Laurel Shared "sensory" - 22 Picmonics
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sensory
Parkinson's Disease Assessment
- Assessment
- Decreased Dopamine
- Older Adult
- Cogwheel Rigidity
- Bradykinesia
- Shuffling Gait
- Resting Tremor
- Pill-Rolling
- Mask-Like Face
- Cognitive Decline
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
2 mins
Parkinson's Drugs
- Parkinsons Characteristics
- Decreased Dopamine
- Increased Acetylcholine
- Drug Names
- BALSA Acronym
- Bromocriptine
- Amantadine
- Levodopa
- Selegiline
- Antimuscarinics
2 mins
Levodopa/Carbidopa (Sinemet)
- Indications
- Parkinson's Disease
- Mechanism of Action
- Increase Dopamine in Brain
- Cross blood-brain barrier
- Increase bioavailability
- Side Effects
- Arrhythmias
- Dyskinesia
1 min
Amantadine
- Treats Parkinson Disease
- MECHANISM
- Increases dopamine availability
- Increases dopamine release
- Decreases dopamine reuptake
- toxicity
- Ataxia
- Livedo reticularis
- No longer used as an antiviral medication (Influenza A and Rubella) due to increase resistance
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
2 mins
Amantadine
- Anti-viral
- Mechanism of Action
- Stimulates D2 Receptors
- Blocks DAT (Dopamine Transporter)
- Indication
- Mild Parkinson's Disease (2nd-line)
- Influenza
- Side Effects
- Ataxia
- Livedo reticularis
- Psychosis (C)
- Nausea (C)
- Dizziness (C)
- Insomnia (C)
- Seizures (C)
- Considerations
- Contraindicated in elderly with dementia (C)
- Used in malaria: Positive charge helps chloroquine overcome chloroquine-resistant malaria vacuoles; point mutations against amantadine return bacteria to chloroquine-sensitivity
Benztropine (Cogentin)
- Mechanism
- Anticholinergic
- Indications
- Parkinson's Disease
- Acute Dystonia
- Side Effects
- Mydriasis
- Dry Mouth
- Urinary Retention
- Tachycardia
- Constipation
- Psychosis
1 min
Selegiline and Rasagiline
- Mechanism
- Monoamine Oxidase Inhibitor (MAO-B)
- Increase Dopamine
- Indications
- Adjunctive agent to L-DOPA in treatment of Parkinson's Disease
- Early Parkinson's (C)
- Selegiline treats depression at high doses (C)
- Side Effects
- May enhance adverse effects of L-DOPA
- Selegeline comes in patch (EMSAM) to treat depression (C)
- Hypotension (C)
- Dizziness (C)
- Insomnia (C)
- Weight gain (C)
- Nausea and Vomiting (C)
Dopamine receptor agonists
- Ergot D2 Receptor Agonist
- Bromocriptine
- Increase Dopamine Activity
- Mild Parkinson's Disease
- Restless Legs Syndrome
- Hyperprolactinemia
- Must be titrated slowly due to hypotension
- Ergot
- Selective D2 Receptor Agonist
- Pramipexole
- Ropinerole
- Mlid Parkinson's Disease
- Restless Legs Syndrome
- Less effective with motor symptoms of PD
- D2 receptor agaonist
- Apomorphine
- Injectable Only
- Serotonin Receptor Antagonist Contraindicated (e.g. Ondansetron)
- D2 and D3 Partial Receptor Agonists
- D2 and D3 receptor partial agonist
- Aripiprazole (Abilify)
- Brexpiprazole
- Cariprazine
- Schizophrenia
- Depression
- Less side effects than other DA agonists
- Akathisia (restlessness)
- Side Effects
- Mania
- Nausea
- Dizziness
- Fatigue
- Peripheral Dopamine Like Effects
Prevention of Falls
- Risk Factors
- Physical Aging
- Polypharmacy
- Environmental
- Hospital / Facility Prevention
- Call Light within Reach
- Assistive Devices Available
- Bed Alarms
- Home Prevention
- Improve Lighting
- Remove Home Hazards
- Priority Nursing Interventions
- Promote Exercise
- Fall Risk Assessment
