Anticancer Drugs/Reproductive Drugs
This is the term for an agent/drug that causes blistering or severe damage to tissues if there is extravasation.
What is a vesicant?
These antidepressent medications block serotonin reuptake into the nerve terminal of the CNS thereby enhancing its transmission at the serotonergic synapse. Side effects may include dry mouth, headache, insomnia, nausea, diarrhea, and suicidal ideation.
What are Selective Serotonin Reuptake Inhibitors (SSRIs)?
* Review the prototype chart and think about patient teaching for these medications*
This describes continued involvement in an activity despite the substantial harm it causes.
What is addiction?
This is a neurological medical emergency defined as a seizure lasting more than five minutes or two or more seizures in a row without a full recovery of consciousness in between them.
What is status epilepticus?
What time of day should amphetamine and amphetamine-like drugs be taken?
These medications can cause insomnia
This type of drug increases the effects of dopamine in the brain by reducing the effects of acetylcholine. This medication reduces rigidity and some of the tremors associated with Parkinson's Disease. This drug class typically ends in "-tropine"
What are anticholinergics?
Benztropine is commonly used in PD.
This is the reason adolescents taking testosterone must have X-ray testing.
What is the early closure of skeletal epiphyses?
You need to review adolescent and adult teaching for testosterone
This symptom may occur within days of taking antipsychotic medications. It presents with facial muscle spasms, grimacing, and upward eye movements.
What is acute dystonia?
See Fig. 22.2 - Review the definitions of pseudoparkinsonism, akathisia, acute dystonia, and tardive dyskinesia
This term is defined by a need for markedly increased amounts of the substance to achieve intoxication, or a markedly diminished effect with continued use of the same amount of the substance.
What is tolerance?
*Review the criteria and subcomponents located in Table 8.1 entitled "Substance Use Disorder Categories"*
This class of medication is given to patients when they are in status epilepticus.
What are benzodiazepines?
Name two benzodiazepines you can administer for status epilepticus (see the lecture slides)
What does the AWAKE acronym stand for when learning about Modafinil?
Arrhythmias, Wakefulness, AST/ALT, Know to take in the morning and Eliminate alcohol.
Be sure to review this medication and the side effects.
Name three patient teaching points with benztropine.
Advise patients to avoid alcohol and caffeine.
Address "Dry-Can'ts" - if not contraindicated: use hard candy, or ice chips to relieve dry mouth.
Advise patients to void before taking the medication to minimize urinary retention
Have routine eye examinations - anticholinergics are contraindicated in glaucoma patients.
*Review the Clinical Judgment Box entitled "Antiparkinson Anticholinergic Agent" on p. 230
What does ACHES stand for when reviewing the serious complications of oral contraceptives?
What is Abdominal pain, Chest pain, Headaches, Eye problems, and Severe leg pain?
See the Clinical Judgement Box labeled Combined Hormonal Contraceptives on p. 720
This older antidepressant class can lower the seizure threshold and cause cardiotoxicity. This medication can also cause anticholinergic effects and orthostatic hypotension.
What is amitriptyline?
* Be familiar with side effects, adverse reactions, and patient teaching. p 275*
This is the drug of choice for respiratory depression caused by opioids (e.g. fentanyl, morphine). The patient may require more than one dose depending on how much of the opioid the patient received.
What is naloxone?
This medication is the antidote for benzodiazepines.
What is flumazenil?
What are some examples of the adverse effects amphetamines can have on the CNS, Cardiovascular, and GI system?
Adverse effects can include dizziness, headache, euphoria, insomnia, tachycardia, palpitations, hypertension, dry mouth, and diarrhea.
See page 200 - Amphetamine Actions, Side Effects, and Adverse reactions
This medication exhibits selective monoamine oxidase B inhibition, an enzyme that is responsible for breaking down dopamine in the brain. It is usually used in combination therapy with carbidopa-levodopa.
What is selegiline?
*Don't forget to review the case study on Carbidopa-Levodopa we did in class!
This anticancer medication can lead to congestive heart failure and cardiotoxicity due to the damage of cardiac cell mitochondria. In addition, there is a life-time max out dose for patients.
What is doxorubicin (an anthracycline)?
This class of antidepressants has multiple side effects and drug/food interactions. Foods with tyramine must be avoided - examples of foods to avoid include: aged cheese, yogurt, coffee, bananas, raisins, pickled foods, and sausage. In addition, they have multiple drug-to-drug interactions, so be sure the patient notifies providers when taking this med!
What are Monoamine Oxidase Inhibitors (MAOIs)?
This medication keeps patients from consuming alcohol by inhibiting alcohol metabolism and creating very unpleasant side effects (nausea, vomiting, headache, and chest pain). The patient should avoid all exposure to alcohol-containing products including rubbing alcohol, aftershave, certain mouthwashes, perfumes, and hand sanitizer.
What is disulfiram (Antabuse)?
*Reactions to alcohol can last up to two weeks after stopping disulfiram
These sedative-hypnotic medication class has numerous side effects, including sedation, respiratory depression, and tolerance with prolonged use. The short-acting and intermediate-acting are typically short-term use only. The long-acting group, including phenobarbital, can be used to control seizures.
What are barbiturates?
* Review side effects, adverse reactions, and patient teaching for barbiturates
Methylphenidate taken within 14 days of a monoamine oxidase inhibitor (MAOIs) may cause this.
What is hypertensive crisis?
See page 200 "pharmacodynamics"
Methylphenidate should not be given within 2 weeks of a MAOI. Additional drug-drug interactions include sympathomimetics (e.g. pseudoephedrine) and caffeine. If taken with methylphenidate those can cause irritability, nervousness, tremors, and insomnia.
This medication is used to treat multiple sclerosis by suppressing the inflammatory response. This immunomodulator can cause myelosuppression leaving the patient at increased risk of infection.
What is Beta Interferon?
Women taking Depot Medroxyprogesterone Acetate (DMPA) injection are at risk for this complication related to musculoskeletal health.
What is decreased bone density?
This can lead to osteoporosis! Educate the patient on weight-bearing exercise and calcium/vitamin D supplementation
This is the therapeutic drug range for lithium, a mood stabilizer
What is 0.8 - 1.2 mEq/L?
* Signs of lithium toxicity include weakness, tremor, ataxia, poor concentration, diarrhea, and confusion
This medication is used to help patients stop tobacco use. This medication cannot be stopped suddenly as it will lead to withdrawal symptoms. It can also cause false positive urine drug screen results, so be sure to education the patient to let providers know if they are taking this medication.
What is bupropion?
*Familiarize yourself with p. 67-68 Tobacco use, withdrawal symptoms, and medication (bupropion) use
This is the therapeutic serum level for phenytoin (Dilantin).
What is 10-20 mcg/mL?
Name three adverse reactions associated with methylphenidate.
What are tachycardia, hypertension, growth suppression, palpitations, seizures, and tourette syndrome?
*Review the Clinical Judgment box on p. 203
This medication is the antidote for pyridostigmine (acetycholinesterase inhibitor) overdose.
What is atropine (an anticholinergic)?
*Review "Pharmacodynamics" 3 Paragraphs on page 245 describing pyridostigmine in MG patients.