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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018 | Registered Nurse (RN) School Study Aid


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Central Nervous System Agents Drug Grid
51 Picmonics to Learn | 1 hr 24 mins

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Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
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Aspirin (Acetylsalicylic Acid)
Mechanism
Inhibits Platelet Aggregation
NSAID
Indications
Thrombotic Event Prevention
General Pain
Inflammatory Conditions
Fever
Side Effects
Pancytopenia
GI Ulcers
Bleeding
Considerations
Withhold Before Surgery 7-10 Days
Reye's Syndrome
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Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
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NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
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Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
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Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
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47 secs
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
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Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly inhibits COX
Acts primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
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33 secs
Gabapentin
Primary Indication
Seizure Treatment
Secondary Indications
Peripheral Neuropathy
Postherpetic Neuralgia
Bipolar Disorder
Migraine Prophylaxis
Mechanism of Action
Inhibits Voltage-Gated Ca2+ channels
GABA Analog
Side Effects
Ataxia
Sedation
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Pregabalin (Lyrica)
Mechanism
GABA Analog
Indications
Seizures
Neuropathic Pain
Fibromyalgia
Side Effects
Headache
Dizziness
Somnolence (Fatigue)
Weight Gain
Angioedema
Rhabdomyolysis
Considerations
Dependence
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Gout Treatment
Acute (Acute-angle)
NSAIDs
Glucocorticoids
Colchicine
Impairs Leukocyte Chemotaxis
Chronic Gout (Crone Goat)
Inhibit Xanthine Oxidase
Allopurinol
Febuxostat
Inhibit Reabsorption of Uric Acid
Probenecid
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Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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Opioid Antidote
Antidote
Naloxone
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28 secs
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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Benzodiazepines Overview
Indications
First Line for Status Epilepticus
Anesthesia Induction
Anxiety
Eclampsia
Detoxification
Mechanism of Action
'-zepam' and '-zolam" Suffix
Increase Frequency of Cl- Channel Opening
Side Effects
Decrease REM Sleep
CNS Depression
Dependence
Antidote
Flumazenil for Overdose
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2 mins
Alcohol Abuse Interventions
Withdrawal
Reduce Environmental Stimuli
Antianxiety Medications
Vitamin Supplements
Seizure Precautions
Suicide Precautions
Fever
Considerations
Identify Support Systems
Group Therapy
Disulfiram
Naltrexone
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Seizure Interventions
Maintain Airway
Side-lying Position
Support Head
Move to Floor
Benzodiazepines
Considerations
Never Restrain
No Objects in Mouth
Document Details
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Phenytoin (Dilantin)
Mechanism
Blocks Na+ Channels
Indications
Tonic-clonic Seizures
Side Effects
Ataxia
Nystagmus
Sedation
Gingival Hyperplasia
Purple Glove Syndrome
Hirsutism
Rash
Anemia
Considerations
Individualized Dosing
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Ethosuximide (Zarontin)
Indications
First Line Absence Seizure
Mechanism of Action
Blocks Thalamic T-Type Ca2+ Channels
Side Effects
Stevens-Johnson Syndrome
Fatigue
Diarrhea
Blood Dyscrasias
Considerations
Do Not Stop Abruptly
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2 mins
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
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2 mins
Lamotrigine (Lamictal)
Mechanism
Blocks Na+ Channels
Indications
Seizures
Bipolar Disorder
Side Effects
Diplopia
Stevens-Johnson Syndrome
Headache
Aseptic Meningitis
Nausea and Vomiting
Considerations
Screen for Suicide Risk
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Topiramate
Indications
Seizure Treatment
Migraine Prophylaxis
Mechanism of Action
Increase GABA Action
Blocks Voltage-Gated Na+ Channels
Side Effects
Kidney Stones
Weight Loss
Sedation
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1 min
Valproic Acid (Valproate) Side Effects
V-A-L-P-R-O-A-T-E
Vomiting
Alopecia
Liver Toxicity
Pancreatitis/Pancytopenia
Retain Fat (Weight Gain)
Oedema (Edema)
Appetite Increase
Tremor
Enzyme Inhibitor (P450)
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Fluoxetine (Prozac)
Mechanism of Action
Inhibits Reuptake of Serotonin
Indications
Depression
Side Effects
Sexual Dysfunction
CNS Stimulation
Weight Changes
Serotonin Syndrome
Contraindications
No MAO-Is
No Anticoagulants / Antiplatelets
Considerations
Suicide Risk
Delayed Onset of Action
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Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Indications
Depression
Diabetic Peripheral Neuropathy
Duloxetine
Panic and Anxiety
Venlafaxine
Mechanism of Action
Inhibits Reuptake of Serotonin and NE
Side Effects
Hypertension
Insomnia
Nausea and Vomiting
Decreased Libido
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1 min
Selective Serotonin Reuptake Inhibitor (SSRI) Overview
Indications
Depression
Anxiety
Mechanism of Action
Selective Serotonin Reuptake Inhibitors
Drugs
Paroxetine
Sertraline
Escitalopram
Fluoxetine
