PHARMACOLOGY REVIEWER

I. Antidepressants and Mood Stabilizers

- Antidepressants:

- Fluoxetine (Prozac):

- Therapeutic actions: Selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the
brain.

- Indications: Depression, anxiety disorders, obsessive-compulsive disorder (OCD), panic disorder,

premenstrual dysphoric disorder (PMDD), bulimia nervosa.

- Nursing considerations: Monitor for suicidal thoughts, especially in the early stages of treatment.
Educate patients about potential side effects such as nausea, headache, and sexual dysfunction.

- Amitriptyline (Elavil):

- Therapeutic actions: Tricyclic antidepressant (TCA) that blocks the reuptake of serotonin and
norepinephrine.

- Indications: Depression, anxiety disorders, chronic pain, migraines.

- Nursing considerations: Monitor for anticholinergic side effects such as dry mouth, constipation, and
blurred vision. Educate patients about the risk of overdose and the importance of taking the medication
as prescribed.

- Sertraline (Zoloft):

- Therapeutic actions: SSRI that increases serotonin levels in the brain.

- Indications: Depression, anxiety disorders, OCD, panic disorder, PTSD, premenstrual dysphoric disorder
(PMDD).

- Nursing considerations: Monitor for suicidal thoughts, especially in the early stages of treatment.
Educate patients about potential side effects such as nausea, headache, and sexual dysfunction.

- Mood Stabilizers:

- Lithium:

- Therapeutic actions: Lithium is a mood stabilizer that helps regulate the levels of certain
neurotransmitters in the brain.

- Indications: Bipolar disorder, preventing manic episodes.

- Signs of lithium toxicity: Nausea, vomiting, diarrhea, tremors, confusion, seizures, coma.

- Nursing considerations: Monitor lithium levels regularly, educate patients about the importance of
maintaining adequate fluid intake, and advise them to avoid alcohol and NSAIDs.

- Valproic Acid (Depakote):

- Therapeutic actions: Anticonvulsant medication that also has mood-stabilizing effects.

- Indications: Bipolar disorder, epilepsy, migraines.

- Nursing considerations: Monitor liver function and platelet count regularly. Educate patients about the
risk of hepatotoxicity and pancreatitis.

II. CNS Stimulants and Depressants

- CNS Stimulants:

- Amphetamines (Adderall, Ritalin):

- Therapeutic actions: Increase the release of dopamine and norepinephrine in the brain, leading to
increased alertness, focus, and energy.

- Indications: Attention-deficit/hyperactivity disorder (ADHD), narcolepsy.

- Nursing considerations: Monitor for potential side effects such as insomnia, anxiety, and appetite
suppression. Educate patients about the risk of dependence and abuse.

- CNS Depressants:

- Barbiturates:

- Therapeutic actions: Depress the central nervous system, leading to sedation, sleep, and muscle
relaxation.

- Indications: Anxiety, insomnia, seizures, anesthesia.

- Adverse effects: Drowsiness, dizziness, confusion, respiratory depression, addiction, overdose.

- Benzodiazepines (Xanax, Valium):

- Therapeutic actions: Enhance the effects of GABA, a neurotransmitter that inhibits nerve activity.

- Indications: Anxiety, insomnia, seizures, muscle spasms, alcohol withdrawal.

- Nursing considerations: Monitor for potential side effects such as drowsiness, dizziness, and confusion.
Educate patients about the risk of dependence and abuse.

III. Analgesics and Anticonvulsants

- Narcotic Analgesics:

- Oxycodone (OxyContin):
- Therapeutic actions: Relieve moderate to severe pain by binding to opioid receptors in the brain and
spinal cord.

- Indications: Pain management, especially after surgery or for chronic pain conditions.

- Nursing considerations: Monitor for respiratory depression, constipation, and potential for addiction.
Educate patients about the importance of taking the medication as prescribed and the risks of misuse.

- Nursing interventions:

- Pain assessment: Regularly assess pain levels and response to medication.

- Respiratory monitoring: Closely monitor respiratory rate and depth, especially during the initial stages
of treatment.

- Constipation management: Encourage fluids and fiber intake, consider stool softeners.

- Addiction prevention: Educate patients about the risks of addiction and misuse.

- Non-narcotic Analgesics:

- Acetaminophen (Tylenol):

- Therapeutic actions: Relieve mild to moderate pain and fever by reducing prostaglandin production.

- Indications: Headache, muscle aches, fever.

- Nursing considerations: Monitor for potential liver toxicity, especially in patients with liver disease.
Educate patients about the maximum daily dose.

- Anticonvulsants:

- Valproic Acid (Depakote): (See Mood Stabilizers section)

IV. Drugs for Neuromuscular Disorders

- Muscle Relaxants:

- Therapeutic actions: Reduce muscle spasms and stiffness.