2 mins
Multiple Sclerosis Assessment
- Cause/Mechanism
- Nerve Fiber Demyelination
- Assessment
- Motor Issues
- Cerebellar Signs
- Fatigue
- Paresthesias
- Spasticity
- Urinary Incontinence
- Optic Neuritis
- Considerations
- Women Between 20-50 Years Old
- Relapse and Remission of Symptoms
2 mins
Multiple Sclerosis Interventions
- Drug Therapy
- Corticosteroids
- Interferon Beta
- Dimethyl Fumarate (Tecfidera)
- Fingolimod (Gilenya)
- Mitoxantrone (Novantrone)
- Natalizumab (Tysabri)
- Considerations
- Increase Exercise
- Identify Triggers
2 mins
Fingolimod for MS (Class)
- Mechanism
- Sphingosine-1-phosphate analog
- Prodrug
- Sequesters circulating lymphocytes in secondary lymphoid organs via induction of intracellular internalization of receptors on lymphocytes
- Indication
- Relapsing Remitting Multiple Sclerosis
- Consideration
- Oral daily
- Patients must be VZV immune before prescription
- Side Effects
- Bradycardia
- Heart Block
- EKG/ECG for first 6 hours
- Macular edema
- Decreased FEV1
- Increased LFT's
- Leukopenia
- Lymphopenia
- Asthenia (Weakness and lack of energy)
- Back Pain
- Blurred Vision
- Headache
- Dizziness
- Infections
Monoclonal antibody (Natalizumab, Alemtuzumab, Daclizumab) for Multiple Sclerosis (Class)
- Daclizumab information
- Daclizumab
- Binds IL-2 receptor & prevents activation of T cells
- Infection
- Skin rash
- Liver Toxicity
- Alemtuzumab information
- Alemtuzumab
- Binds CD52 surface antigen on mature lymphocytes
- Thrombocytopenia
- Kidney Failure
- Infusion Reactions
- Infection
- Natalizumab information
- Natalizumab (Tysabri)
- 2nd line treatment for RRMS
- Binds VLA4 (integrin subunit), inhibiting leukocyte migration across BBB
- Progressive Multifocal Leukoencephalopathy (PML)
- JC virus
- Hives (Urticaria)
- Infusion Reactions
- Headache
- Dizziness
- Fatigue
- Shivering (Rigors)
- Arthralgia
Dimethyl fumarate for MS (Class)
- Mechanism
- Enhances Nrf2 pathway
- Th1 -> Th2 shift
- Consideration
- Oral BID
- Side Effects
- Diarrhea
- Abdominal Pain
- Nausea and Vomiting
- Flushing
- Pruritis
- Rash
- Redness
Types of Seizures
- Tonic-Clonic
- Tonic
- Clonic
- Absence (Petit Mal)
- Myoclonic
- Atonic
- Partial (Focal) Seizure
- Focal Aware (Formerly Called Simple Partial)
- Focal Impaired Awareness (Formerly Called Complex Partial)
3 mins
Seizure Interventions
- Maintain Airway
- Side-lying Position
- Support Head
- Move to Floor
- Benzodiazepines
- Considerations
- Never Restrain
- No Objects in Mouth
- Document Details
2 mins
Seizure Precautions
- Reduce Environmental Stimuli
- Identify Triggers
- Aura
- Pad Side Rails
- Bed Lowest Position
- Oxygen and Suction Available
- Consideration
- Monitor Therapeutic Drug Levels
2 mins
Carbamazepine and Oxcarbamazepine for Antiepileptics (Class)
- Mechanism
- Stabilizes Inactive State of Na+ Channels
- Blocks Voltage-Gated Na+ Channels
- Indication
- More effective for complex partial seizure than primary generalized
- Bipolar Disorder
- Neuropathic Pain
- Side Effects
- Rash
- Stevens-Johnson Syndrome
- Mild Myelosuppression
- Mild increase in LFTs
- Can cause contraceptive failure
- Carbamazepine information
- Hepatic enzyme inducer (both auto- and hetero-inducer)
- Highly protein bound
- Must increase dose in 1-2 wks due to autoinduction
- Side effects likely due to epoxide metabolite
- Oxcarbamazepine information
- Long half-life (Longer than Carbamazepine)
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