Pharmacology ATI (6.0) Chpt 10

Methylphenidate (Ritalin), Daytrana , Focalin function and what do they treat?
These meds raises the level of norepinephrine, serotonin, and dopamine in the CNS. Treats ADHD & Conduit Disorder

Trans-dermal Methylphenidate trade name is
(Daytrana)

Concurrent use of MAOIs can cause?
Hypertensive crisis

Nursing Intervention for a pt experiencing hallucinations or paranoia side effects
Discontinue med and report manifestations immediately

Daytrana can be placed where? when? and for how long?
On 1 hip daily, AM, no longer than 9 hrs, rotate hip daily.

CNS Stimulant meds have a high potential for development of what?
A substance abuse disorder, especially in adolescents.

Complications of CNS Stimulants ( Ritalin, Daytrana, Focalin) are?
Wt. Loss, growth suppression, psychotic manifestations such as hallucinations, paranoia, withdrawal reaction, & Hypersensitivity skin reaction

Ritalin is contraindicated in pts who have a history of?
Substance abuse disorder, cardiovascular disorders, severe anxiety & psychosis.

Nursing Intervention for a pt experiencing wt loss/ growth suppression side effects. (CNS Stimulant)
Monitor pt’s wt and compare to baseline. Administer medication immediately a.c. & p.c.

Client education for a pt experiencing withdrawal reaction side effect. (CNS Stimulant)
Advice pt Do NOT STOP taking med suddenly. May lead to depression and severe fatigue

How do you know the CNS stimulant has been therapeutic & effective?
Increased ability to focus and complete tasks, interact with peers and manage impulsivity. Improved ability to stay awake.

What is the generic name for (Strattera)
atomoxetine

What is atomoxetine’s pharmacological action?
It blocks reuptake of norepinephrine at synapses in the CNS.

Is Strattera a stimulant medication? What does this medication treat?
No; ADHD

What are some side effects of atomoxetine?
appetite suppression, wt loss, growth suppression, suicidal ideation, & hepatotoxicity.

You must avoid concurrent use of what drug with Strattera & why?
MAOI’s; hypertensive crisis.

Nursing Intervention for pt on Strattera w/possible appetite suppression & wt. loss s/e?
Monitor clients wt and compare with baseline, administer med right b4 meals.

Intervention/Client education for pt on Strattera w/possible suicidal ideation & hepatotoxicity s/e?
Monitor for indications of depression, change in mood, excessive sleeping. Advise client to report indications of liver damage (influenza-like symptoms), yellowing skin, and abd pain.

TCA stands for
Tricyclic Antidepressant

Norpramin is the trade name for?
desipramine

desipramine, imipramine & clomioramine are used to treat?
Depression (bipolar), autism spectrum disorder, ADHD, panic, OCD, & PTSD

Norpramin belongs to what class of drugs?
TCA’s

Nurses should monitor for what adverse effects caused by desipramine?
Orthostatic Hypotension, Anticholinergic effects, Wt. gain, sedation, decreased seizure threshold, excessive sweating & toxicity

Use desipramine( Norpramin) cautiously with clients who have?
seizure disorders, diabetes, liver, kidney, and resp. disorders; and hyperthyroidism

Nursing Intervention/ Client education for pt with orthostatic hypotension after taking clomipramine?
Monitor B/P with 1st dose; instruct client to change positions slowly.

List the s/s of anticholinergic effects
dry mouth, blurred vision, photophobia, urinary hesitancy or retention, constipation, & tachycardia

Client teaching for a pt who frequently suffers from sedation s/e of norpramin?
Take med @ bedtime.

If a pt takes Norpramin with a _____ they will experience increased anticholinergic effects?
antihistamine

How often should norpramin be taken?
daily basis to establish therapeutic plasma levels

How long does it take to experience therapeutic effects of norpramin?
1-3 wks

How long does it take to get full therapeutic effects of norpramin?
2-3 months

Can you suddenly discontinue norpramin? Yes or No & Why?
No; sudden d/c can result in relapse.

Effectiveness of desipramine (Norpramin) is evidenced by?
verbalizing improvement in mood, increased sleeping & eating habits & increased interaction w/ peers

Effectiveness of desipramine in a pt w/ autism spectrum disorder is evidenced by?
decreased anger and compulsive behavior

Effectiveness of desipramine in a pt w/ ADHD is evidenced by?
Less hyperactivity; greater ability to pay attention

guanfacine (Intuniv) & clonidine (Kapvay) belongs to what medication class?
Alpha2-Adrenergic Agonists

guanfacine and clonidine treat what?
ADHD

Stimulants cause clients to suffer from wt loss or gain?
Wt. loss.

Adverse effects of Intuniv & Kapvay?
CNS effects (sedation, drowsiness & fatigue), wt. gain & cardiovascular effects (hypotension & bradycardia)

Pts on Intuniv should avoid concurrent use of ? Why?
Alcohol, CNS depressants & Antihypertensives; can increase CNS effects ; can worsen hypotension

atomoxetine belongs to what medication class?
Norepinephrine Selective Reuptake inhibitor

Methylphenidate (Ritalin), Daytrana , Focalin belong to what medication class?
CNS Stimulants

Intuniv med cannot be abruptly d/c because the pt can result in having?
rebound hypertension

Is Intuniv a med that has to be tapered when d/c treatment?
Yes according to the prescribed dosage schedule

resperidone (Risperdal)& olanzapine (Zyprexa) belongs to what medication class?
Antipsychotics – Atypical

Risperdal is used to treat?
Autism spectrum disorder, conduct disorder, ptsd, & relief of psychotic manifestations

Adverse effects of Risperdal & Zyprexa?
Onset of DM (loss of glucose control), hypercholesterolemia w/ increased risk for HTN and other Cardiovascular disease, orthostatic hypotension & anticholinergic effects, wt gain, etc.

Nursing Intervention for pt on Risperdal with loss of glucose control?
obtain pt baseline fasting blood glucose ; report indications of increased thirst, urination and appetite

PT teaching for pt on Risperdal with wt gain?
advise pt to follow low-calorie diet and have regular exercise.

What are the medication classifications used to treat children and adolescents with mental health issues?
TCA’s, Antipsychotics, Nonbarbiturate Anxiolytics, CNS Stimulants & norepinephrine selective reuptake inhibitors

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