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Class 2 nsg 2500 Summer 2011
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Class 2 nsg 2500 Summer 2011

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    Class 2 nsg 2500 Summer 2011 Class 2 nsg 2500 Summer 2011 Presentation Transcript

    • Class 2CNS Stimulants
    • Ch. 20-Benzodiazepines/Anxiolytics
      Oxazepam
      triazolam
    • Barbiturates
      Greater Sedation
      Great Dependence
    • Chapter 20: AnxiolyticsHypnotics
    • SE of Hypnotics, Anxiolytics, Sleep AidsSedation
    • Drowsiness
    • Lethargy
    • Blurred Vision
    • Confusion
    • Dry Mouth
    • Constipation
    • Nausea/Vomiting
    • Hypotension
    • Urinary Retention
    • Antidepressants: Signs of Depression
    • Sleep disturbances
    • Lack of appetite
    • Limited Libido
    • Feelings of Sadness
    • Inability to perform daily activities
    • Tricyclic Antidepressants-TCAs
    • Prototype: Imipramine
    • Monoamine Oxidase inhibitors
    • MAOI Interactions
    • Selective Serotonin Reuptake Inhibitors
    • Serotonin Syndrome
    • Other Antidepressants
    • Ch. 22: Psychotherapeutic DrugsAntipsychotics/Neuroleptics: Used to Treat
      Schizophrenia
      Narcolepsy/ADD
      Mania/BiPolar disorder
    • Typical Antipsychotics
    • Atypical Antipsychotics
    • Antipsychotics & Adolescents
    • Antipsychotics and Dementia
    • Antipsychotic SE
      Akathisia
      Tongue thrusting
      Facial grimacing
      Jerking of head
      Mouth puckering
      Finger movement
      Blinking
      Rolling the tongue around the mouth
      Twitching hands
      Tapping feet
      Twisting the trunk
    • Anti-Mania Drugs
      Lithium
      Therapeutic Level:
      0.6-1.2 mEq/L
    • CNS Stimulants
    • Anti-Seizure Drugs
      Hydantoins
    • Confusing Drug Names??
      Celebrex
      Cerebyx
      Celexa
    • Dilantin-Phenytoin
      Serious Skin Reactions: Side/Adverse Effects
      Gingival hyperplasia
      Liver toxicity
      CNS depression
    • Other Drugs for Seizures:Benzodiazepams: Klonopin & Valium
    • Central Nervous System
    • Use of CNS Stimulants
      ADHD
      Narcolepsy
      Cluster Headaches/Migraines
    • Anorexiants: Obesity
      NO MORE Phenylpropanolamine
    • Xanthines
      Purpose: stimulate respiration in newborns
      Side effects: restlessness, tremors, twitching, palpitations, insomnia
      Xanthines (methylxantine)
      Caffeine used in newborns with respiratory distress to stimulate respirations
      Theophylline
    • Caffeine
      Increased alertness; Diuretic, cardiovascular stimulation, bronchodilation, increased GI secretion, skeletal muscle stimulation
      Large amts can cause excessive CNS stimulation: Anxiety, agitation, diarrhea, insomnia, irritable, nervous, PVCs,
      Toxicity: Delirium, seizures
      Withdrawal: Headache, fatigue, muscle pain
    • Item
      Item Size
      Caffeine Content (mg)
      Coffee
      150 ml (5 oz)
      60-150
                    
                
      Coffee, decaf
      150 ml (5 oz)
      2-5
      Tea
      150 ml (5 oz)
      40-80
      Hot Cocoa
      150 ml (5 oz)
      1-8
      Chocolate Milk
      225 ml
      2-7
      Jolt Cola
      12 oz
      71
      Josta
      12 oz
      58
      Mountain Dew
      12 oz
      55
      Surge
      12 oz
      51
      Tab
      12 oz
      47
      Diet Coca Cola
      12 oz
      45
      Coca Cola
      12 oz
      45
    • Copyright 2003, Elsevier Science (USA). All Rights Reserved.
      Coca Cola
      12 oz
      45
      Tab
      12 oz
      46
      RC Cola
      12 oz
      43
      Dr. Pepper
      12 oz
      41
      Mr. Pibb
      12 oz
      40
      Pepsi Cola
      12 oz
      37
      Cherry Coca-Cola
      8 oz
      31
      7-Up
      12 oz
      0
      Mug Root Beer
      12 oz
      0
      Sprite
      12 oz
      0
    • Copyright 2003, Elsevier Science (USA). All Rights Reserved.
      This is No BULL!
      Red Bull contains approx 80 mg caffeine in one can (similar to a cup of regular coffee)
      Caffeine is FATAL in doses of 10 grams
    • And What about Starbucks? (amounts vary by web site)
      Coffee, tall (12 oz.) 240 mg
      Coffee, venti (20 oz.) 480 mg
      Coffee, short (8 oz.) 180 mg
      Coffee, grande (16 oz.) 320 mg
    • Copyright 2003, Elsevier Science (USA). All Rights Reserved.
      OTC Drugs with Caffeine
      Dextrim
      200
                     
      Vivarin
      200
      No Doz
      100
      Excedrin
      65
      Vanquish
      33
      Anacin
      32
      Midol
      32
      Triaminicin
      30
      Dristan
      16
    • Copyright 2003, Elsevier Science (USA). All Rights Reserved.
      Caffeine in Common Products
      Caffeine IS addictive
      3-4 cups of coffee is maximum recommended/day
      Listed as GRAS (Generally Recognized as Safe!)
      Should be avoided by pregnant women, people with CAD, HTN
    • Respiratory CNS Stimulant
      Purposes: respiratory depression from drug overdose, postanesthetic respiratory depression, occasionally COPD
      Doxapram (Dopram)
    • Herbal Stimulants
      Guarana
      High in caffeine
      Found in weight loss products and energy drinks
      Ma Huang
    • Peripheral Nervous System
    • Autonomic Nervous System
    • Sympathetic Nervous System:Fight or Flight
    • STRESS!!!!
    • Parasympathetic Nervous System: controls Pee, Poop, Puke
    • Adrenergic Drugs
    • Alpha Adrenergic Blocking Agents
    • Alpha Adrenergic Blocking Agents
      Examples of alpha blockers include:
      Alfuzosin (Uroxatral)
      Doxazosin (Cardura)
      Prazosin (Minipress)
      Terazosin (Hytrin)
      Tamsulosin (Flomax)
    • Alpha Adrenergic Blocking Agents
    • Alpha Adrenergic Blocking Agents
    • Beta Adrenergic Blocking Agents
    • Beta Adrenergic Blocking Agents
      Assess BP, Heart Rate
    • Effects of Beta Blockers:
      Pupil construction
      Tears
      Saliva
      Slow Heart Rate
      Bronchoconstriction
      Increased GI motility
      Urinary Frequency
    • Cholinergic Drugs
    • Myasthenia Gravis
      Tensilon Test (edrophonium)
    • Cholinergics
      Organophosphates used as incecticides
      Sarin Gas-Bioterrorism
      Antidote
    • Drugs for Alzheimer’s Disease
      Cholinesterase Inhibitors:
      Razadyne® (galantamine)
      Exelon® (rivastigmine)
      Aricept® (donepezil).
      Nursing Care??
      Namenda® (memantine)
    • Cholinergic Blocking AgentsAKA Anticholinergics
    • Anticholinergic Effects
      RED AS A BEET
    • Anticholinergic Effects
      DRY AS A BONE
    • Anticholinergic Effects
      MAD AS A HATTER