dysrhythmia serotonin syndrome pregnancy B Methocarbamolrenal liver failure

Dysrhythmia serotonin syndrome pregnancy b

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dysrhythmia; serotonin syndrome (pregnancy B) Methocarbamol—renal, liver failure (pregnancy C) ADRs sedation, drowsiness, dizziness CNS sedation (drowsiness, dizziness, weakness, fatigue, malaise), diarrhea, Clinical use Baclofen—spasticity related to multiple sclerosis, spinal cord injuries, CP Chlorzoxazone—short term tx of painful muscle spasm impacting daily living Metaxalone & Methocarbamol—short term tx of acute, painful musculoskeletal pain Orphenadrine—short term relief of moderate pain w/ musculoskeletal disorders Tizanidine-spasticity Dantrolene--Treat spasticity associated with upper neuron disorders, including spinal cord injury, stroke, cerebral palsy, and multiple sclerosis. Opioid Analgesics & Antagonists Agonists Mixed agonist- antagonists Partial agonist Tylenol #3 or #4, Fentanyl (Sublimaze, Duragesic), hydrocodone (Vicodin, Lortab), Hydromorphone (Dilaudid), Levorphanol (Levo- Dromoran), Meperidine (Demerol) Methadone (Dolophine), Morphine (MSIR, Roxanol, MS Contin, Oramorph, Kadian), Oxycodone (Percocet, Percodan, Roxicodone, OxyContin), Tramadol (Ultram) Butorphanol (Stadol), Nalbuphine (Nubain), and Pentazocine (Talwin) Buprenorphine (Buprenex) and Dezocine (Dalgan) Pharmaco - dynamics Mu & kappa receptors for analgesic effect Activating delta & sigma dysphoria, hallucination, resp & vasomotor stimulation Cause withdrawal Sx when giving to narcotic dependent pts Opioid antagonis t Naloxone HCL (Narcan), Naltrexone HCL (Revia) , Nalmefene HCL (Revex) acting within 2-15 min & lasting 1-4 hr Pharmaco -kinetics Metabolized in liver and excreted in urine Pharmaco - therapeut ics d/t resp depressant effect, contraindication in compromised pul function, head injury, IICP, acute abd condition; Pregnancy C ADRs Constipation, respiratory depression, hypotension, confusion, sedation, nausea, vomiting, dizziness, visual disturbances, hallucinations, euphoria, lethargy, uncoordinated movements, constipation, agitation, depression of cough reflexes, and paresthesia. Rational drug selection Mild to moderate pain not alleviated by nonopioid, start with lower potency opioid codeine w/ Tylenol no relief oxycodone, hydrocodone w/ ASA or Tylenol effective in treating moderate to severe pain Effective in moderate to severe pain; Buprenorphine:
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Moderate to severe pain not treated w/ opioids short half-life (morphine, hydromorphone, oxycodone) Severe pain morphine Methadone: tx of chronic & neuropathic pain; detoxification Tramadol: mod-severe pain, chronic pain Meperidine not recommended for chronic pain maintenance of opioid dependence Monitorin g Baseline ECG for QT prolongation; BP, DNS & Resp depression, sedative; physical dependence; withdrawal Sx—muscle cramps, dilated pupils, lacrimation, sneezing, anxiety, anorexia, N/V, diarrhea Stimulants Amphetamine Dextroamphetamine (Dexedrine) Methylphenidate (Ritalin) Methamphetamine (Desoxyn)—treat ADHA & narcolepsy Adderall—combined w/ Dexedrine & amphetamine salts Non-amphetamine: Atomoxetine (Strattera) Indication treating attention deficit-hyperactivity disorder (ADHD), narcolepsy, and weight reduction. In therapeutic ranges, these drugs improve alertness,
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  • Spring '14
  • Henrikson,J
  • Major depressive disorder

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