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