Classification Dopamine agonists Levodopa / carbidopa

Indications PD Dementia.

Contraindications Abrupt discontinuation Asthma or emphysema Cardiac disease, hypotension Active peptic ulcers Diabetes Renal / hepatic disease Glaucoma and psychosis Pregnancy and lactation Nursing Considerations

Mechanism of Action

Adverse Effects

Actively transported into CNS and converted into dopamine. Levodopa crosses BBB, but has many adverse effects when it dopamine in blood stream, so with carbidopa combo it doesnt convert into dopamine till its in brain. That dec. the side effects, but needs to administered in bigger doses this way.

Dyskinesias (involuntary body part movements) Nausea, vomiting, and anorexia Anxiety, agitation, confusion, depression, psychosis Hypotension, dizziness, syncope

Usually given as LevodopaCarbidopa-Entacapone combinations to enhance CNS entry Young patients respond better Long time periods of use lead to tolerance and drug wearing off

Classification acetaminophen Nonopioid analgesic (Pain medication for mild to moderate pain), antipyretic (prevent or reduce fever). PO/RECT 325-650 mg q46hr prn, max 4g/day.

Indications Mild to moderate pain or fever, arthralgia (pain in a joint), dental pain, dysmenorrhea (painful menstruation or abdominal cramps), headache, myalgia (pain in a muscle), osteoarthritis. Adverse Effects drowsiness, nausea, vomiting, abdominal pain, GI bleeding, seizure, renal failure, leukopenia, rash, hypersensitivity, cyanosis, jaundice, coma, death, CNS stimulation, delirium followed by vascular collapse.

Contraindications Hypersensitivity, intolerance to tartrazine, alcohol, table sugar, saccharin, depending on product.

Mechanism of Action May block pain impulses peripherally that occur in response to inhibition of prostaglandin synthesis; does not possess anti-inflammatory properties; antipyretic action results from inhibition of prostaglandins in the CNS.

Nursing Considerations Assess health status and alcohol usage before administering. Assess for pain (type and location), use pain scale. Allergic reactions like rash, if it occurs product may have to discontinued. Decreasing output may indicate renal failure.

Classification Calcium Channel Blockers amlodipine (Norvasc) PO/IV

Indications Angina Pectoris Hypertension Atrial Fibrillation Atherosclerosis Tachycardia

Contraindications Allergy Digoxin use (increases serum digoxin levels) -blocker use (additive effects to both medications)

Mechanism of Action Dilates and relaxes arterial muscle, decreases blood pressure and heart rate, thus decreasing cardiac workload

Adverse Effects Hypotension Bradycardia Nausea Headache Dizziness

Nursing Considerations Thorough cardiovascular assessment is required prior to administration immediate release forms have a very short duration and require frequent administration

Classification

Indications

Contraindications

Parathyroid- like drug Rocaltrol (calcitriol)

Hypocalcemia Hypoparathyroidism

Magnesium containing antacids. Hypersenstivity

Mechanism of Action Stimulates calcium absorption from GI tract and promotes movement of calcium from bone to blood.

Adverse Effects Headache N/V/C HTN Arrhythmias Pancreatitis Bone and muscle pain Decreased lidibo

Nursing Considerations Avoid magnesium containing antacids with the drug. Give drug without regard for food,

Classification

Indications

Contraindications

Cholinesterase Inhibitors
Examples: donepezil, rivastigmine, and galantamine

Dementia

Known drug allergies

Mechanism of Action Prevent the breakdown of acetylcholine in the synapse Drugs not curative; only slow disease progression

Adverse Effects

Nursing Considerations

GI upset: nausea, vomiting, Donepezil may be taken with or and anorexia without food Increased urination Drugs may lead to bradycardia and heartblock Drugs can cause significant weight loss Can increase gastric acid secretions

Classification

Indications

Contraindications

NMDA Antagonists
Examples: memantine

Monotherapy or adjunct therapy with cholinesterase inhibitors for AD

Known drug allergies

Mechanism of Action Increases glutamate (amino acid) availability; leads to decreased symptoms

Adverse Effects Acne AV block Cerebral infarction Gallstones Hepatitis Impotence Sedation Hypotension

Nursing Considerations Adjustments in dose based on age is not required However: Monitor kidney and liver function along with BP