Contradictions: Pregnancy Category X, lactation, glaucoma, younger than 18.
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.
Contradiction- suicidal ideation and during labor/delivery.
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.
Contradictions- Allergy to baclofen, pt taking MAOI’s within past 2 weeks (may have hypertensive crisis), pt with cerebral palsy taking cyclobenzaprine.
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.
Tonic clonic, partial seizures
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 disorderInteractions- IV phenytoin incompatible with dextrose and other solutions. Alcohol increase or decrease phenytoin levels. Depressants increase effects. Decrease efficacy of oral contraceptives.
Treats all seizures types, controls mania in bipolar disorder, prevents migraine headaches,
Action: Inhibits influx of sodium through sodium channels. Inhibits influx of calcium through calcium channels. Enhances inhibitory effects of GABA.
Contradictions- category D, lactation, liver disease, other anti-convulsants, thrombocytopenia, hyperammonemia.
Precautions- Kidney disease, elderly, children under 10.
Interactions-Increase blood level of phenytoin. Topiramate increases risk for hyperammonemia.
Contradictions- Category D, absence/myoclonic seizures, hematologic disorders, heart failure, use of MAOI’s (within 2 last weeks) hypersensitivity to TCA’s. Coadministration of nefazodone and NNRTI’s.
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.
Contradictions- Allergy to amide type of anesthetics, sepsis/severe trauma, bradycardia or heart blocking.
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)
Rapid induction of anesthesia and hypnosis for brief procedures, adjunction with other procedures more than 15 mins.
Action: Depresses CNS significantly enhances inhibitory effects of GABA.
Contradictions- allergies to barbiturates. hepatic porphyria/ paradoxical excitation with depressants, status asthmaticus,
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.
Contradictions- Category D, lactation, obstetric delivery, sensitivity to benzodiazepines, glaucoma
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
Contradictions- substance abuse, obstetric delivery, MS,
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)
Contradictions- allergies to amphetamines, hypertension, cardiovascular disease, structural cardiac defects (children), hyperthyroidism, history of drug abuse, glaucoma
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
Promotes wakefulness, narcolepsy, shift-work sleepiness, obstructive sleep apnea,
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)
Relieves symptoms of Parkinsons, addition of Carbidopa allows for reduced dose of levodopa and prevents some adverse effects
Action: Crosses blood brain barrier and taken up by the dopaminergic nerves converted to dopamine.
Contradictions- narrow angle glaucoma, history of melanoma, psychosis, suicidal thoughts,
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.
Interferon Beta-1A: multiple sclerosis (relapsing-remitting type)
Beta 1B:Multiple sclerosis (relapsing-relapsing-remitting types)
1A: IM weekly, subq- 3 days each week, 48 between injections.
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,
administration is orally, subq, or nasal,
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
Contradictions- CAD, PVD, elderly, stroke, use of MAOI’s (past 2 weeks) use of another triptan within 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.