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Pharmacology (NG 360) HESI Pharm Review

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Sandra Watson
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Brenau University

Pharmacology (NG 360)

PHARMACOLOGY HESI REVIEW
DRUGS AFFECTING THE NERVOUS SYSTEM
ANTICONVULSANTS/ANTISEIZURE MEDICATIONS
Prototype :
a. Hydantoins – phenytoin (Dilantin)
b. Barbiturates – phenobarbital ( Luminal)
Adverse effects :
– sedation & drowsiness, gingival hyperplasia
– diplopia, nystagmus, vertigo, dizziness
– thrombocytopenia, aplastic anemia
Nursing considerations :
1. Advise female clients to use contraceptives.
2. Inform clients taking phenytoin that harmless urine discoloration is common.
3. Warn clients with diabetes that hydantoins may increase blood sugar level.
4. Reassure that barbiturates are not addictive at a low dosage.
5. Avoid taking alcohol with barbiturates.
6. Administer IV phenytoin slowly to avoid cardiotoxicity.
7. Avoid mixing other drugs in same syringe with phenytoin.
ANTIPARKINSONIAN AGENTS
Prototype :
a. Anticholinergic agents – trihexyphenidyl (Artane), benztropine (Congentin)
b. Dopaminergic agents – Levodopa, carbidopa-levodopa (Sinemet), amantidine (Symmetrel)
Adverse effects of dopaminergic agents:
a. levodopa–nausea, vomiting, anorexia, orthostatic hypotension, dark-colored
urine and sweat
b. amantidine – ankle edema, constipation
Nursing considerations:
1. Give dopaminergic agents after meals to reduce GI symptoms.
2. Reassure client that levodopa may cause harmless darkening of urine and sweat.
3. Avoid taking Vit B6 (pyridoxine) because it reverses effects of levodopa.
4. Change positions slowly to avoid orthostatic hypotension.
5. Elevate leg to reduce ankle edema.
DRUGS AFFECTING MENTAL FUNCTIONING
SEDATIVES, HYPNOTICS, AND ANXIOLYTICS – induce sleep, sedate & calm clients
Prototype:
a. Benzodiazepines (end with –epam)
– diazepam (Valium), lorazepam (Ativan),
alprazolam (Xanax), flurazepam (Dalmane)
b. Barbiturates
– phenobarbital,
Adverse effects:
– hangover-effect, dizziness, CNS depression
– respiratory depression, drug-dependence
lOMoARcPSD|5735817
2
Nursing considerations:
1. Warn clients of injuries and falls.
2. Brief period of confusion and excitement upon waking up is common with benzodiazepines.
3. Warn clients not to discontinue medications abruptly without consulting a physician.
4. Avoid alcohol while taking these drugs.
6. Rotate and don’t shake the ampoules of barbiturates. Don’t mix with other drugs.
7. Warn female clients that diazepam is associated with cleft lip.
ANTIDEPRESSANTS AND MOOD DISORDER DRUGS
Prototype:
a. Tricyclic antidepressants – amitriptyline (Elavil), imipramine (Tofranil), desipramine
b. MAOI (monoamine oxidase inhibitors) -phenelzine (Nardil), tranylcypromine (Pernate)
c. Second-generation antidepressants – fluoxetine (Prozac)
Adverse effects:
– dry mouth, blurred vision, urine retention, constipation (anticholinergic effects)
– orthostatic hypotension, insomnia
– hypertensive crisis (MAO)
Nursing considerations:
1. Caution client to rise slowly to reduce the ef

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Pharmacology (NG 360) HESI Pharm Review

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