This document provides information on common conditions affecting the nervous system and medications used to treat them. It discusses the anatomy and functions of the central and peripheral nervous systems. It then summarizes various neurological and psychiatric conditions like epilepsy, Parkinson's disease, depression, anxiety, pain, insomnia, psychosis, and others. For each condition, it lists common medications used for treatment and their potential side effects and nursing considerations. The document aims to educate medication aides on neurological disorders and corresponding pharmacologic therapies.
3. CONT.
• Consists of the central nervous system
• Brain & spinal cord
• Peripheral nervous system
• Nerves throughout the body
• Nerves carry messages to/from the brain
• Nerves connect to the spinal cord-are easily damaged & take a long time
to heal
• Some have a protective covering(myelin sheath) that protects & insulates-
causes impulses to travel faster
• Central nervous system-brain is protected by the skull
• The 3 main parts
• Cerebrum-the outside is called the cerebral cortex & controls the highest
functions of the brain-center of thought & intelligence
• Cerebellum-regulates & co-ordinates body movements-balance &
smooth movement of the muscles
• Brainstem-connects the cerebrum to the spinal cord-it controls vital
functioning of the organs such as breathing, heart rate, blood vessel size,
swallowing, coughing & vomiting
4. DRUGS AFFECTING THE AUTONOMIC
NERVOUS SYSTEM
• They maintain a constant internal environment &
responds to emergencies
• Most organs have both adrenergic(excite or
increase ht. rate) & cholinergic(slows the ht. rate)
5. BETA BLOCKERS
• Used after a MI-use with caution with respiratory
diseases as can cause severe broncho-constriction
• Onset is fairly rapid though takes several
days/weeks to stabilize(must be DC’d slowly)
• Examples Side Effects
• Tenorrmin SOB
• Coreg Low BP
• Lopressor Low BS’s if Diabetic
• TopralXL Slow Pulse
• Inderal Peripheral constriction(skin
• becomes purple & mottled)
6. CHOLINERGIC AGENTS
• Slows the heart beat
• Increases GI motility & secretion
• Increases bladder contractions
• Increases smooth muscle contractions of the resp.
system
• Causes the pupil to contract which decreases
intraocular pressure & increases skeletal muscle
contraction
• Used to treat myasthenia gravis
12. BARBITURATES
• Depresses the CNS, used in anesthesia & seizures
• Risk of addiction is high
• Short acting ones can be used for sedation prior to
diagnostic procedures
• Long acting-phenobarbital is used for control of seizures
• Side Effects
• Drowsiness
• Lethargy
• HA
• Muscle or joint pain
• Mental depression
• Increased confusion
13. BENZODIAZEPINES
• Most commonly used as sedative-hypnotics
• Not to be used more then 4 wks.
• Very highly addictive
• Must be DC’d over a period of 2-4 wks.
• Side effects include
• Drowsiness
• Hangover
• Sedation
• Lethargy
• Liver toxicity
14. PARKINSON’S DISEASE
• Is a slow, progressive disorder with no cure.
• The area of the brain that controls muscle
movement is affected.
• Dopamine deficiency
• Persons over the age of 50 are at risk.
• Signs and symptoms
• Tremors
• Rigid, stiff muscles
• Slow movements
• Stooped posture and impaired balance
• Mask-like expression
15. ANTIPARKINSONIANS
• Used to treat Parkinson’s disease
• Common side affects
• Nausea
• Vomiting
• Confusion
• Hallucinations
• Fatigue
• Diarrhea
• Constipation
• Dry mouth
• Nursing precautions
• Observe for signs of improvement in symptoms of disease
(muscle tremors, rigidity)
17. ALZHEIMER’S DISEASE
• Brain disease
• Memory, thinking, reasoning, judgment, language,
behavior, mood, and personality are affected
• Gradual onset
• Seven stages
• No impairment
• Very mild cognitive decline
• Mild cognitive decline
• Moderate cognitive decline
• Moderately severe decline
• Severe cognitive decline
• Very severe decline
18. DEMENTIA/ALZHEIMER’S DISEASE
• Used to treat symptoms of Alzheimer’s by helping to slow
cognitive decline
• Common side affects
• Nausea
• Diarrhea
• Vomiting
• Muscle cramps
• Dizziness
• insomnia
• Nursing precautions
• Monitor for side effects
• Examples
• Donepezil (Aricept)