Side Effects
Sexual Dysfunction
Serotonin Syndrome
Treat with Cyproheptadine
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Trazodone
Indications
Insomnia
Depression
Mechanism of Action
Inhibit Serotonin Reuptake
Alpha-1 Blocker
Histamine (H1) Blocker
Side Effects
Sedation
Orthostatic Hypotension
Dry Mouth
Priapism
Arrhythmias
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Tricyclic Antidepressants (TCAs) Indications
Indications
Major Depression
Bedwetting
Fibromyalgia
OCD
Drugs
-Iptyline or -Ipramine Suffix
Amitriptyline
Desipramine
Clomipramine
Imipramine
Nortriptyline
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2 mins
Bupropion
Indications
Depression
Smoking Cessation
Mechanism of Action
Increase Dopamine and NE
Side Effects
Stimulant Side Effects
Seizure
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Atypical Antipsychotics
Indications
Schizophrenia
Mechanism of Action
Unknown Mechanism
Side Effects
Seizures
Prolonged QT Interval
Agranulocytosis
Weight Gain
Fewer Extrapyramidal Side Effects
Fewer Anticholinergic Side Effects
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2 mins
Aripiprazole (Abilify)
Mechanism
2nd Generation Atypical Antipsychotic
Indications
Schizophrenia
Bipolar Disorder
Depression
Side Effects
Headache
Dizziness
Nausea and Vomiting
Insomnia
Anxiety
Considerations
Low Risk of Extrapyramidal Symptoms
Lowest Risk of Weight Gain
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Clozapine (Clozaril)
Mechanism
Atypical Antipsychotic
Indications
Schizophrenia
Levodopa-Induced Psychosis
Side Effects
Weight Gain
Hypersalivation (Sialorrhea)
Myocarditis
Agranulocytosis
Sedation
Orthostatic Hypotension
Constipation (Risk of Bowel Ileus)
Considerations
Weekly Lab Tests
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2 mins
Risperidone (Risperdal)
Mechanism
Atypical Antipsychotic
Indications
Schizophrenia
Bipolar Mania
Autism-Associated Irritability
Side Effects
Extrapyramidal Symptoms
Hyperprolactinemia
Gynecomastia
Galactorrhea
Amenorrhea
Prolonged QT
Considerations
Intramuscular Long Acting (Depot) Form
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2 mins
Haloperidol (Haldol)
Mechanism
High Potency Antipsychotic
Indications
Migraine
Schizophrenia
Side Effects
Extrapyramidal Symptoms
Weight Gain
QT Prolongation
Restlessness
Considerations
Caution in Seizure Patients
Neuroleptic Malignant Syndrome
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2 mins
Attention-Deficit Hyperactivity Disorder (ADHD) Interventions
Drug Therapy
CNS Stimulants
Amphetamine
Methylphenidate
Bupropion (Wellbutrin)
Atomoxetine (Strattera)
Guanfacine (Intuniv)
Considerations
Manage Disruptive Behavior
Provide Simple Instructions
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2 mins
CNS Stimulants
Indications
Attention Deficit Hyperactivity Disorder (ADHD)
Obesity
Mechanism of Action
Increase Catecholamines at Synaptic Cleft
Increase Norepinephrine
Increase Dopamine
Drug Names
Methylphenidate (Ritalin)
Methamphetamine
Side Effect
Potential for Abuse
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56 secs
Benzodiazepine Intoxication Assessment
Drowsiness
Confusion
Respiratory Depression
Hypotension
Coma
Treatment
Flumazenil (Romazicon)
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2 mins
Buspirone (Buspar)
Mechanism
Increases Serotonin
Indications
Anxiety
Side Effects
Dizziness
Insomnia
Considerations
Delayed Effect
No Alcohol Interaction
No CNS Effects
Low Abuse Potential
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2 mins
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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2 mins
Zolpidem (Ambien)
Mechanism
Hypnotic
Indications
Insomnia
Side Effects
Daytime Drowsiness
Bizarre Sleep Behaviors
Sleep Driving
Angioedema
Considerations
Short Term Administration
Take Immediately Before Bedtime
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1 min
Lithium
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Indications
Bipolar Disorder
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Tremor
Heart Block
Contraindication
Pregnancy
Considerations
Monitor Plasma Levels
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2 mins
Valproic Acid (Depakote)
Mechanism
Blocks Na+ Channels
Increases GABA Concentration
Indications
Tonic-clonic Seizures
Bipolar Disorder
Migraine Prophylaxis
Side Effects
Hepatotoxicity
Blood Dyscrasias
GI Distress
Tremor
Pancreatitis
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1 min
Sumatriptan
Mechanism of Action
Short Half-Life
5-HT Agonist
Inhibits Trigeminal Nerve Activation
Induces Vasoconstriction
Indications
Migraine
Cluster Headache
Side Effects
Increased Risk of Serotonin Syndrome
Paresthesias
Coronary Vasospasm
Contraindication
Prinzmetal's Angina
Coronary Artery Disease (CAD)
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3 mins
Parkinson's Drugs
Parkinsons Characteristics
Decreased Dopamine
Increased Acetylcholine
Drug Names
BALSA Acronym
Bromocriptine
Amantadine
Levodopa
Selegiline
Antimuscarinics
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2 mins
Benztropine (Cogentin)
Mechanism
Anticholinergic
Indications
Parkinson's Disease
Acute Dystonia
Side Effects
Blurred Vision
Dry Mouth
Urinary Retention
Tachycardia
Constipation
Psychosis
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2 mins
Levodopa/Carbidopa (Sinemet)
Mechanism
Increases Dopamine in Brain
Indications
Parkinson's Disease
Side Effects
Nausea and Vomiting
Arrhythmias
Dyskinesia
Psychosis
Orthostatic Hypotension
Considerations
Report Uncontrolled Movements
Darkened Sweat or Urine
Off and On Phenomenon
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2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
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2 mins

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