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NCLEX > Nervous System Medications > Flashcards

Nervous System Medications Flashcards

1
Q

Anti-anxiety medication action

A

Increase the efficacy of GABA to reduce anxiety

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2
Q

Anti-anxiety medications (3)

A
  • Benzodiazepines
  • Buspirone
  • Antidepressants
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3
Q

Antidepressant medications (4)

A
  • Venlafaxine
  • Duloxetine
  • Paroxetine
  • Escitalopram
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4
Q

Anti-anxiety uses (4)

A
  • Generalized anxiety disorder, panic disorder
  • Insomnia
  • Alcohol withdrawal
  • Anesthesia induction
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5
Q

Anti-anxiety precautions (2)

A
  • Use caution when giving benzos to patients with substance use disorder and liver disease
  • Venlaxafine contraindicated in patients on MAOIs
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6
Q

Anti-anxiety side/adverse effects (4)

A
  • CNS depression
  • Paradoxical response (insomnia, excitation, euphoria)
  • Withdrawal symptoms (not buspirone)
  • Risk of abuse/overdose (benzodiazepines)
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7
Q

Anti-anxiety nursing interventions (4)

A
  • Monitor vitals
  • Never stop abruptly
  • Monitor for side/adverse effects
  • Avoid alcohol
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8
Q

SSRI antidepressants action

A

Block serotonin reuptake

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9
Q

SNRI antidepressants action

A

Block reuptake of norepinephrine and serotonin

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10
Q

Tricyclic antidepressants action

A

Block reuptake of norepinephrine and serotonin

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11
Q

MAOI antidepressants action

A

Increase norepinephrine, dopamine, serotonin by blocking MAO-A

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12
Q

SSRI medications (4)

A
  • Citalopram
  • Fluoxetine
  • Paroxetine
  • Sertraline
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13
Q

SNRI medications (2)

A
  • Duloxetine
  • Venlafaxine
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14
Q

SSRI/SNRI precautions (3)

A
  • Avoid alcohol
  • Don’t stop abruptly
  • Monitor for serotonin syndrome (agitation, confusion, hallucinations) within first 72 hours
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15
Q

SSRI/SNRI side/adverse effects (4)

A
  • Weight gain
  • Sexual dysfunction
  • Fatigue
  • Drowsiness
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16
Q

Tricyclic medications (2)

A
  • Amitriptyline
  • Imipramine
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17
Q

Tricyclic precautions (3)

A
  • Don’t use with MAOIs, St. John’s wort
  • Avoid alcohol
  • Contraindicated in patients with seizure disorders
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18
Q

Tricyclic side/adverse effects (4)

A
  • Anticholinergic effects
  • Orthostatic hypotension
  • Cardiac dysrhythmias
  • Decreased seizure withhold
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19
Q

MAOI medications (3)

A
  • Isocarboxazid
  • Tranylcypromine
  • Phenelzine
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20
Q

MAOI precautions (3)

A
  • Avoid foods with tyramine
  • Antihypertensives have additive hypotensive effect
  • Contraindicated with SSRIs, tricyclics, heart failure, CVA, renal insufficiency
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21
Q

MAOI side/adverse effects (3)

A
  • CNS stimulation
  • Orthostatic hypotension
  • Hypertensive crisis in patients taking tyramine, SSRIs, tricyclics
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22
Q

Antidepressant nursing interventions (7)

A
  • Assess for suicide risk
  • Take daily and don’t miss doses
  • Teach client about therapeutic effects and time of onset
  • Avoid stopping abruptly
  • Take SSRIs in the morning to minimize sleep disturbances
  • Give patients list of tyramine containing foods if taking MAOIs
  • Avoid taking other medications without consulting with provider
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23
Q

Bipolar disorder medications action

A

Produce neurochemical changes in the brain to control acute mania, depression, and incidence of suicide

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24
Q

Bipolar disorder medication

A

Lithium carbonate

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25
Q

Bipolar medication uses (4)