• Rivastigmine (Exelon)
• Galantamine (Razadyne)
• Tacrine HCL (Cognex)
• Memantine (Namenda)
19. MENTAL DISORDERS
• Mental- means mind
• Causes of mental health disorders
• Not being able to cope or adjust to stress
• Chemical imbalances (lithium)
• Genetics
• Drug or substance abuse
• Social and cultural factors
20. ANXIETY
• Vague, uneasy feeling in response to stress
• Signs and symptoms(Responses to stressful
situations)
• Abnormal or irrational
• Impair normal daily function
• Can last months
26. PSYCHOSES
• Delusions
• False belief
• Hallucination
• Seeing, hearing, smelling, or feeling something that is not real
• Paranoia
• Suspicion
• Delusion of grandeur
• Exaggerated belief about one’s importance
• Delusion of persecution
• False belief that one is being mistreated or abused
• Schizophrenia is most common cause
• Dementia, delirium, mood disorders, and drugs and
substance abuse
27. ANTIPSYCHOTICS
• Used to treat schizophrenia, mania, & dementia- related
problems (psychotic disorder group of sever mental health
illnesses where person’s ability to perceive reality,
communicate, and form stable interpersonal relationships are
impaired
• Common side affects
• Drowsiness
• Dry mouth
• Constipation
• Blurred vision
• Confusion
• Headache
• Sedation
• Muscle spasms
• Stiffness
• Spasms
28. CONT…
• Nursing precautions
• Monitor for adverse effects
• Report new signs of muscle tremors, stiffness, spasms(cogentin
is used to reduce involuntary muscle movements)
• Examples
• Thioridazine (mellaril)
• Chlorpromazine (thorazine)
• Haloperidol (Haldol)
• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Lithium (Lithotabs)
• Aripiprazole (Abilify)
29. ALCOHOL REHAB
• Is a chronic disease with no cure(can be treated)
• Counceling
• Meds are Antabuse & Campral
• Side effects
• Drowsiness & fatique
• Anorexia, nausea & vomiting
• Hives(allergic reaction)
30. SEIZURE DISORDERS
• Involves violent and sudden contractions or tremors
of muscle groups. Movements are uncontrolled.
• Causes
• Head injury
• High fever
• Brain tumors
• Poisoning
• Drug overdose or withdrawal
• Nervous system disorders
• Epilepsy- clusters of nerve cells signal abnormally
• No cure
31. ANTIEPILEPTIC
• Used to reduce or prevent generalized, partial and other
seizure types
• Common side effects
• Dizziness
• Fatigue
• Vision problems
• Somnolence
• Unsteadiness
• Nausea
• vomiting
• Nursing precautions
• Monitor for seizure frequency
• Shake oral suspensions before using
• Don’t crush tablets or capsules unless labeled chewable
• Never stop antiepileptic medication suddenly
33. PAIN
• Means to ache, hurt, or be sore
• Is personal
• A warning from the body
• Acute pain less than 6 months- isolated incident
• Chronic pain greater than 6 months
• Radiating pain
• Phantom pain
• Past experience
• Anxiety
• Rest and sleep
• Attention
34. PAIN CONT…
• Personal and family duties
• Value or meaning to pain
• Support from others
• Culture
• Illness
• Age
36. QUESTIONS TO ASK
• Location
• Onset and duration
• Description
• Factors causing pain
• Factors affecting pain
• Other signs and symptoms
37. DOCUMENTATION
• Response to the pain med
• Need for additional pain med
• Response to any additional interventions
38. ASA
• Inhibits platelet Activity
• Used to reduce risks of TIA or CVA
• Reduce risks of MI with previous history
• Enteric forms is usually used to reduce stomach
irritation
• Watch for S/S of GI bleed
39. NSAID’S
• ASA like drugs
• Used to reduce pain, inflammation & fever
• Examples
• Celebrex
• Lodine
• Motrin
• Advil
• Aleve
• Toradol
• Feldene
40. TYLENOL
• Max dose of 4000mg/day
• Give with food or milk
• Side effects
• Stomach irritation
• Anorexia, nausea or vomiting
• Low blood pressure
• Confusion
• Drowsiness
• Abd. Pain & jaundice(liver toxicity)
41. CONT.
• Nsg. Precaution: Give with food
• Side Effects
• GI bleed
• Dizziness or drowsiness
• Constipation
• Confusion
• Anorexia, nausea or vomiting
Editor's Notes
Chapter 14, p. 181-185
Chapter 14, p. 186-187
Later on swallowing and chewing problems, constipation, and bladder problems occur. Sleep problems, depression, and emotional changes can occur. Memory loss and slow thinking can also occur.