phenytoin (Dilantin)
Therapeutic: Antiepileptic drug
IV with NS because of precipitate
Has to be diluted and pushed slow because it can cause cardio collapse!
***Does not work prophalytically on absence seizures. Can treat ventricular tachycardia, off label. A/E: Suicidal tho
divalproex sodium (Depakote)
Therapeutic: Antiepileptic drug
PO or IV given over at least an hour IV
A/E: N/V, diarrhea, abdominal pain, and diminished appetite. Suicidal thoughts
Hepatotoxicity risk... monitor liver enzymes!
Skin rash possibility
Do not stop abruptly, taper off
carbamazepine (Tegretol)
Therapeutic: Antiepieptic drug
ONLY PO but a lot like Dilantin
A/E: drowsiness, dizziness, ataxia, and nausea, and vomiting. Confusion, blurred, vision, lethargy, and visual disturbances, myalgia, leg cramps, and suicidal thoughts. Can cause SLE. Contrain
diazepam (Valium)
Therapeutic: Antianxiety & Antiepileptic drug, skeletal muscle relaxant
PO or IV (IV in Status Epilepticus, SLOW push)
A/E: Droswiness, sedation, lethargy, ataxia, dizziness, headache, confusion, paradoxical excitation, hypotension, respiratory depression
mannitol (Osmitrol)
Osmotic Diuretic (used with high ICP)
Monitor perfusion!
IV PB over 30-60 minutes w/ filter!
Should see increased output
Serum Osmo 275-300, monitor
Monitor fluid and electrolytes
Monitor everything like a diuretic
dexamethasone (Decardron)
Steroid (decreases inflammation)
Monitor for infection because of lowered immunity!
Monitor glucose (hyperglycemia, up to 200 okay)
Sodium and water retention
PO or IV (with fluids, slow push) IV with Craniotomy
Do not stop abruptly, taper off
clonazapam (Klonopin)
Prophylactic Treatment of Seizures
Skeletal muscle relaxant
PO
Suicidal thoughts, seizure precautions
ADMINISTER WITH FOOD
Short term use
Do not stop abruptly, taper off
carbidopa/levodopa (Sinemet)
Parkinson's Treatment (lack of dopamine)
PO
Liver function tests, Hepatotoxicity (dark urine and sweat)
Take with meals
Oral Hygiene, Dry mouth treat
benztropine mesylate (Cogentin)
Parkinson's Treatment (improves physical mobility)
PO
Mydriasis, drowsiness, blurred vision, dry mouth
After meals, if dry mouth occurs before
Do not stop abruptly, taper off
pyridostigmine (Mestinon)
Therapeutic: AchE Inhibitors for Myasthenia Gravis
PO, IM, and IV
Seizures, bronchospasms, bradycardia can occur.
Atropine is the antidote
Give with milk
Do not stop abruptly, taper off **This drug is used to reverse the actions of neuromuscular blockers
baclofen (Lioresal)
Therapeutic Class: Muscle Relaxant and used in treatment of Multiple Sclerosis
Treats spasticity of muscles in MS or spinal cord issues.
PO
Seizures, drowsiness, ataxia , weakness, headache, fatigue, urinary frequency, constipation, nausea, vomiting *prol
gabapentin (Neurontin)
Therapeutic: Antiepileptic drug
Treats partial seizures, neuropathic pain, spasticity, ocular ataxia
PO
A/E: drowsiness, fatigue, nystagmus, and dizziness. The administration can lead to frequency viral infections, weight gain, and gastric upset. Contrain
edrophonium chloride (Tensilon)
Therapeutic: Anticholinesterase Agents, Edrophonium (Tensilon) is the test for myasthesia gravis IV or IM Routes Involuntary contraction or twitching of muscles, nausea,vomiting, miosis,and increased salivation. Potentially serious side effects: bradycard
glatiramer acetate (Copaxone)
Therapeutic: Immunomodulators(drugs that affect body defenses) for MS Subcutaneous, once daily dose. A/E: Local reactions, arthralgia, back pain, flulike symptoms, infection, anxiety,vasodilation, chest pain, palpitations, rash, pruritus, diarrhea, nausea
interferon beta-1a (Rebif)
Therapeutic: Immunomodulators for MS: subcutaneous, three times a week. IM: 30 mcg/week available too. A/E: Myalgia, upper respiratory tract infection, flulike symptoms, local reactions, depression, headache, **Hepatotoxicity, anemia, myelosuppression
mitoxantrone (Novantrone)
Therapeutic: Immunomodulators for MS and Antitumor IV Route A/E nausea, vomiting, diarrhea, cough, headache, abdominal pain, fever, alopecia, **Myleosuppression, renal failure, hepatotoxicity, cardiotoxicity (heart failure, MI, fetal harm)
dantrolene (Dantrum)
Therapeutic: Direct-acting skeletal muscle relaxant It is the drug of choice when treating malignant hyperthermia. Routes: PO, IV A/E: muscle weakness, drowsiness, hepatotoxicity, other side effects: xerostomia, dizziness, nausea, photosensitivity, diarrh
benzotropine mesylate(Cogentin)
Therapeutic: Antiparkinson agent Routes: PO, IM, IV A/E: sedation, constipation, blurred vision, dry mouth, decreased sweating, urinary retention, and confusion. Paralytic ileus is the only identified life-threatening adverse reaction. Contraindications:
sumatriptan (Imitrex)
Therapeutic Class: Antimigraine Agent Route: PO, Intranasal, SQ A/E: mild and transient dizziness or nausea, diarrhea, myalgia, and inflammation, and pain at the subcutaneous injection site. Rare but serious cardiac events include coronary artery vasospas
methylprednsiolone (Solumedrol)
Therapeutic Class: Corticosteriods Route: PO A/E: Mood swings, weight gain, acne, facial flushing, hyperglycemia, nausea, insomnia, sodium and fluid retention, impaired wound healing, menstrual abnormalities, **Peptic ulcer, hypocalcemia, osteoporosis wit
amantadine hydrochloride (Symmetrel)
Therapeutic Class: Antiviral for influenza*
Drug is used off label to benefit Parkinson's Patients Route: PO A/E: insomnia, dizziness, light-headness, nervousness, loss of concentration, and mental confusion.