A
  • Bipolar
  • Alcohol use disorder
  • Bulimia
  • Schizophrenia
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26
Q

Bipolar medication precautions (3)

A
  • Use caution in patients with renal dysfunction, heart disease, hyponatremia, dehydration
  • NSAIDS increase lithium levels
  • Monitor serum sodium levels
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27
Q

Bipolar medication side/adverse effects (5)

A
  • GI distress
  • Fine hand tremors
  • Polyuria
  • Hypothyroidism
  • Renal toxicity
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28
Q

Bipolar medication nursing interventions (6)

A
  • Monitor therapeutic levels
  • Monitor serum sodium levels
  • Therapeutic effects appear 7-14 days
  • Dosing is 1-3 times daily
  • Nutritional counseling for food sources with sodium
  • Give with food to decrease GI distress
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29
Q

Antipsychotic medication action

A

Block dopamine, acetylcholine, histamine, norepinephrine receptors in the brain and periphery

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30
Q

Typical antipsychotic medications (4)

A
  • Chlorpromazine
  • Fluphenazine
  • Thiothixene
  • Haloperidol
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31
Q

Atypical antipsychotic medications (6)

A
  • Aripiprazole
  • Clozapine
  • Olanzapine
  • Paliperidone
  • Quetiapine
  • Ziprasidone
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32
Q

Antipsychotic medication uses (6)

A
  • Acute/chronic psychosis
  • Schizophrenia
  • Manic phase of bipolar
  • Tourette syndrome
  • Delusional/schizoaffective disorders
  • Dementia
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33
Q

Antipsychotic medication precautions (2)

A
  • Contraindicated in patients with severe depression, Parkinson’s disease, prolactin dependent cancer, severe hypotension
  • Use caution in patients with glaucoma, paralytic ileus, prostate enlargement, seizure disorder
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34
Q

Typical antipsychotic medication side/adverse effects (7)

A
  • Sedation
  • Extrapyramidal effects
  • Anticholinergic effects
  • Tardive dyskinesia
  • Agranulocytosis
  • Neuroleptic malignant syndrome
  • Seizures
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35
Q

Atypical antipsychotic medication side/adverse effects (6)

A
  • Agranulocytosis
  • Weight gain
  • Diabetes
  • Dyslipidemia
  • Orthostatic hypotension
  • Extrapyramidal effects
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36
Q

Antipsychotic medication nursing interventions (5)

A
  • Monitor for side effects within 5 hours- 5 days of giving
  • Inform patient of potential side effects
  • Monitor CBC
  • Encourage fluids
  • Stop medication if experiencing signs of neuroleptic malignant syndrome
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37
Q

ADHD medication action

A
  • Increase attention span, reduce impulsiveness/hyperactivity
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38
Q

ADHD stimulant medication action

A

Increase levels of norepinephrine, serotonin, dopamine into CNS

39
Q

ADHD non stimulant medication action

A

Increase levels of norepinephrine into CNS

40
Q

ADHD stimulant medications (3)

A
  • Dextroamphetamine
  • Amphetamine
  • Methylphenidate
41
Q

ADHD stimulant medication side/adverse effects (4)

A
  • Insomnia
  • Headache
  • Suppressed appetite
  • Abdominal pain
42
Q

ADHD stimulant medication nursing interventions (3)

A
  • Give early in the morning with/without food
  • Don’t stop abruptly
  • Monitor for signs of abuse, agitation
43
Q

ADHD non-stimulant medications (2)

A
  • Atomoxetine
  • Guanfacine for Asperger’s syndrome
44
Q

ADHD non-stimulant medication side/adverse effects (3)

A
  • GI upset
  • Insomnia
  • Mood swings
45
Q

ADHD non-stimulant medication nursing interventions (4)

A
  • Take medication daily
  • Don’t crush/chew
  • Report immediately if worsening anxiety, agitation
  • Don’t take with MAOIs
46
Q

Sedative/hypnotic medication action

A

Slow neuronal activity in brain to induce sedation/sleep

47
Q

Sedative/hypnotic medications (2)

