MEDICATION REVIEW 3 - Carbiodooa levodopa(sinemet...

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Carbiodooa- levodopa (sinemet) CLASSIFICATION: autonomic nervous system agent; anticholinergic (parasympatholytic); antiparkinsonism agent ACTION: Drug is a metabolic precursor of dopamine, a catecholamine neurotransmitter. Unlike dopamine, levodopa readily crosses the blood–brain barrier. Precise mechanism of action unknown. THERAPUTIC EFFECTS: Levodopa restores dopamine levels in extrapyramidal centers (believed to be depleted in parkinsonism). USES: Idiopathic Parkinson's disease, postencephalitic and arteriosclerotic parkinsonism, and parkinsonism symptoms associated with manganese and carbon monoxide poisoning. ADVERSE EFFECTS: Choreiform and involuntary movements, increased hand tremor, bradykinetic episodes, trismus, grinding of teeth (bruxism), ataxia, muscle twitching, numbness, weakness, fatigue, headache, opisthotonos, confusion, agitation, anxiety, euphoria, insomnia, nightmares; psychotic episodes with paranoid delusions or hallucinations, severe depression DIAGNOSTIC TEST INTERFERENCE: Elevated BUN, AST, ALT, alkaline phosphatase, LDH, bilirubin, protein- bound iodine, serum level of growth hormone; decreased glucose tolerance; hypokalemia, decreased WBC, Hgb, Hct. Urine glucose NURSING IMPLICATIONS: Monitor vital signs, Orthostatic hypotension, Lab tests: Monitor blood glucose & HbA1c, CBC, Hgb and Hct, serum potassium, and liver & kidney function periodically PATIENT EDUCATION •Do not take with high-protein foods. Also avoid high consumption of food sources of pyridoxine, including wheat germ, green vegetables, banana, whole-grain cereals, muscular and glandular meats (especially liver), legumes. Learn good dietary practices. •Do not take OTC preparations or fortified cereals unless approved by physician. Multivitamins, antinauseants, and fortified cereals usually contain vitamin B6. Diazepam (valium) CLASSIFICATION: central nervous system agent; benzodiazepine anticonvulsant; anxiolytic Actions: Psychotherapeutic agent related to chlordiazepoxide; reportedly superior in antianxiety and anticonvulsant activity, with somewhat shorter duration of action. Like chlordiazepoxide, it appears to act at both limbic and subcortical levels of CNS.
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Therapeutic Effects: Shortens REM and stage 4 sleep but increases total sleep time. Antianxiety and anticonvulsant agent. Uses: Drug of choice for status epilepticus. Management of anxiety disorders, for short-term relief of anxiety symptoms, to allay anxiety and tension prior to surgery, cardioversion and endoscopic procedures, as an amnesic, and treatment for restless legs. Also used to alleviate acute withdrawal symptoms of alcoholism, voiding problems in older adults, and adjunctively for relief of skeletal muscle spasm associated with cerebral palsy, paraplegia, athetosis, stiff-man syndrome, tetanus. Adverse effects: Throat and chest pain, Drowsiness, fatigue, ataxia, confusion, paradoxic rage, dizziness, vertigo, amnesia, vivid dreams, headache, slurred speech, tremor Nursing Implications: Observe necessary preventive precautions for suicidal tendencies that may be present in anxiety states accompanied by depression.Observe patient closely and monitor vital signs
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  • Fall '15
  • Decker
  • adverse effects, Selective serotonin reuptake inhibitor, Headache, Nursing Implications

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