- Indications: Muscle spasms, back pain, neck pain.

- Contraindications: Myasthenia gravis, pregnancy.

- Nursing considerations: Monitor for drowsiness, dizziness, and potential for dependence.

- Drugs for Myasthenia Gravis:

- Pyridostigmine (Mestinon):
- Therapeutic actions: Inhibits the breakdown of acetylcholine, a neurotransmitter that helps muscles
contract.

- Indications: Myasthenia gravis.

- Nursing considerations: Monitor for cholinergic side effects such as nausea, vomiting, diarrhea, and
muscle weakness.

V. Drugs for Neurologic Disorders

- Drugs for Parkinson's Disease:

- Levodopa/Carbidopa (Sinemet):

- Therapeutic actions: Levodopa is converted to dopamine in the brain, helping to improve motor
function. Carbidopa prevents the breakdown of levodopa in the periphery.

- Indications: Parkinson's disease.

- Adverse effects: Nausea, vomiting, dyskinesia, hallucinations.

- Nursing considerations: Monitor for potential side effects and educate patients about the importance
of taking the medication as prescribed.

- Drugs for Alzheimer's Disease:

- Donepezil (Aricept):

- Therapeutic actions: Inhibits the breakdown of acetylcholine, a neurotransmitter involved in memory

and learning.

- Indications: Alzheimer's disease.

- Nursing considerations: Monitor for potential side effects such as nausea, vomiting, and diarrhea.

VI. Adrenergic and Adrenergic Blockers

- Adrenergic Agents:

- Therapeutic actions: Stimulate the sympathetic nervous system, leading to increased heart rate, blood
pressure, and bronchodilation.

- Indications: Asthma, shock, hypotension.

- Nursing considerations: Monitor for potential side effects such as tachycardia, hypertension, and
anxiety.

- Adrenergic Blockers:

- Atropine:
- Therapeutic actions: Blocks acetylcholine receptors, leading to decreased heart rate, bronchodilation,
and decreased secretions.

- Indications: Bradycardia, asthma, poisoning.

- Side effects: Dry mouth, blurred vision, constipation, urinary retention.

- Nursing responsibilities: Monitor for potential side effects and educate patients about the importance
of taking the medication as prescribed.

VII. Cholinergic and Cholinergic Blocking Agents

- Cholinergic Agents:

- Therapeutic actions: Mimic the effects of acetylcholine, a neurotransmitter that helps muscles contract
and regulate various bodily functions.

- Indications: Myasthenia gravis, glaucoma.

- Nursing considerations: Monitor for potential side effects such as nausea, vomiting, diarrhea, and
muscle weakness.

- Cholinergic Blocking Agents:

- Therapeutic actions: Block the effects of acetylcholine, leading to decreased muscle activity, decreased
secretions, and increased heart rate.

- Indications: Motion sickness, Parkinson's disease, irritable bowel syndrome.

- Adverse reactions: Dry mouth, blurred vision, constipation, urinary retention.

- Nursing responsibilities: Monitor for potential side effects and educate patients about the importance
of taking the medication as prescribed.

VIII. Pituitary, Thyroid, Parathyroid, and Adrenals

- Growth Hormone:

- Therapeutic actions: Stimulates growth and development.

- Indications: Growth hormone deficiency, Turner syndrome.

- Nursing considerations: Monitor for potential side effects such as fluid retention, joint pain, and
headaches.

- Thyroid Hormones:

- Therapeutic actions: Replace or supplement thyroid hormone.

- Indications: Hypothyroidism.

- Nursing considerations: Monitor for potential side effects such as tachycardia, palpitations, and
insomnia.
- Nursing responsibilities: Monitor for potential side effects and educate patients about the importance
of taking the medication as prescribed.

IX. Antidiabetic Drugs

- Insulin:

- Therapeutic actions: Regulates blood sugar levels by allowing glucose to enter cells.

- Indications: Type 1 diabetes, some cases of type 2 diabetes.

- Nursing considerations: Monitor blood sugar levels, educate patients about proper injection
techniques, and teach them about the signs and symptoms of hypoglycemia.

- Oral Antidiabetic Drugs:

- Metformin (Glucophage):

- Therapeutic actions: Improves insulin sensitivity and reduces glucose production by the liver.

- Indications: Type 2 diabetes.

- Nursing considerations: Monitor for potential side effects such as gastrointestinal upset, lactic acidosis,
and vitamin B12 deficiency.

Key Points to Remember:

- Thorough Research: Ensure all information is accurate and up-to-date. Refer to reliable medical sources
like the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and reputable
medical journals.

- Organization: Structure your review logically, using clear headings and subheadings.

- Clarity: Write in a clear and concise style, avoiding technical jargon when possible.

- Patient Safety: Emphasize the importance of patient education and safety, including potential side
effects, drug interactions, and proper dosage.