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Medication presentation

Transcript: - It is the most widely used TCA and is an efficacious treatment for major depressive disorder - Common effects: Dizziness, headache, tremor, sweating and anxiety - Common overdose symptoms: Tachycardia (high heart rate), severe hypotension, congestive heart failure, coma and drowsiness Assessment of the situation Conclusion - Commonly used to treat insomnia, anxiety and panic attacks - Common effects: Supression of REM sleep, impaired motor functions and depression - Common overdose symptoms: Coma, dizziness, hypotension and drowsiness - Patient is 78 year old man who has sleeping problems and lives in a care home - Patient uses amitriptyline and diazepam for his mental and sleeping problems - Phsysiotherapist walks into the room around noon and finds patient sleeping and undressed Amitriptyline and Diazepam used together Justification - It is very likely that the patient is feeling drowsy because of the combination of both medications - Doctor should examine and determine the cause of the drowsiness. Tests may include: Blood tests, CT scan, sleep studies and urine tests - Patients quality of life should be improved - Assistive devices should be introduced so that the patient would go out and exercise more - Amount of medications should be reduced - Physical activity should be increased so that the body would naturally require the sleep Effects of Diazepam Medication presentation Effects of amitriptyline - Call for help - Check past medical and patient records - Check the surroundings (possibility of a concussion or a fall) - Interview if Neighbours have seen or heard anything - Finding out the effects of the medications - They are classified as a safe combination when used together - However, some side effects of using both at the same time have been found: Increases sedation and makes the patient more drowsy Information about the situation

Medication Presentation:

Transcript: Generic Name Side Effects Adult Dosage BUSPIRONE Patient Education Medication Compliance Do not use OTC drugs Do not drive or engage in hazardous activities Report signs of repetitive motions Avoid Grapefruit juice & St. Johns's Wort- both can increase drug levels Tachycardia Palpitations Arthralgias Hyperventilation Shortenss of Breath Trade name How it works: CLozapine interferes with the binding of dopamine to D1 and D2 receptors It also blocks Serotonin Receptors Agranulocytosis Orthostatic Hypotension Tachycardia ECG changes Seizures Hyperglycemia Urinary Retention EPS: Dystonic Reaction Monitor Blood Glucose Compliance with Blood tests Caution while driving/use of machinery Rise slowly due to orthostatic hypotension Do not take OTC meds or alcohol without physician's permission No breastfeeding CLOZAPINE Action ORAL: 12.5mg QD or BID to start, then increase by 25mg-50mg QD and titrate to a target dose of 300mg-450mg/day in 3 divided doses. (MAX 900mg/QD) Range: 100mg-150mg/per dose. Side Effects CLassification BUSPAR BRAND NAME GENERIC NAME Pt Use: Mx of Schizophrenia-decreases both Pos & Neg Sx. Prototype: Clozapine CLOZARIL Site of Action: Limbic region of the brain Trade Name Classification Summary Adverse Effects Nonproprietary name Site of Action: In the brain Mainly on the D2 receptor Agonist effects on the presynaptic Dopamine Receptors High affinity for serotonin CLOZARIL and BUSPAR Quiz Handout Background Information Dizziness Drowsiness Headache Light-headedness Nausea Insomnia Blurred Vision Mechanism of Action Weight Gain Drowsiness Sedation Dizziness Constipation Dry mouth Restlessness Hypersalivation Increased Metabolic Syndrome Brand Name Patient Education Adult= Oral dose: 7.5-15mg/day in divided doses, may increase by 5mg/day every 2-3 days as needed. (MAX 60mg/day) Geriatrics= Oral dose: 5mg BID, may increase (MAX 60mg/day) Note* Give with food to decrease nausea. Background Information Advantages to Buspirone: Group: Anxiolytic/Anti-anxiety Group: Atypical Antipsychotic Nonproprietary Name Prototype: Lorazepam CLozapine: Preceded by Haldol Introduced to U.S. in 1990 Advantages: Produces fewer EPS SE in comparison to 1st generation antipyschotics Adverse Effects Uses: Mx of Anxiety Disorders (GAD) Adult Dosage Nonsedating No potential for addiction unlike benzodiazepines Does not interact with CNS depressants ie alcohol

