Mod 8 Flashcards

Question

Describe the nursing interventions for an overdose of alprazolam (xanax).

Answer 1

Treatment: Flumazenil (benzodiazepine antagonist) Reverses sedative effects but not respiratory depression Monitor respirations, keep airway patent, support BP with IV No charcoal

Answer 2

Electrolytes Creatinine GFR BUN Thyroid function tests CBC EKG

Answer 3

Foods that are high in tyramine Cheese Beer Fermented soy products Cured meats

Answer 4

Resolves symptoms slow: 1-3 weeks initial response Cannot be taken PRN Increased risk of suicide SSRI -Serotonin symptoms -Confusion, poor concentration, tachycardia, seizures, N & V, hallucinations -Taper dose gradually -Use a mouth guard if experiencing bruxism (teeth grinding) at night and report to provider SNRIs: -Avoid driving until effects are known -Monitor for serotonin syndrome -Report sexual dysfunction to provider Atypical antidepressants -Sip on fluids for dry mouth -Headache, GI distress, constipation, tachycardia, restlessness, and insomnia and notify provider -Avoid grapefruit with vilazodone and trazodone Tricyclic antidepressants -Orthostatic hypertension- sit up slowly -Anticholinergic effects - sip on water -Sedation - avoid driving until effects are known -Excessive sweating MAOIs -CNS stimulation effects (anxiety, etc) and notify provider -Sit up slowly -Monitor for severe headaches bc MAOIs can cause hypertensive crisis -Don’t eat tyramine rich foods

Answer 5

Second and third gen psychotics Risperidone Causes weight gain and dyslipidemia Clozapine Patients with diabetes can cause new onset of diabetes mellitus or loss of glucose control

Answer 6

If diabetic: monitor blood glucose (glucose masking) Monitor HR and BP Monitor orthostatic hypotension Teach to stand slowly Common side effects: Tiredness & fatigue Can exacerbate symptoms of asthma Promote depression

Answer 7

Suppression of migraines/headache Suppression of associated symptoms include nausea, neck pain, photophobia, phonophobia

Answer 8

Adverse Effects: Respiratory depression (Low RR below 12) Low BP Low CNS sedation (easily falls asleep while talking, unarousable) Nausea / Vomiting Dizziness Constipation Antidote: Naloxone

Answer 9

Drugs: Lidocaine, Tetracaine, Bupivacaine Adverse Effects: Hypotension Bradycardia Dizziness Paresthesia Respiratory depression Nursing Interventions: Monitor vital signs Monitor for CNS effects: respiratory depression Have IV access and fluid therapy ready for hypotension

Answer 10

CNS drug that enhances GABA (reduces nerve excitability) to produce sedative effects & acts in the spinal cord to depress hyperactive spasticity of muscles Reduces discomfort of spasticity Adverse Effects: Nausea, constipation, urinary retention, seizures

Answer 11

Nursing Interventions: Taper slowly over 6 weeks Provide safety measures to prevent injury Monitor for hypersensitivity reactions

Answer 12

It is a cholinesterase inhibitor which stops cholinesterase from inactivating acetylcholine Increases the amount of acetylcholine available at receptor sites ⇨ increased transmission of nervous impulse at all sites Adverse Effects: INCREASE muscarinic stimulation Increase GI motility, GI secretions, diaphoresis, salivation, bradycardia, urinary urgency Cholinergic crisis Excessive muscarinic stimulation and respiratory depression from neuromuscular blockade Paralysis of respiratory muscles

Answer 13

**1st line drug for PD** Carbidopa / Levodopa Activate dopamine receptors to balance dopamine and acetylcholine extrapyramidal nervous system Treats motor symptoms

Answer 14

Tolerance & Physical Dependence CNS depression: Avoid activities that require alertness Avoid alcohol Taper dose Antidotes for toxicity: Opioids ⇨ Naloxone Benzodiazepines ⇨ Flumazenil Alcohol withdrawal ⇨ Chlordiazepoxide Tricyclic Antidepressants ⇨ sodium bicarbonate Administer medication with food for GI distress

Answer 15

Nursing Implications: Observe for development of suicidal tendencies Monitor BP Patient Education: Slow onset 2-6 weeks Slow position changes Red, brown urine normal Take w/ food, but avoid high protein meals Warn patients about abrupt loss of therapeutic effects Adverse Effects: Nausea / Vomiting Drowsiness Dyskinesia Orthostatic hypotension Cardiovascular effects Psychosis Activation of malignant melanoma

Answer 16

A patient’s health hx is important to consider prior to drug administration because of allergic reactions and anaphylactic shock. Avoid drug-drug interactions and look at allergies. Propofol has a narrow therapeutic range. Contraindications: Hypersensitivity rxn to allergies of eggs and soybeans Asthma Bleeding disorders Cardiac diseases Hepatic impairment

Answer 17

Cross-tolerance: Becoming tolerant to all drugs in a drug class by becoming tolerant to just one of the drugs in the class Physical dependence: Experiencing physical symptoms when drug use is abruptly stopped Tolerance: Body gets used to drug dose ⇨ larger dose is required to achieve therapeutic response Addiction: The inability to control the use of drugs due to behavioral and brain disorders