older adults.
Sedatives and hypnotics share this dose-dependent relationship.. what is it?
low dose = calm CNS; high dose = sleep