Medication Presentation

Transcript: Pharmacology Neuromuscular Blocking Agents & Tranquilizers INTRO Lauren Provost Neuromuscular Blocking Agents List of Meds 1 atracurium besylate 2 pancuronium bromide 3 rocuronium bromide 4 succinylcholine 5 vecuronium bromide Tranquilizers .... diazepam hydroxyzine hydrochloride lorazepam Neuromusclar Blocking Agents ATRCURIUM BESYLATE laboratory synthesic liquid solution 5-[3-[1-[(3,4-dimethoxyphenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propanoyloxy]pentyl 3-[1-[(3,4-dimethoxyphenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propanoate only given IV Tracrium pancuronium bromide Laboratory synthetic aminosteroid 2β, 16β - dipiperidino-5α-androstane-3α, 17-β diol diacetate dimethobromide PAVULON® liquid form given IV rocuronium bromide NAMES & SOURCE rocuronium bromide Liquid 1-[(2β,3α,5α,16β,17β)-17-(acetyloxy)-3-hydroxy-2-(4-morpholinyl)androstan-16-yl]-1-(2-propenyl)-pyrrolidinium Zermuron Esmeron LABORATORY SYNTHETIC For IV injection only KINETICS & DYNAMICS PROGRAM 2 SURGICAL SETTING PROGRAM 3 SUCCINYLCHOLINE SUCCINYLCHOLINE Anectine, Quelicin Ethanaminium, 2,2'-((1,4-Dioxo-1,4-butanediyl)bis(oxy))bis(N,N,N-trimethyl-) liquid solution administered IV laboratory synthetic VECURONIUM BROMIDE (2β,3α,5α,16β,17β)-3,17-Diacetoxy-16-(1-methyl-1-piperidiniumyl)-2-(1-piperidinyl)androstane bromide VECURONIUM BROMIDE Norcuron laboratory synthetic liquid solution administered IV only DIAZEPAM DIAZEPAM 9-chloro-2-methyl-6-phenyl-2,5-diazabicyclo[5.4. 0]undeca-5,8, 10,12-tetraen-3-one or 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepine-2-one Valium laboratory synthetic solid: tablet semisolid: gel liquid: solution oral, IM, IV, rectal VISTARIL® HYDROXYZINE HYDROCHLORIDE (±)-2-(2-{4-[(4-chlorophenyl)-phenylmethyl]piperazin-1-yl}ethoxy)ethanol laboratory synthetic solid: capsule, tablet liquid: syrup, suspension oral or IM LORAZEPAM Ativan Title 7-chloro-5-(2-chlorophenyl)-3-hydroxy-1,3-dihydro-1,4-benzodiazepin-2-one. laboratory synthetic oral, IV or sublingual solid: tablet, capsule liquid: solution

Medication Presentation

Transcript: AVANDIA GENERIC: ROSIGLITAZONE *CATAGORY: C COUMADIN GENERIC: WARFARIN *CATAGORY: X ACIPHEX GENERIC: RABEPRAZOLE *CATEGORY: B ARICEPT GENERIC: DONEPEZIL *CATEGORY: C CLONAZEPAM GENERIC: KLONOPIN *CATEGROY: D-POSITIVE CLOBAZAM GENERIC: ONFI *CATEGORY: C ZOLPIDEM GENERIC: AMBIEN *CATEGORY: C ZYLOPRIM GENERIC: ALLOPURINOL *CATEGORY: C ZANTAC GENERIC: RANITIDINE CATEGORY: B XANAX GENERIC: ALPRAZOLAM CATEGORY:D-POSITIVE Similarities N/A CLONAZEPAM PANIC DISORDER AXIETY HAVEA GREAT DAY!!! Avandia Treats Type 2 Diabetes Brookline College - MOD A By: Luis D Manzanares Villa Differences Coumadin Prevent new blood clots & helps from any clots getting worse Category C Studies have shown a development effect on the fetus on animal reproduction, and there are no accurate or well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Category X Studies in animals/humans have shown fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits. Category B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. ZYLOPRIM ALSO TREATS SOME KIDNEY STONES Differences TREATS SEIZURES ZYLOPRIM USED TO TREAT GOUT ZOLPIDEM SLEEP DISORDER SIMILARITIES Aciphex Treats problems such as heartburn, stomach ulcers, GERD (Gastroesophageal reflux disease), damaged esophagus, or the stomach making too much acid DIFFERENCES CLOBAZAM Lennox-Gastaut syndrome (LGS) ZOLPIDEM USED TO TREAT INSOMNIA DIFFERENCES Medications Medication Presentation SIMILARITIES ZANTAC TREATS & PREVENTS HEARTBURN. TREATS "GERD" & CONDITIONS THAT CAUSE STOMACH TO MAKE TOO MUCH ACID THANK YOU!!! Aricept Treats symtoms of Alzheimers Disease XANAX TREATS ANXIETY PANIC DISORDER Category D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Avandia VS Coumadin Aciphex VS Aricept Clonazepam VS Clobazam Zolpidem VS Zyloprim Zantac VS Xanax DIFFERENCES

