Pharm final 2 set 1

unknown

• Nervousness
• Insomnia
• Increased or decreased pulse rate and blood pressure
• tachycardia
• loss of appetite
• nausea
• abdominal pain

Arrange to interrupt the drug periodically in children who are receiving the drug for behavioral syndromes.

Monitor weight CBC and ECG

PO 15-60 min

IM 20-30 min

IV Rapid

• Sleep aid
• motion sickness
• allergic rhinitis
• anaphylaxis

antagonizes the effects of histamine at the H1 receptor sites, does not bind to or inactivate histamine, significant CNS depressant and anticolonergic properties

• drowsiness
• anorexia
• drymouth
• anticolonergic effects

• assess for urticaria and patency of airway
• administer 20 meds before bedtime and scheduled activity to minimize interruption of sleep
• administer at least 30 min and preferably 1-2 hrs before exposure to conditions that may precipitate motion sickness
• administer w/ meals or milk

• seizures
• panic attacks
• restless leg syndrome
• neuralgias
• acute manic episodes

anticonvulsant effects may be due to presynaptic inhibition. Produces sedative effects in the CNS probably by stimulating inhibitory GABA receptors.

20-60 min

• behavioral changes
• drowsiness
• ataxia

assess patient for drowsiness, unsteadiness and clumsiness, these symptoms are dose related and most severe during initial therapy. Administer w/ food, largest dose at bedtime, no alcohol,

15-30 min

management of manifestations of psychotic disorders: relief of preoperative restlessness; restlessness; adjunctive treatment of tetanus; acute intermittent porphyria; severe behavioral problems in children; controlled hiccups and nausea and vomitting

• blocks post-synaptic dopamine receptors in the brain
• depresses those parts of the brain involved in wakefulness and emesis
• anticolonergic
• antihistamine
• alpha-adrenergic

• drowsiness
• insomnia
• vertigo
• extra pyrimidal symptoms
• orthostatic hypotension
• photophobia
• blurred vision
• dry mouth
• n/v
• anorexia
• urinary retention
• photosensitivity

• parenteral forms - keep recumbent for 30 min
• monitor CBC
• provide positioning of legs and arms
• provide sugarless candy and ice chips
• void before taking a dose
• vision examinations

• PO 1-2 hrs
• IM - 15-30 min
• IV 1-5 min

• anxiety
• alcohol withdrawal
• preoperative anxiolytic

depresses the CNS probably by potentiating GABA and inhibitory neurotransmitter

• dizziness
• drowsiness
• pain at IM site
• paradoxical excitation

• parenteral-remain recumbent and observe 3-8 hrs or longer
• after hrs or w/ milk greater doses at bedtime

antiparkinson

1- hrs

• parkinsonism
• drug-induced parkinsonism
• drug-induced EPS
• dystonic reactions

• blocks colonergic activity in the CNS
• restores natural balance of neurotransmitters in the CNS

• anticolonergic effects (dry mouth, blurred vision, constipation, paralytic ileus, urinary retention, tachycardia, elevated temperature, decreased sweating)
• nausea, NGI upset, sedation, dizziness, orthostatic hypotension, exacerbation of psychoses

• assess parkinsonian NEPS before and throughout therapy
• assess bowel functions daily
• administer w/ food or immediately after meals
• parenteral route is used only for dystonic reactions

• Therapeutic: antipsychotics, mood stabilizers
• pharmacologic: thienobenzodiazepines

• PO unknown
• IM rapid

short-term management of acute manic episodes associated with bi-polar disorder

• antagonizes dopamine and seratonin type 2 n the CNS
• anticolonergic and antihistamine and anti alpha-adranergic effects

• neuroleptic malignant syndrome
• siezures
• agitation
• dizziness
• headache
• restlessness
• sedation
• weakness
• amblyopia
• orthostatic hypotension
• tachycardia
• constipation
• dry mouth
• weight changes
• tremor

