ati assesment pharm

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  1. Diazepam (Valium)
    • Benzodiazepine Muscle relaxant, antispasmodic, sedative (enhances GABA)
    • Treats anxiety disorders, muscle spasms, alcohol withdrawal
    • Side effects: CNS depression, amnesia,, respiratory depressionPhysical dependence - do not d/c abruptly
    • Avoid other CNS depressants
    • Antidote: flumazenil (Romazicon)Taper dose to d/c
  2. Amitriptyline (Elavil)
    • Tricyclic antidepressant (TCA)Blocks NE, serotonin reuptake
    • Used for depression, migraines
    • Can cause orthostatic hypotension, anticholinergic effects, sedation, cardiac toxicity, decreased seizure threshold, sweating
    • Avoid St. John's wort (serotonin syndrome, antihistamines, anticholinergics, alcohol, CNS depressants, MAOIs
  3. Fluoxetine (Prozac)
    • SSRI (depression)
    • Can cause sexual dysfunction, CNS stimulation, weight loss/gain, serotonin syndrome, withdrawal syndrome, hyponatremia, bruxism, rash, fatigue, GI bleeding
    • Do not take w/ MAOIs or TCAs, St. John's wort, lithium
    • Caution w/ Coumadin, NSAIDs (suppresses platelet aggregation)
    • Take in the morning, takes several weeks for full effects, take w/ food for GI effects
  4. Lithium
    • Mood stabilizer
    • Used for bipolar disorder
    • Blocks serotonin receptors, decreases neuronal atrophy/increases neuronal growth
    • Can cause GI distress, fine hand tremors, polyuria and thirst, weight gain, renal toxicity, goiter and hypothyroidism, bradydysrhythmias, hypotension, electrolyte imbalance
    • Early toxicity: N/V/D, thirst, polyuria, muscle weakness, slurred speechLow Na increases toxicity
    • NSAIDs increase toxicity
    • Avoid anticholinergics
    • Normal level 0.4-1.0mEq/L (toxicity > 1.5)
  5. Valproic acid (Depakote)
    • Antiepileptic (also bipolar)
    • Can use for absence seizures
    • Can cause N/V, hepatotoxicity, pancreatitis, thrombocytopeniaIncreases levels of phenytoin and phenobarbital
  6. Chlorpromazine (Thorazine)Haloperidol (Haldol)
    • Conventional antipsychotic (positive symptoms)
    • Block dopamine, ACh, NE, histamine
    • Can cause:Acute dystonia (treat w/ anticholinergics - benztropine/Cogentin or Benadryl) - EARLYParkinsonism (treat w/ antcholinergics or amantadine)
    • Akathisia (beta blocker, benzodiazepine, anticholinergic)
    • EPS or tardive dyskinesia - LATE Neuroleptic malignant syndrome (d/c, antipyretics, Valium, dantrolene)
    • Anticholinergic effects, orthostatic hypotension, sedation, gynecomastia, seizures, sexual dysfunction, photosensitivity, agranulocytosis, dysrhythmias
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ati assesment pharm
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