*Dysrhythmias, leukopenia (rare), heart failur
bromocriptine mesylate (Parlodel)
Therapeutic Class: Dopamine Agonists Indications: Parkinson's Disease Route: PO A/E: Nausea, orthostatic hypotension *Shock, acute myocardial infarction (MI)
heparin (Hep-Lock)
Therapeutic Class: Anticoagulants Route: IV infusion or SQ A/E Minor bleeding, nausea, vomiting, transient thrombocytopenia, anemia, **Hemorrhage, anaphylaxis
enoxaparin (Lovenox)
Therapeutic Class: Low Molecular Weight Heparins Route: Subcutaneous A/E: Minor bleeding, nausea, vomiting, hematoma, local pain, fever *Hemorrhage, thrombocytopenia, pancytopenia, anaphylaxis
levetiracetam (Keppra)
...Therapeutic Class: anticonvulsant Indications: adunct treatment of partial onset seizures; primary generalized tonic-clonic seizures; myoclonic seizures - juvenile myoclonic epilepsy. A/E: dizziness, weakness, suicidal thoughts. **May cause decreased W
warfarin (Coumadin)
Therapeutic Class: Anticoagulants Route: PO/IV based on target INR, which is usually within the range of 2-3 A/E Minor bleeding, nausea, vomiting, transient thrombocytopenia, anemia, **Hemorrhage, anaphylaxis
thiothixene hydrochloride (Navane)
Therapeutic Class: Nonphenothiazines Route: PO A/E: Akathisia, sedation, transient drowsiness, EPS, tremor, orthostatic hypotension, weight changes, anticholinergic effects *TD, NMS, acute renal failure, respiratory depression, laryngospasm, hepatotoxicit
topiramate (Topamax)
Therapeutic Class: Antiepileptic Drugs Route: PO A/E Paresthesia, drowsiness, weight loss, **Depression, difficulty with memory, psychomotor slowing
clopidogrel (Plavix)
Therapeutic Class: Antiplatelet agent Route: PO A/E: flulike symptoms, headache, diarrhea, dizziness, bruising, upper respiratory tract infection, and rash, or pruritus. *
Excessive bleeding, risk for GI bleeding
*Education: Immediately report signs of bl
Intravenous Immune Globulin (IVIG)
Antibodies are administered to provide passive immunity. Route: IV or IM A/E: Local reactions at the injection site (pain erythema, myalgia, influenza-like symptoms (malaise, fever, chills) headache, joint stiffness *Anaphylaxis
ropinirole (Requip)
Therapeutic Class: Dopamine Agonists for Parkinson's Disease Route: PO A/E: Fatigue viral infection, dizziness, somnolence, nausea, vomiting, dyspepsia, *Sleep attacks, syncope
riluzole (Rilutek)
Used to slow the progression of Lou Gehrig's disease or amyotrophic lateral sclerosis A/E: dizziness, tiredness, upset stomach, stomach pain, diarrhea, muscle weakness or aches, loss of appetite, headache. ***difficulty breathing, fever, depression
furosemide (Lasix)
Therapeutic Class: Antihypertensive
Loop Diuretics Route: PO, IM, IV A/E: Minor hypokalemia, orthostatic hypotension, tinnitus, nausea, diarrhea, dizziness, fatigue
Serious hypokalemia, blood dyscrasias, dehydration, ototoxicity, electrolyte imbalances, c
alteplase (tPA) (Activase)
Therapeutic Class: None Pharmacologic: Thrombolytic Route: IV A/E: Bleeding, spontaneous ecchymoses, hematomas, or epistaxis should be reported to the healthcare provider immediately. Angioedema and IC bleeding are rare. Contraindications: History of CVA
lorazepam (Ativan)
Therapeutic Class: Benzodiazepines Route:IV inject it slowly Antianxiety and used for status epilepticus A/E: Sedation, headache, drowsiness, weakness, vertigo, ataxia, paradoxical excitement, short term amnesia, **Coma, respiratory depression, cardiac ar