Drugs that end in "ase
Interfere with enzymes that break down NT's
Baclofen: Indications
Centrally acting drug used for muscle spasms
SCI
MS
Cerebral Palsy
Musculoskeletal Injury
Baclofen: Adverse Effects
Drowsiness, Dizziness
Constipation/Urinary Retention
Baclofen: Withdrawal symptoms
Anxiety
Restlessness
Hallucinations
Seizures
(withdrawal occurs if d/c too quickly)
A patient tells their nurse they want to stop taking Baclofen. How should the nurse respond?
must taper over 1/2 weeks
Baclofen: Patient education
take with food/milk to avoid GI upset
increase fluids/fiber
Baclofen: Intrathetical administration
if stopped abruptly: risk of rebound spasticity
risk of organ failure/death
risk of rhabdomyolysis: muscle weakness, low urine output, dark-tea colored urine, bruising
A patient receiving Baclofen via the intrathecal route develops dark tea colored urine. What is this a sign of
rhabdomyolysis
Baclofen: Interactions
alcohol (CNS depression)
MAOIs -> hypotension
Cyclobenzaprine interactions
MAOI -> hyper pyretic crisis and seizures
Danrolene: Indications
peripherally acting drug used for muscle spasms
CVA
stroke
SCI
MS
cerebral palsy
MALIGNANT HYPERTHERMIA
Dantrolen: Adverse effects
Muscle weakness / drowsiness
Diarrhea
Liver toxicity
A patient presents for their surgery who has a history of malignant hyperthermia. Which drugs will be administered 1-2 days before their procedure?
Dantrolene
Dantrolene: Patient education
inform the provider of prolonged diarrhea, abdominal pain, or jaundice
Dantrolene: Interactions
estrogen -> increases risk of liver toxicity
CCB -> dysrhythmias
Phenytoin: Indication
tonic clonic seizures (grand mal) and partial seizures (affect one part of the brain/body)
Traditional AED (Hydantoin)
Phenytoin: AE drug reactions
drowsiness
gingival hyperplasia
skin rash
Phenytoin: Nursing
monitor for CNS depression (indicates toxicity)
monitor for SJS
Phenytoin: Administration
give with meals to prevent GI upset
ADMINISTER SLOWLY -> may lead to cardiac collapse
When educating a patient about the therapeutic levels for phenytoin- what should the nurse explain:
narrow range 10-20 mcg
S/s of toxicity:
nystagmus
ataxia (loss of control of body movements)
sedation
blurred/double vision
Phenytoin: education
Reduces birth control
regular dental checkups
soft bristle tooth brush
Phenytoin: Contraindications
Pregnancy
Heart block
Phenytoin: Interactions
incompatible in solution with many drugs and dextrose
Carbamazepine: Indication
Traditional AED
mood stabilizer
Carbamazepine: Adverse drug reaction
visual disturbance
ataxia
fluid retention
photosensitivity
bone marrow suppression
Carbamazepine: Interventions
gradually increase dose
larger dose at bedtime
monitor WBC count
limit sun
Carbamazepine: instructions
administer with meals
monitor for fluid retention (avoid HF - decreased UO, edema, SOB)
report fever, sore throat, easy bruising
Carbamazepine: contraindications
Pregnancy
Tx of absent or myoclonic seizures
HF
hematologic disorder
Carbamazepine: interactions
grapefruit juice (increase drug's plasma level)
birth control
false pregnancy test