• monitor patient for onset of akathisia (restlessness or desire to keep moving) and EPS (parkinsonian) every two months during therapy and 8-12 wks after therapy has been discontinued
• monitor for tardive diskinesia (uncontrolled rhythmic movements of mouth, face, and extremities)
• monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, changes in BP, pallor, tiredness, severe muscle stiffness, loss of bladder control)

antimanic

5-7 days

treatment of manic episodes of manic-depressive or bipolar illness and for maintenance to prevent or diminish the frequency and intensity of future manic episodes under investigation for treatment of migraines

alter sodium transport in nerve and muscle cells; inhibits the release of NE and dopamine but not 5HT from stimulated neurons; increases the intraneuronal stores of NE and dopamine slightly;

serum levels of <1.5 mEq/L: CNS problems, including lethargy, slurred speech, muscle weakness, fine tremor; polyuria, which relates to renal toxicity and beginning of gastric toxicity w/ n/v and diarrhea

serum level of 1.5-2mEq/L: intensification of all of the above reactions w/ ECG changes

serum levels of 2-2.5 mEq/L: progression of CNS effects to ataxia, clonic movements, hyperreflexia and seizures, possible CV effects such as severe ECG changes and hypotension, large output of dilute urine and secondary to renal toxicity, fatalities secondary to pulmonary toxicity

serum level >2.5 mEq/L: complex multi-organ toxicity

• screen for dehydration and sodium depletion and use of diuretics, protracted sweating or diarrhea
• w/ food or milk
• daily monitoring of lithium levels and adequate intake of salt and fluid
• small, frequent meals

anti-convulsant, mood stabilizer, PROTOTYPE!!!!

• PO up to one month
• PO-ER up to one month

drug of choice for partial (focal) seizures; tonic-clonic (grand mal) seizures, trigeminal neuralgia; bipolar disorder

inhibits polysynaptic responses, blocks sodium channels to prevent the formation of repetitive action potentials in the abnormal focus, related to tricyclic antidepressants

• itaxia
• drowsiness
• agranulocytosis
• aplastic anemia
• thrombocytopenia
• hepatitis
• stephen-johnson's syndrome

• w/ food
• monitor CBC
• discontinue the drug if skin rash, bone marrow suppression, unusual depression or personality changes occur
• evaluate therapeutic blood levels

• MAOI
• PROTOTYPE!!!

2-4 weeks

depression in patients who are not responsive to other antidepressant therapy

irreversibly inhibits MAO, allowing NE 5HT and dopamine to accumulate in the synaptic cleft

• dizziness
• vertigo
• headache
• tremors
• hyperreflexia
• mania
• weakness
• drowsiness
• fatigue
• sweating
• orthostatic hypotension
• constipation
• diarrhea
• dry mouth
• edema
• anorexia
• hypertensive crisis

• screen for impaired liver or kidney function, cardiac dysfunction, GI or GU obstruction, surgery, seizure disorders, psychiatric conditions, occurrence of myelography w/in the past 24 hrs or in the next 48 hrs.
• monitor patient for 2-4 weeks
• no foods w/ tryamine (aged cheeses or meats, red wines, smoked or pickled meats, avocados, meat extracts, light or pale beer, distilled liquors, chocolate, fruits, sour cream, soy sauce, yogurt)

• SSRI
• PROTOTYPE!!!

1-4 wks

treatment of depression, OCD's, bulimia, PMDD, panic disorders, unlabeled uses include chronic pain, alcoholism, neuropathies, obesity

inhibits CNS neuronal reuptake of 5HT w/ little on NE and little affinity for colonergic histaminic or alpha-adranergic sites

• H/A
• nervousness
• insomnia
• drowsiness
• anxiety
• tremor
• dizziness
• sweating
• rash
• n/v
• diarrhea
• dry mouth
• anorexia
• sexual dysfunction
• URI
• weight loss
• fever

• monitor patient up to 4 weeks
• suggest patient use barrier contraceptives
• administer 1/day in morning

TCA

2-3 weeks

• depression
• unlabeled uses
• anxiety
• insomnia
• chronic pain syndrome

• potentiates effect of 5HT and NE in the CNS
• has significant anticolonergic properties

• lethargy
• sedation
• blurred vision
• dry eyes
• dry mouth
• ARRHYTHMIAS
• hypotension
• constipation

• ECG monitored before and periodically during
• drug effects may not be notice for at least two weeks
• avoid alcohol
• use suncreen and protective clothing