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Benzodiazepine Benzo- "am" drugs Drug: Lorazepam (withdrawal) Diazepam (status epilepticus) Alprazolam (anxiety) Midazolam (conscious anesthesia) Therapeutic Effects:
- Substance abuse withdrawal
- Acute seizures (status epilepticus)
- Anxiety
- Conscious Sedation for minor procedures Side effects:
- Decreased HR
- Decreased BP
- Decreased RR
- Dizziness
- Headache Fatigue Adverse Reactions:
- Hypotension
- Tachycardia
- Respiratory depression
- Dependency Seizures Considerations/Contradictions:
- Older adult
- Patients with renal impairment
- Patient on other CNS depressants
- Pregnant women
- Patients with sleep apnea
- Patient with respiratory depression,
- Hypotension or alcoholism -Flumazenil antidote
Non-benzodiazepine ZZZZ for sleepy zolpidem TE- insomnia SE: Decreased HR,BP,RR, Dizziness, headache fatigue AR: Hypotension, Tachycardia, Respiratory depression, Dependency, Seizures CC: Older adults
- Renal impairment
- pts with other CNS depressants
- Pregnant women
- Pts w/ sleep apnea
- Pts w/ respiratory depression
- Hypotension or alcoholism
local anesthetics Loco- Lido beach Lidocaine TE: block pain at specific site, achieves rapid onset of action SE: Dizziness and Drowsiness
- Restlessness
- Euphoria
- Metallic taste AR: Allergic reaction which is rare CC: Monitor Cardiac enzymes
- Monitor liver enzymes
Spinal Anesthetic Epidural TE: Injected in subarachnoid space SE: Decrease BP,HR,RR AR: Hypotension, Respiratory depression, unresponsiveness CC: Monitor urine output
- Monitor effectiveness
- Monitor VS before during and after
Anti-gout pure gout Allopurinol TE: Treat gout and hyperuricemia SE: GI upset, Abdominal discomfort AR: Elevated liver enzypes
- Elevated BUN and Creatinine CC: Monitor pts w/ renal disease & hepatic disease
- Monitor ALT,AST, liver enzypes, BUN and creatine
- Educate on diatary restrictions (no meats, salmon legumes high in purine)
Non-opioid Acetaminophen (Tylenol) TE: Pain and fever SE: Insomnia, anorexia, N&V, constipation, Rash AR: Oliguria, elevated liver enzymes, hepatotoxicity CC: Pts with liver disease, hx of alcoholism and renal impairment
Opioids Morphine sulfate TE: moderate to severe pain SE: Urinary retention
- Constipation
- Lethargy
- Sedation
- Pruritus AR: Hypotension, respiratory depression, dependancy, seizures CC: Pts w/ CNS depression, respiratory depression, ICP, renal or hepatic impairment ****Naloxone is the antidote for overdose
CNS stimulant Methylphenidate (Ritalin) TE: Used to treat narcolepsy and ADHD SE: Anorexia, dry mouth, insomnia, dizziness, irratability AR: Tachycardia, Hypertension, Seizures, growth, suppression, wt loss in children CC: Monitor sleep, ht & wt and VS
- Pts with hx of cardiac, anxiety, glaucoma, psychosis, hyperthyroidism and seizures
Valproate Valproic Acid TE: Treats tonic-clonic and mixed types of seizures SE: dizzy & drowsy, GI upset and diplopia AR: Hepatoxicity CC: Pregos, pt w/ liver impairment, hx of alcoholism and children under 2
Barbiturate Barb & phoebe Phenobarbital TE: treats tonic-clonic, myoclonic and partial seizures SE: Drowsy & Dizzy, confusion AR: Respiratory depression, sedation, tolerance CC: Pts in coma and respiratory depression Safe for pregnant women
Hydantoin Hyphen Phenytoin TE: treats tonic-clonic, seizures and partial seizures SE: Gingival, hyperplasia, headache, dizziness and fatigue AR: Thrombocytopenia
- leukopenia
- hepatic imairment
- hyperglycemia CC: Pts w/ thyroid disease, diabetes, cardiac and liver disease
Seratonin-Norepinephrine reuptake inhibitors Venlafaxine TE: treats depression, anxiety and panic disorders SE: Drowsy & dizzy, dry mouth. and weight loss AR: Tachycardia, hypertension, NMS and seizures CC: Pregnancy, pts w/anticoagulants, renal impairment and glaucoma
Tricyclic Triamp Amitriptyline TE: depression SE: Dizzy & drowsy, blurred vision and dry mouth AR: Suicidal ideations, ortho hypo, seizures and paresthesia CC: 2-4 weeks for effectiveness, never stop abruptly
