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AHIP HESI Pharmacology 2022/2023

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Nursing considerations of ANTICONVULSANTS/ANTISEIZURE MEDICATIONS - ANS 1. Advise female clients to use contraceptives. 2. Inform clients taking phenytoin that harmless urine discoloration is common. 3. Warn clients with diabetes that hydantoins may increase blood sugar level. 4. Reassure th...

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  • December 17, 2022
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  • 2022/2023
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AHIP HESI Pharmacology 2022/2023
ANTICONVULSANTS/ANTISEIZURE MEDICATIONS - ANS Hydantoins - phenytoin
(Dilantin)
Barbiturates - phenobarbital (Luminal)

Adverse effects of ANTICONVULSANTS/ANTISEIZURE MEDICATIONS - ANS -
sedation & drowsiness, gingival hyperplasia
- diplopia, nystagmus, vertigo, dizziness
- thrombocytopenia, aplastic anemia

Nursing considerations of ANTICONVULSANTS/ANTISEIZURE MEDICATIONS - ANS
1. Advise female clients to use contraceptives.
2. Inform clients taking phenytoin that harmless urine discoloration is common.
3. Warn clients with diabetes that hydantoins may increase blood sugar level.
4. Reassure that barbiturates are not addictive at a low dosage.
5. Avoid taking alcohol with barbiturates.
6. Administer IV phenytoin slowly to avoid cardiotoxicity.
7. Avoid mixing other drugs in same syringe with phenytoin.

ANTIPARKINSONIAN AGENTS - ANS Anticholinergic agents - trihexyphenidyl
(Artane), benztropine (Congentin)
Dopaminergic agents - Levodopa, carbidopa-levodopa (Sinemet), amantidine
(Symmetrel)

Adverse effects of dopaminergic agents: - ANS levodopa-nausea, vomiting, anorexia,
orthostatic hypotension, dark-colored urine and sweat b. amantidine - ankle edema,
constipation

Nursing considerations of ANTIPARKINSONIAN AGENTS - ANS 1. Give dopaminergic
agents after meals to reduce GI symptoms.
2. Reassure client that levodopa may cause harmless darkening of urine and sweat.
3. Avoid taking Vit B6 (pyridoxine) because it reverses effects of levodopa.
4. Change positions slowly to avoid orthostatic hypotension.
5. Elevate leg to reduce ankle edema.

SEDATIVES, HYPNOTICS, AND ANXIOLYTICS - induce sleep, sedate & calm clients -
ANS - Benzodiazepines (end with -epam) - diazepam (Valium), lorazepam (Ativan),
alprazolam (Xanax), flurazepam (Dalmane)
- Barbiturates - phenobarbital

Adverse effects of SEDATIVES, HYPNOTICS, AND ANXIOLYTICS - ANS hangover-
effect, dizziness, CNS depression - respiratory depression, drug-dependence

, Nursing considerations of SEDATIVES, HYPNOTICS, AND ANXIOLYTICS - ANS 1.
Warn clients of injuries and falls.
2. Brief period of confusion and excitement upon waking up is common with
benzodiazepines.
3. Warn clients not to discontinue medications abruptly without consulting a physician.
4. Avoid alcohol while taking these drugs.
6. Rotate and don't shake the ampoules of barbiturates. Don't mix with other drugs.
7. Warn female clients that diazepam is associated with cleft lip.

ANTIDEPRESSANTS AND MOOD DISORDER DRUGS - ANS Tricyclic
antidepressants - amitriptyline (Elavil), imipramine (Tofranil), desipramine
MAOI (monoamine oxidase inhibitors) -phenelzine (Nardil), tranylcypromine (Pernate)
Second-generation antidepressants - fluoxetine (Prozac)

Adverse effects of ANTIDEPRESSANTS AND MOOD DISORDER DRUGS - ANS - dry
mouth, blurred vision, urine retention, constipation (anticholinergic effects)
- orthostatic hypotension, insomnia
- hypertensive crisis (MAO)

Nursing considerations ANTIDEPRESSANTS AND MOOD DISORDER DRUGS - ANS
1. Caution client to rise slowly to reduce the effects of orthostatic hypotension.
2. Take antidepressant with food to enhance absorption
3. Explain to client that full response may take several weeks (2 weeks)
4. Assess client for constipation resulting from tricyclic antidepressant use.
5. Client taking MAO inhibitors should avoid tyramine-rich foods to avoid hypertensive
crisis. -aged cheese, sour cream, yogurt, beer, wine, chocolate, soy sauce and yeast
6. Inform physician and withhold fluoxetine if client develop rashes.

ANTIPSYCHOTIC DRUGS (Neuroleptics) - ANS Phenothiazines - chlorpromazine
(Thorazine), - thioridazine (Mellaril)
Other Agents - olanzapine (Zyprexa) , haloperidol (Haldol)

Mechanism of action of neuroleptics - ANS block dopamine receptors in the limbic
system, hypothalamus, and other regions of the brain

Adverse effects of neuroleptics - ANS - Extra pyramidal syndrome (or EPS) such as
dystonia, pseudoparkinsonism, and an irreversible tardive dyskinesia as manifested by:
a. lip smacking b. fine wormlike tongue movement c. involuntary movements of arms
and leg - Neuroleptic malignant syndrome (NMS) a. fever, tachycardia, tachypnea,
diaphoresis, cardiovascular collapse b. muscle rigidity, seizures. - Orthostatic
hypotension

Nursing considerations of neuroleptics - ANS 1. Teach family members the signs of
EPS and NMS, and report to physician immediately 2. Normalization of symptoms may
not occur for several weeks after beginning of therapy 3. Watch out for orthostatic

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