NCLEX-RN ATI COMPRHENSIVE REVIEW PART 4D PHARMACOLOGY

NCLEX-RN ATI COMPRHENSIVE REVIEW PART 4D PHARMACOLOGY

Neurological, Pain, Reproductive, & Complementary

ANTIANXIETY MEDICATIONS

Antianxiety Antidepressants Bipolar disorder medications Antipsychotics ADHD medications Sedative/hypnotic medications Abstinence maintenance medications Antianxiety Increase GABA to reduce anxiety Benzodiazepines-Alprazolam, Chlordiazepoxide, Diazepam, Lorazepam Buspirone Antidepressants- Venlafaxine, Duloxetine, Paroxetine, Escitalopram Uses- anxiety disorder, panic disorder, insomnia, alcohol withdrawal, induce anesthesia Side effects- CNS depression, paradoxical response, withdrawal (not w/ buspirone), risk for abuse/OD Monitor vitals, never stop abruptly, avoid alcohol Antidepressants SSRI/SNRI - Citalopram, Fluoxetine, Paroxetine, Sertraline / Duloxetine, Venlafaxine Side effects- weight gain, sexual dysfunction, fatigue, drowsiness Other- take SSRI in AM, no alcohol, DO NOT stop abruptly, monitor for serotonin syndrome during first 72hrs (if occurs, discontinue immediately) TRICYCLIC - Amitriptyline, Imipramine Side effects-anticholinergic, orthostatic hypotension, cardiac dysrhythmias, decrease seizure threshold Contraindication- pt. with seizure, alcohol, MAOI, St. John Wart MAOI - Isocarboxazid, Tranylcypromine, Phenelzine Side effects- CNS stimulation, orthostatic hypotension, & hypertensive crisis with tyramine, SSRI, and Tricyclics Other- no tyramine foods, antihypertensives, SSRI/Tricyclic, HF, CVA, renal insufficiency Assess for suicide risk “Are you thinking of harming yourself?”. Give pt. list of foods to avoid Bipolar Disorder Medications Lithium Carbonate Uses- bipolar, alcohol use disorder, bulimia, schizophrenia Side effects- GI distress, fine tremors, polyuria, hypothyroidism, renal toxicity Caution- pt. with renal dysfunction, heart disease, hyponatremia, dehydration Other- Monitor therapeutic level 0.8-1.2. Therapeutic effect begins 1-2 weeks, given 1-3 times daily, given with food, WATCH SODIUM LEVELS Antipsychotics This study source was downloaded by 100000849840424 from CourseHero.com on 01-26-2023 01:37:08 GMT -06:00 https://www.coursehero.com/file/75201357/NCLEX-RN-ATI-COMPRHENSIVE-REVIEW-PART-4D-PHARMACOLOGYdocx/

Typical Haloperidol, Fluphenazine, Chlorpromazine, Thiothixene Side effects- sedation, EPS, anticholinergic effects, tardive dyskinesia, agranulocytosis (monitor WBC), neuroleptic malignant syndrome, seizures Atypical Aripiprazole, Clozapine, Olanzapine, Paliperidone, Quetiapine, Ziprasidone Side effects- Agranulocytosis, weight gain, diabetes, dyslipidemia, orthostatic hypertension, EPS Other- Monitor side effects, CBC, stop if pt. develops neuroleptic malignant syndrome (In NMS pt. will have fever, muscle rigidity, altered mental status, autonomic dysfunction. LIFE THREATENING) ADHD Medications Stimulants Dextroamphetamine, Amphetamine Side effects- insomnia, headache, suppressed appetite, abdominal pain Give in AM, DO NOT stop abruptly, abuse, agitation Nonstimulants Atomoxetine, Guanfacine Side effects- GI upset, insomnia, mood swings Sedative/Hypnotic Medications Benzodiazepines- Lorazepam, Temazepam Other- Zolpidem, Eszopiclone Uses- insomnia Caution- with alcohol and other meds that depress CNS Side effects- amnesia, respiratory depression, drowsiness/dizziness Take right before bed; avoid alcohol Abstinence Maintenance Medications Disulfiram For alcohol Side effects- drowsiness, headache, metallic taste, hepatotoxicity Wait 12hrs after alcohol to use. Tell pt. what will happen if they have alcohol (throbbing, syncope, flushing) Methadone For opioids Side effects- sedation, respiratory depression, paradoxical CNS excitation (opposite of slowing down) Contraindication- pt. with QT syndrome, severe asthma, respiratory disease, history of head injury CHRONIC NEUROLOGICAL DISORDER MEDICATIONS This study source was downloaded by 100000849840424 from CourseHero.com on 01-26-2023 01:37:08 GMT -06:00 https://www.coursehero.com/file/75201357/NCLEX-RN-ATI-COMPRHENSIVE-REVIEW-PART-4D-PHARMACOLOGYdocx/