Medication Presentation

Transcript: Medication Presentation Fentanyl Morphine Hydromorphone Ketamine Narcan Medication Presentation Discussion: -The drug -Indications -Precautions -Interactions -Half life -Adverse effects -Patient education Discussion: Indications for use: -Premedication for surgery, general anesthesia, analgesia to manage moderate to severe pain and breakthrough pain. -Fentanyl is available as a skin patch, lozenge, pills, shots, a film that dissolves in your mouth, nasal spray, or by IV. Fentanyl Precautions: -Hypersensitivity, caution in: geriatric, debilitated or critically ill patients, diabetes, severe renal, head trauma. Fentanyl Interactions: - Should not use within 14 days of MAO inhibitors, avoid alcohol and other CNS depressants that would further depress the CNS. Fentanyl Half life: -Adults 2-4 hours IV route. Fentanyl Adverse effects: -Confusion, delirium, postoperative depression, drowsiness, nausea, cns depression, hypotention, bradycardia, itching. Fentanyl Patient teaching: -Side effects such as dizziness, risk for falls, avoid other CNS depressants, alcohol and driving. Fentanyl Indications: -Severe pain. Pumonary edema. Pain associated with MI. Morphine Precautions: -Allergy/reaction, use cautiously with head trauma, increase ICP, severe renal, ect... Morphine Interactions: -Extreme caution in patients receiving MAO inhibitors within 14 days prior and other CNS depressants. Risk for serotonin syndrome when taking other medications that raise serotonin levels. These include other antidepressants certain pain and headache medications. Morphine Half life: -Adults 2-4 hours IV. Morphine Adverse Effects: -Confusion, sadation, dizziness, hypotension, bradycardia, tolerance. Morphine Patient teaching: -Side effects, avoid alcohol, driving and other depressants, risk for falls, constipation. Morphine Indications: -Moderate to severe pain. Extended release product for opioid-tolerant patients requiring around the clock management of petsistant pain. Antitussive (lower doses). Hydromorphome Precautions: -Allergy/reaction to, Increased risk for falls, monitor for decrease in BP and HR, and respiratory depression. Hydromorphone Interaction: -Extreme caution in patients receiving MAO inhibitors, discontinue MAO inhibitors 2 weeks prior to hydromorphone. Also avoid other CNS depressants, driving and alcohol. Hydromorphone Half life: -Oral, immediate release, or injection 2-4 hours. Hydromorphone Adverse effects: -Confusion, sedation, dizziness, headache, hypotension, bradycardia, urinary retention, constipation. Hydromorphone Patient education: -Medication instruction, side effects, avoid alcohol, driving and other depressants, risk for falls, constipation. Hydromorphone Differences: -Hydromorphone is ER. -Has antitussive properties at low doses. Fentanyl, Morphine, hydromorphone Indication: -Anesthetic medication used to put patient to sleep for surgery and to prevent pain and discomfort during certain medical tests or procedures. It induces a trance like state while providing pain relief, sedation, and memory loss. Ketamine Precautions: -Hypersensitivity, head trauma, HTN, angina, stoke, underlying psychiatric disorder. Ketamine Interactions: -Drug is incompatible with barbituates and diazepam. Ketamine Half life -10 to 15 minutes. Ketamine Aderse effects: - Bradycardia, blurred vision, N/V, insomnia, drowsiness, painful urination. Ketamine Patient teaching: -Explain purpose and effects of medication. Ketamine Indication: -Reversal of CNS depressants and respiratory depression because of suspected opioid overdose. Precauctions: -Hypersensitivity, caution in cardiovascular disease and opioid dependent patients. Interactions: -Can precipitate withdrawal in dependent patients. Half life: -60 to 90 minutes. Narcan Advers effects: -Ventricular arrhythmias, hypertension, hypotension, nausea, vomiting. Patient teaching: -Explain purpose and effects of medication. Narcan Resource: Davis's Drug Guide for Nurses, 12th edition. Thank You!!

Medication Presentation

Transcript: 82% of adults in the US are taking at least one medication 17-19% of men and women greater than 65 take at least 10 medications 45% of all prescription medications are taken by people 65 or older An estimated 1.5 million people are harmed by medications 700,000 emergency Department visits 100,000 hospitalizations 530,000 men and women aged 65 and older affected by ADE's 100,000 people per year die as a result of medication errors An estimated 3.5 billion in extra medical costs Nearly half of this amount is caused by ADE's in patients 65 and older If medication related problems were ranked as a disease by cause of death where would it rank? -More phones than toothbrushes -Convenience factor -Scheduling -Medication reconciliation at time of discharge is not enough. -Regular calls and in-home follow-up is necessary to ensure compliance. Statistics Homeless population Chameleons Synthesis of Evidence Medication Usage -Nurses can do both jobs -A separate job or in combination Interventions -Nurses have the tranining -Most cost effective Question Cost Search Strategy Inclusion Criteria Supporting Evidence Expert Interview Medication Management -Counseling about disease targeted. -Involving patients in their care (Self-monitoring BP) -Telemedicine follow-up calls. Minimizing Cost In home-patients 65 and older, what is the effect of home medication reconciliation and nurse follow-up on ADE's Phone Abundence -Without frequent clinical encounters, regular standardized functional status assessment is essential to ensure compliance and proper use of drug regimen. PICO Preventing Adverse Drug Events Feasability - Phone follow up not as possitble -Only 40% of patients will bring meds What does an in-home visit look like? -This option is cheaper -Better outcomes Recommendations Adverse Drug Events -Assessment of manual dexterity. (Only 27% of patients with problems seek help.) -show simplification of dosing. -Assessment of health literacy and instructions for regimen. -Assessment of support system at home. Convincing Facilities

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