Precautions: hepatic, renal dysfunction. Depression. Alcohol dependence. Chronic respiratory disorders. Sleep apnea. Neuromuscular disorders. Fall risks (elderly).
Interactions: severe sedation when taken with CNS depressants. Cimetidine increases levels. Smoking decreases effects. Kava and valerian increase effects.
Precautions- hepatic, renal dysfunction. Older adults. Depression. Substance abusers. Chronic respiratory disorders. Sleep apnea. younger than 18.
Interactions- when taken with food, increased sedatives when taken with depressants.
Precautions- Elderly, child under 2, mental illness, seizure disorders, stroke or a cerebral vascular accident.
Interactions- CNS depressant increase sedation, pt with DM may require increase in insulin or anti-diabetics
Precautions- Cardiac, pulmonary disease and neurological disorders. Pt older than 35 b/c liver damage increases after this age.
Interactions- Estrogen use increase his for liver toxicity in women older than 35. CNS depressants- excessive sedation. IV- calcium channel blockers increase risk for severe cardiac dysrhythmias.
Action- Inhibits the influx of sodium through channel. Decreasing discharge of neurons around areas of activity.
Precautions- liver/kidney disease, cardiac/respiratory dysfunction, DM, elderly, alcohol use disorder
Interactions- IV phenytoin incompatible with dextrose and other solutions. Alcohol increase or decrease phenytoin levels. Depressants increase effects. Decrease efficacy of oral contraceptives.
Action: Inhibits influx of sodium through sodium channels. Inhibits influx of calcium through calcium channels. Enhances inhibitory effects of GABA.
Precautions- Kidney disease, elderly, children under 10.
Interactions-Increase blood level of phenytoin. Topiramate increases risk for hyperammonemia.
Precautions- cardiac or hepatic disease, positive to HLA-B*1502 gene. Alcohol disorder.
Interactions- Drinking grapefruit juice increase plasma levels. May cause false pregnancy test and decrease efficacy of oral contraceptives.
Precautions- elderly, MG, respiratory depression, history of malignant hyperthermia
Interactions- beta blockers increase lidocaine levels, phenytoin increase risk for cardiac effects, procainamide increases risk for CNS and cardiac effects (arrest)
Action: Depresses CNS significantly enhances inhibitory effects of GABA.
Precautions- Hepatic/Renal/Cardiac disease, MG, severe anemia, chronic respiratory disorders
Interactions- used w/ depressant may cause respiratory depression. use w/ probenecid increases length of anesthesia. Herbs- kava kava and valerian sedative properties, incompatibilities with other solutions, use with other benzondiazepines results in prolonged anesthesia.
Precautions- parkinsron disease/ other neuromuscular disorders, cardiac/pulmonary/renal disorders
Interactions-CNS Depressants anticoagulants increase sedation, cimetidine may cause toxicity, smoking decrease sedative effects, herbals may increase or decrease effects
Precautions- pt with increased intercranial pressure, elderly, children, debilitated patients, cardiac/respiratory disorders, liver/kidney disorders
Interactions- MAOI’s given within 2 weeks (hypertensive crisis) CNS depressants increase sedation (respiratory depression)
Precautions- mild hypertension
Interactions-pt taking MAOI’s w/in past 2 weeks (hypertension), increase chance of cardiac effect, ascorbic acid/ammonium chloride decrease elimination, sodium bicarbonate (vitamin c) increases effects
Precautions- hypertension, hyperthyroidism
Interactions- MAOI’s within 2 weeks, increase cardiac effects with other stimulants
Action: Unclear, possibly ability to block re-uptake of norepinephrine.
Precautions- cardiovascular disease, hypertension, hepatic/renal impairment, drug/alcohol abuse, mania, psychosis, elderly or children under 16, pregnancy category C
Interactions- causes increase levels of warfarin, back up contraceptives (+30 days after)
Action: Crosses blood brain barrier and taken up by the dopaminergic nerves converted to dopamine.
Precautions-elderly, renal/hepatic/endocrine/respiratory, wide angle glaucoma, peptic ulcer disease, depression/bipolar disorder
Interactions- traditional antipsychotics and preparations with vitamin B decrease action, MAOI’s hypertensive crisis, high proteins decrease action, anticholinergic drugs increase response.
Precautions- renal dysfunction, compulsive behaviors, children
Interactions-Cimetidine increase levels, CNS depressants increase adverse effects.
Precautions-hypertension, bipolar disorders, psychosis, lactation
Interactions- MOAI’s can cause high fevers, hypertension, rigidity, foods containing tyramine (hypertension), herbal drug and anti-hypertensive drugs (hypotension)
Precautions- liver/renal/ cardiac/GI or pulmonary disorders, hyperthyroidism, seizures,
Interactions- use of NSAIDS increase risk for GI bleeding, anticholinergic (antihistamines) drugs decrease effects
Precautions- liver/renal/seizures disorders, elderly
Interactions- over the counter antacids (vitamin C) increases ph of urine (possible toxicity) , other NMDA antagonists may increase levels.
Beta 1B:Multiple sclerosis (relapsing-relapsing-remitting types)
1B: Give SC every other day, use within others after reconstituting
precaution: suicidal tendencies, history of liver disorders, alcohol abuse, children under 18, seizures, mental health/ thyroid disorders
Interactions: any drug that surppreses the immune system increase risk for myelosuppression,
Nasal: 5-20 mg, maximum dose is 40 mg in 24 hours
Subq: No more than 2 in 24 hours,
Oral: max dose of 200mg in 24 hours
Precautions- liver/kidney insufficiency, CAD risk factors, seizures disorders, BP elevation, serotonin syndrome, chest tightness, fertility impairment
Interactions- MAOI (within 2 weeks) ergotamine triptan patients use of 24 hours or sumatriptan increase chance of angina, serotonin agonist can cause serotonin syndrome, herbal- st. Johns can cause toxicity.