A
  • Benzodiazepines
  • Benzodiazepine like medications
48
Q

Benzodiazepine like medications (2)

A
  • Zolpidem
  • Eszopiclone
49
Q

Sedative/hypnotic medication uses (2)

A
  • Short term insomnia
  • Difficulty falling/staying asleep
50
Q

Sedative/hypnotic medication precautions (2)

A
  • Use caution in patients with severe mental depression
  • Avoid combining with alcohol and medications that depress CNS function
51
Q

Sedative/hypnotic medication side/adverse effects (3)

A
  • Amnesia
  • Respiratory depression
  • Daytime drowsiness, dizziness
52
Q

Sedative/hypnotic medication nursing interventions (3)

A
  • Take before bedtime because has abrupt onset of sleep
  • Avoid alcohol
  • Potential for sleep activities without recall, report to provider immediately
53
Q

Abstinence maintenance medications (2)

A
  • Disulfiram
  • Methadone
54
Q

Disulfiram action

A

Interferes with hepatic oxidation of alcohol resulting in elevation of blood acetaldehyde levels

55
Q

Disulfiram use

A
  • Maintain sobriety in treatment for alcohol use disorder
56
Q

Disulfiram precautions (3)

A
  • INH increases risk of adverse CNS effects
  • Ingestion of large amounts of alcohol may cause respiratory depression, dysrhythmias, cardiac arrest
  • Adjust doses of warfarin, phenytoin
57
Q

Disulfiram side/adverse effects (4)

A
  • Drowsiness
  • Headache
  • Metallic taste
  • Hepatotoxicity
58
Q

Disulfiram nursing interventions (5)

A
  • Start medication 12 hours of last ingestion of alcohol
  • Inform patient that if they consume alcohol while taking disulfiram they can experience flushing, throbbing headache/neck pain, dyspnea, n/v, sweating ,thirst, chest pain
  • Effects last 30 minutes-several hours when alcohol is consumed
  • Effects of disulfiram can stay in the body for weeks after medication is stopped
  • Therapy can last weeks-years
59
Q

Methadone action

A

Binds with opiate receptors in CNS to produce analgesic and euphoric effects

60
Q

Methadone use

A

Prevent withdrawal symptoms in patients addicted to opioids

61
Q

Methadone precautions (2)

A
  • Don’t use in patients with severe asthma, chronic respiratory disease, history of a head injury
  • Avoid in patients with QT syndrome
62
Q

Methadone side/adverse effects (3)

A
  • Sedation
  • Respiratory depression
  • Paradoxical CNS excitation
63
Q

Methadone nursing interventions (4)

A
  • Monitor for drug tolerance, psychological dependence
  • Monitor for respiratory depression
  • Slowly taper dose to produce detoxication
  • Patient must be monitored through treatment center
64
Q

Cholinesterase inhibitor action

A

Prevent cholinesterase from inactivating acetylcholine resulting in improved transmission of nerve impulses

65
Q

Cholinesterase inhibitor medications (3)

A
  • Neostigmine
  • Ambenonium
  • Edrophonium
66
Q

Cholinesterase inhibitor use

A

Myasthenia gravis

67
Q

Cholinesterase inhibitor precaution

A
  • Don’t give if heart rate is less than 60/min
68
Q

Cholinesterase inhibitor side/adverse effects (11)

A
  • Slow heart rate
  • Chest pain
  • Weak pulse
  • Increased sweating
  • Dizziness
  • Feeling faint
  • Weak/shallow breathing
  • Urinating more than usual
  • Seizures
  • Trouble swallowing
69
Q

Cholinesterase inhibitor nursing interventions (4)

A
  • Dose individualized
  • Keep diary to record side effects
  • Wear medical alert bracelet
  • Monitor for cholinergic crisis
70
Q

Anti-parkinson’s medication action

A

Increase dopamine to minimize tremors and rigidity

71
Q

Anti-parkinson’s medications (3)

