Multiple Sclerosis Interventions
- Corticosteroids
 - Interferon Beta
 - Dimethyl Fumarate (Tecfidera)
 - Fingolimod (Gilenya)
 - Mitoxantrone (Novantrone)
 - Natalizumab (Tysabri)
 - Increase Exercise
 - Identify Triggers
 
Gabapentin
- Seizure Treatment
 - Peripheral Neuropathy
 - Postherpetic Neuralgia
 - Bipolar Disorder
 - Migraine Prophylaxis
 - Inhibits Voltage-Gated Ca2+ channels
 - Designed as a GABA Analog
 - Ataxia
 - Sedation
 
Selective Serotonin Reuptake Inhibitor (SSRI) Overview
- Depression
 - Anxiety
 - Selective Serotonin Reuptake Inhibitors
 - Paroxetine
 - Sertraline
 - Escitalopram
 - Fluoxetine
 - Sexual Dysfunction
 - Serotonin Syndrome
 - Treat with Cyproheptadine
 
Fluoxetine (Prozac)
- Inhibits Reuptake of Serotonin
 - Depression
 - Sexual Dysfunction
 - CNS Stimulation
 - Weight Changes
 - Serotonin Syndrome
 - No MAO-Is
 - No Anticoagulants / Antiplatelets
 - Suicide Risk
 - Delayed Onset of Action
 
Carbamazepine (Tegretol)
- Inactivates Na+ Channels
 - Seizures
 - Bipolar Disorder
 - Trigeminal Neuralgia
 - Nystagmus
 - Ataxia
 - Hepatotoxicity
 - Blood Dyscrasias
 - Water Retention
 - Stevens-Johnson Syndrome
 - Avoid Grapefruit Juice
 
Levodopa/Carbidopa (Sinemet)
- Increases Dopamine in Brain
 - Parkinson's Disease
 - Nausea and Vomiting
 - Arrhythmias
 - Dyskinesia
 - Psychosis
 - Orthostatic Hypotension
 - Report Uncontrolled Movements
 - Darkened Sweat or Urine
 - Off and On Phenomenon
 
Parkinson's Disease Interventions
- Levodopa/Carbidopa (Sinemet)
 - Entacapone (Comtan)
 - Selegiline (Eldepryl)
 - Amantadine (Symmetrel)
 - Bromocriptine (Parlodel)
 - Benztropine (Cogentin)
 - Allow Extra Time
 - Ensure Patient Safety
 - Surgery As Last Resort
 
Anticholinergics
- B.O.AT.S Acronym
 - Benztropine
 - Parkinson's Disease
 - Oxybutynin
 - Decrease bladder spasms
 - Atropine
 - Mydriasis and Cycloplegia
 - Scopolamine
 - Motion Sickness
 
Anticholinergics Continued
- Glycopyrrolate
 - Reduces Airway Secretions
 - Ulcer Treatment
 - Ipratropium
 - Asthma and C.O.P.D
 - Dicyclomine
 - Hyoscyamine
 - Irritable Bowel Syndrome
 
Phenytoin (Dilantin)
- Blocks Na+ Channels
 - Tonic-clonic Seizures
 - Ataxia
 - Nystagmus
 - Sedation
 - Gingival Hyperplasia
 - Purple Glove Syndrome
 - Hirsutism
 - Rash
 - Anemia
 - Individualized Dosing
 
Phenobarbital (Barbiturates)
- Barbiturate
 - Seizures
 - Ataxia
 - Paradoxical Excitement
 - Fatigue/Drowsiness
 - Monitor Plasma Levels
 - High Potential for Abuse
 
Valproic Acid (Depakote)
- Blocks Na+ Channels
 - Increases GABA Concentration
 - Tonic-clonic Seizures
 - Bipolar Disorder
 - Migraine Prophylaxis
 - Hepatotoxicity
 - Blood Dyscrasias
 - GI Distress
 - Tremor
 - Pancreatitis
 
CNS Stimulants
- Attention Deficit Hyperactivity Disorder (ADHD)
 - Obesity
 - Increase Catecholamines at Synaptic Cleft
 - Increase Norepinephrine
 - Increase Dopamine
 - Methylphenidate (Ritalin)
 - Methamphetamine
 - Potential for Abuse
 
CNS Stimulant Indications
- Amphetamine
 - Methylphenidate (Ritalin)
 - Increased Norepinephrine
 - Increased Dopamine
 - Attention Deficit Hyperactivity Disorder (ADHD)
 - Obesity
 - Narcolepsy
 
Lamotrigine (Lamictal)
- Blocks Na+ Channels
 - Seizures
 - Bipolar Disorder
 - Diplopia
 - Stevens-Johnson Syndrome
 - Headache
 - Aseptic Meningitis
 - Nausea and Vomiting
 - Screen for Suicide Risk
 
NSAIDs
- Anti-inflammatory
 - Analgesic
 - Fever
 - Closure of Patent Ductus Arteriosus 
 - Reversible Inhibition of COX-1 and COX-2
 - Block Prostaglandin Synthesis
 - Interstitial Nephritis
 - Gastric Ulcer
 - Renal Ischemia
 
Aspirin (Acetylsalicylic Acid)
- Inhibits Platelet Aggregation
 - NSAID
 - Thrombotic Event Prevention
 - General Pain
 - Inflammatory Conditions
 - Fever
 - Pancytopenia
 - GI Ulcers
 - Bleeding
 - Withhold Before Surgery 7-10 Days
 - Reye's Syndrome
 
Reye's Syndrome
- Aspirin (Salicylates) to Treat Viral Illness (In Children)
 - Cerebral Edema 
 - Lethargy (Decreased LOC)
 - Vomiting
 - Liver Failure
 - Monitor for Increased ICP
 - Mannitol (Osmitrol)
 - No Aspirin for Children
 
Morphine
- Opioid Receptor Agonist
 - Pain
 - Myocardial Infarction
 - Nausea and Vomiting
 - CNS Depression
 - Biliary Colic
 - Constipation
 - Increased Intracranial Pressure (ICP)
 - Pupillary Constriction
 - Hypotension
 
Increased Intracranial Pressure (ICP) Assessment
- Change in LOC
 - Headache
 - Cushings Triad
 - Irregular Respirations
 - Widening Pulse Pressure
 - Bradycardia
 - Projectile Vomiting
 - Abnormal Pupils
 - Papilledema
 - Posturing
 
Increased Intracranial Pressure (ICP) Interventions
- Elevate Head Of Bed
 - Foley Catheter
 - Mannitol (Osmitrol)
 - High Dose Barbiturates
 - Passive Hyperventilation
 - Dexamethasone (Neoplasm or Infection)
 - Neuro Assessment
 - Maintain Normal Temperature
 - Avoid Activities That Increase ICP
 - Intracranial Monitoring System
 
Meperidine (Demerol)
- Opioid Receptor Agonist
 - Moderate to Severe Pain
 - Post Anesthesia Shivering
 - Tremors
 - Constipation
 - CNS Depression
 - Sedation
 - Short Term Administration
 - Increased Risk Serotonin Syndrome
 - Does NOT cause Miosis
 - Renal Failure Increases Toxicity Risk
 
Naloxone (Narcan)
- Competitive Opioid Receptor Antagonist
 - Opioid Induced CNS Depression
 - Severe Nausea and Vomiting
 - Excitable State
 - Opioid Withdrawal Symptoms
 - Repeated Dosing Often Required