Cholinesterase Inhibitors Antiparkinsons Antiseizure Ophthalmologic Medications/Antiglaucoma Cholinesterase Inhibitors Neostigmine, Ambenonium, Edrophonium Uses- Myasthenia Gravis Side effects- slow HR, chest pain, weak pulse, feel like passing out, urinating a lot, seizures, trouble swallowing Have pt. keep a diary of side effects and wear a med alert bracelet. Watch for cholinergic crisis Antiparkinson Benztropine, Carbidopa/Levodopa, Levodopa Side effects- muscle twitching, headache, dizziness, dark urine, orthostatic hypotension Keep med away from light, moisture, and heat. If darkened, discard.Contraindication- (with benztropine) pt. with narrowed angle glaucoma, discontinue 8hr before anesthesia Antiseizures Carbamazepine Side effects- anemia, leukopenia, Steven Johnson Syndrome Contraindication- bone marrow depression, bleeding disorder, decreases oral contraceptive and warfarin Gabapentin Side effects- headache, weight gain, CNS depression Phenobarbital Side effects- drowsiness, hypotension, respiratory depression Contraindication- history of substance use disorder Phenytoin Side effects- gingival hypertrophy, diplopia, drowsiness, hirsutism Valproic acid Side effects- hepatotoxicity, teratogenic effect, pancreatitis Contraindication- liver disease and pregnancy Other- if status epilepticus (seizure for more than 5 minutes or one after another): give diazepam or lorazepam IV push followed by IV phenytoin Next page Ophthalmologic Medications/Antiglaucoma Levohunolol, Timolol, Pilocarpine, Lantanoprost Interactions- beta blockers, calcium channel blockers This study source was downloaded by 100000849840424 from CourseHero.com on 01-26-2023 01:37:08 GMT -06:00 https://www.coursehero.com/file/75201357/NCLEX-RN-ATI-COMPRHENSIVE-REVIEW-PART-4D-PHARMACOLOGYdocx/

Side effects- bradycardia, HF, bronchospasm, brown discoloration of iris, retinal detachment (emergency) Use sterile technique when handling applicator, apply pressure on the duct after instill drops for 30-60 seconds, and monitor the pulse PAIN & INFLAMMATION MEDICATIONS NSAIDs Acetaminophen Uses- analgesics, antipyretic Side effects- N/V; long term  liver disease Monitor- liver/kidney function test No more than 4000mg/24hrs; based on child’s age no more than 5x/day Overdose- ACETYLCYSTEINE

OPIOID ANALGESICS

Fentanyl, Hydromorphone, Morphine Sulfate, Meperidine, Codeine, Oxycodone Uses- pain and sedation Side effects- orthostatic hypotension, constipation, urinary retention, blurred vision, respiratory depression, abstinence syndrome (anticholinergic effects) Other- monitor vitals and watch for respiratory depression Overdose- NALAXONE

REPRODUCTIVE MEDICATIONS

Contraception This study source was downloaded by 100000849840424 from CourseHero.com on 01-26-2023 01:37:08 GMT -06:00 https://www.coursehero.com/file/75201357/NCLEX-RN-ATI-COMPRHENSIVE-REVIEW-PART-4D-PHARMACOLOGYdocx/