A
  • Benztropine
  • Carbidopa/levodopa
  • Levodopa
72
Q

Anti-parkinson’s medication precautions (4)

A
  • Don’t use levodopa within 2 weeks of using MAOIs
  • Pyridoxine (vitamin B6) decreases effects of levodopa
  • Benztropine contraindicated in patients with narrow angle glaucoma
  • Stop 6-8 hours before anesthesia
73
Q

Anti-parkinson’s medication side/adverse effects (5)

A
  • Muscle twitching (especially in eyelids)
  • Headaches
  • Dizziness
  • Dark urine
  • Orthostatic hypotension
74
Q

Anti-parkinson’s medication nursing interventions (6)

A
  • Family members should help with medication regimen
  • Notify provider if sudden loss of medication effects
  • Maximum therapeutic effects can take up to 4-6 weeks
  • Monitor for signs of adverse reactions
  • Avoid high protein meals and snacks
  • Keep medication away from heat, light, moisture, dark pills means they lost their potency and should be thrown away
75
Q

Anti-seizure medication action

A

Slow rates of neuronal activity in the brain by blocking specific channels responsible for neuron firing resulting in elevated seizure thresholds

76
Q

Anti-seizure medications (5)

A
  • Carbamazepine
  • Gabapentin
  • Phenobarbital
  • Phenytoin
  • Valproic acid
77
Q

Anti-seizure medication use

A

Prevent and/or control seizure activity

78
Q

Carbamazepine precautions (2)

A
  • Contraindicated in patients with bone marrow suppression, bleeding disorders
  • Decreases effectiveness of oral contraceptives and warfarin
79
Q

Carbamazepine side/adverse effects (3)

A
  • Anemia
  • Leukopenia
  • Stevens-Johnson syndrome
80
Q

Gabapentin precaution

A

Don’t stop abruptly

81
Q

Gabapentin side/adverse effects (4)

A
  • Headaches
  • Weight gain
  • Nausea
  • Report CNS depression, seizures, visual changes, unusual bruising
82
Q

Phenobarbital precautions

A

Contraindicated in history of substance use disorder

83
Q

Phenobarbital side/adverse effects (3)

A
  • Drowsiness
  • Hypotension
  • Respiratory depression
84
Q

Phenytoin precautions

A
  • Increased excretion of digoxin, warfarin, oral contraceptives
85
Q

Phenytoin side/adverse effects (4)

A
  • Gingival hypertrophy
  • Diplopia
  • Drowsiness
  • Hirsutism
86
Q

Valproic acid precautions

A
  • Contraindicated in liver disease, pregnancy
87
Q

Valproic acid side/adverse effects (3)

A
  • Hepatotoxicity
  • Teratogenic effects
  • Pancreatitis
88
Q

Nursing interventions for anti-seizure medications (6)

A
  • Monitor for therapeutic effects
  • Monitor patients taking phenytoin for toxic effects and serum levels
  • Compliance important
  • Treatment regimen is individualized
  • Inform patients of side/adverse effects
  • Status epilepticus: IV diazepam/lorazepam then IV phenytoin/fosphenytoin
89
Q

Anti-glaucoma medication action

A

Reduce aqueous humor

90
Q

Anti-glaucoma medications (4)

A
  • Levobunolol
  • Timolol
  • Pilocarpine
  • Latanoprost
91
Q

Anti-glaucoma medication precautions

A
  • Caution in patients taking oral beta blocker, calcium channel blocker
92
Q

Anti-glaucoma medication side/adverse effects (3)

A
  • Systemic effect of beta blockers: bradycardia, heart failure, bronchospasm
  • Brown discoloration of iris (latanoprost)
  • Retinal detachment (pilocarpine)
93
Q

Anti-glaucoma medication nursing interventions (3)

A
  • Use sterile technique when handling applicator portion of container
  • Hold gentle pressure on nasolacrimal duct for 30-60 seconds immediately after instilling drops
  • Monitor pulse rate/rhythm for patients taking beta/calcium channel blockers

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