Therapeutic WINDOW is what?
o Level of the drug between minimal effective concentration in the plasma for
obtaining desired drug response and the minimal toxic concentration
The time it takes for ½ of the drug concentration to be eliminated from the body is
called?
o Half life
What is a patient on two highly protein bound drugs at risk for
o Accumulation and toxicity
o A decreased responsiveness over the course of therapy which may lead to the
need to increase dosages to attain the same effect tolerance
What is it called for drugs to share many common features
o Classification or class
What makes drugs fit into the same “class”
o Related by chemical structure
o Work in the same way
o Used for the same purpose
Another name for antagonist?
o Adrenergic blocker
Who do you not give antagonist or adrenergic blocker to?
o Asthma client
Beta blockers commonly seen in what clients?
o Hypertension
Antagonist suffix
o LOL
Antagonist S/S
o Decreased HR
, o Rest and digest
o Bronchospasm
Agonist S/S
o Increased HR, Fight or flight, Vasoconstriction, Increase blood sugar
Before administering antagonist what do you check
o HR and BP
Cholinergic
o Salivate, Lacrimation, Urinate, Defecate, Decreased weight
Anticholinergic
o Can’t see, pee, spit, poop, and increase HR
What type of drug is Reglan?
o Cholinergic
How do you treat cholinergic crisis
o Atropine
Cholinergic crisis S/S
o Flushing, sweating, nausea, ab cramping
Anticholinergic drugs are contraindicated in who?
o Coronary artery disease (increase HR)
o GI obstruction (constipation)
o Supraventricular tachycardia (increase HR)
CNS stimulant drugs are contraindicated in who?
o Coronary artery disease (cause vasoconstriction=heart attack)
o Hypertension (additive hypertension=stroke)
Hemorrhagic stroke
o Increase BP
o Increase HR
o Increased RR
o Unresponsive to deep pain
Anorexiants can lead to what?
o 16x greater risk for stroke
Most common side effects of Ritalin
o Irritability
o Insomnia
, Weight loss
Decrease appetite
Benzodiazepines increase activity to what neurotransmitter (PAM & LAM)
o GABA
Reversal to benzodiazepines
o Flumazenil
Ambien side effects
o Sedative/hypnotic
o Suicidal ideation
o Dependence
o Abnormal behavior
Drug choice for treating status epilepticus
o Diazepam’s
Dilantin can do what?
o Cause gum disease
o Treat seizures
o Cause high BP
o Cause birth defects
o Decrease effectiveness of anticoagulants
When a client is on Dilantin what are some nursing interventions?
o Monitor for narrow therapeutic index (freq blood test)
o Take as prescribed
o Oral care
o Teach pt to use barrier contraceptives along with oral
What is therapeutic level for Depakote?
o 40-100
If Depakote levels are high (>100) what needs to be done?
o Hold meds
o Check liver function with blood test
o Discuss with DR
o Neuro assessment
o Check vitals
What does Depakote treat?
o Epilepsy
o Migraine
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