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The nurse should do the following for clients who are taking taxane agents:
- Assess client overall well-being prior to chemotherapy administration, including vital signs, hydration status, oral mucosa, skin, weight, cardiac function, and signs of neuropathy.
- Review laboratory values thoroughly, including complete ... | {
"Header 1": "CHAPTER 8 Introduction to Cancer Therapy and Cancer Drugs",
"Header 2": "**Taxanes**",
"Header 3": "**Nursing Implications**",
"token_count": 220,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Because chemotherapy regimens are so complex, supportive care with other pharmacologic agents is usually required. Management of adverse effects is critical to safe and successful chemotherapy treatment. Myelosuppression and nausea and vomiting are most commonly managed with supportive therapies. Corticosteroids and bi... | {
"Header 1": "CHAPTER 8 Introduction to Cancer Therapy and Cancer Drugs",
"Header 2": "**Common Drugs Used as Supportive Therapies for Clients Receiving Chemotherapy**",
"token_count": 744,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Antiandrogens, also known as androgen inhibitors or testosterone blockers, are hormonal therapies used to treat prostate cancer. These drugs block androgen receptors so that cancers that rely on testosterone and other hormones to grow cannot survive. These drugs may induce a reduction in masculine characteristics such ... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Antiandrogens**",
"token_count": 408,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Cancer therapy has experienced an explosion of new treatments with the development of biologics. Monoclonal antibodies are a type of biologic response modifier used to treat autoimmune diseases as well as various cancer types. Rituximab is a monoclonal antibody that enables the immune system to better recognize and des... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Monoclonal Antibodies and PD-1 Inhibitors**",
"token_count": 211,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The nurse should do the following for clients who are taking biologic and biologic response modifying agents:
- Assess client overall well-being prior to chemotherapy administration including vital signs, hydration status, oral mucosa, skin, weight, cardiac function, bowel pain, level of consciousness changes, and si... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Nursing Implications**",
"token_count": 210,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- **adenocarcinoma** cancer development arising from the glandular tissues that line body organs
- **alopecia** abnormal loss of body hair
- **benign** not causing harmful effects
- **chemotherapy** drug therapy focused on killing cancer cells
- **embolization** the introduction of a foreign object (bone fragments, cel... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Key Terms**",
"token_count": 772,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- 9.1 [Introduction to the Nervous System](#page-279-0)
- 9.2 [Structure and Function of the Nervous System](#page-280-0)
- 9.3 [Characteristics of Drugs to Treat Nervous System Disorders](#page-283-0)
**INTRODUCTION** Neurological disorders affect the body's autonomic, peripheral, and central nervous system. These d... | {
"Header 1": "CHAPTER 9 Introduction to the Nervous System",
"Header 2": "**CHAPTER OUTLINE**",
"token_count": 564,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The **nervous system** is composed of the central nervous system (CNS) (i.e., the brain and the spinal cord) and the peripheral nervous system (PNS) (i.e., the nerves that extend from the spinal cord to the body). The PNS is subdivided into the somatic nervous system and the autonomic nervous system. Together the CNS a... | {
"Header 1": "CHAPTER 9 Introduction to the Nervous System",
"Header 2": "**The Nervous System**",
"token_count": 212,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Within the PNS, the autonomic nervous system (ANS) controls involuntary processes and regulates vital functions such as heart rate, digestion, respiration, and glandular secretion, while the somatic nervous system (SNS) consists of motor and sensory pathways that are associated with the voluntary movement of skeletal m... | {
"Header 1": "CHAPTER 9 Introduction to the Nervous System",
"Header 2": "**9.2 Structure and Function of the Nervous System**",
"Header 3": "**Overview of the Nervous System and Neurons**",
"token_count": 667,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The brain has four main components: the cerebrum, cerebellum, brain stem, and limbic system (see [Figure 9.4](#page-281-1)).
**FIGURE 9.4** Basic brain structures include the cerebrum, cerebellum, brain stem, and the limbic system. (attribution: Copyright Rice University, OpenStax, unde... | {
"Header 1": "CHAPTER 9 Introduction to the Nervous System",
"Header 2": "**9.2 Structure and Function of the Nervous System**",
"Header 3": "**Overview of the Brain**",
"token_count": 542,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The peripheral nervous system (PNS) delivers signals between the central nervous system (CNS) and the body. The PNS contains both motor neurons and sensory neurons. Motor neurons coordinate signals that correspond to muscle and gland activity, while sensory neurons provide the signals to sensory organs. The somatic ner... | {
"Header 1": "CHAPTER 9 Introduction to the Nervous System",
"Header 2": "**9.2 Structure and Function of the Nervous System**",
"Header 3": "**Peripheral Nervous System**",
"token_count": 428,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Any pathological process that causes a disruption in the homeostasis between the SNS and the PNS may cause one of these branches to become overexcited while causing the other system to be extremely inhibited (Clar & Sharma, 2023). A wide range of symptoms may occur due to this disruption in homeostasis, and medications... | {
"Header 1": "CHAPTER 9 Introduction to the Nervous System",
"Header 2": "**Nervous System Drug Properties**",
"Header 3": "**Autonomic Nervous System Stimulant and Blocker Characteristics**",
"token_count": 388,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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10.1 [Introduction to Myasthenia Gravis](#page-292-0) 10.2 [Cholinergic Drugs](#page-294-0) 10.3 [Introduction to Alzheimer's Disease](#page-299-0) 10.4 [Alzheimer's Drugs](#page-301-0)
**INTRODUCTION** The peripheral nervous system (PNS) is divided into two main subdivisions: the somatic motor system and the autonom... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 3": "**CHAPTER OUTLINE**",
"token_count": 857,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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By the end of this section, you should be able to:
- 10.1.1 Describe the pathophysiology of myasthenia gravis.
- 10.1.2 Identify the clinical manifestations related to myasthenia gravis.
- 10.1.3 Identify the etiology and diagnostic studies related to myasthenia gravis.
**Myasthenia gravis (MG)** is a progressive a... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 244,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Myasthenia gravis is an autoimmune disorder of neuromuscular junction (NMJ) transmission. In a healthy person, nerve impulses release ACh at the NMJ, the area where nerve cells connect with the muscles they control. This neurotransmitter, ACh, will then travel across the synapse, where it will reach nicotinicM receptor... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Pathophysiology**",
"token_count": 209,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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What triggers an immunological attack on the NMJ receptor sites is not fully understood. The **autoantibodies** (antibodies that destroy a person's own proteins and antigens) against the ACh receptors have been identified as immunoglobulin G (IgG) derived from the plasma B-lymphocytes. These antibodies destroy ACh rece... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Etiology**",
"token_count": 228,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Because weakness is a common and vague complaint, diagnosis of MG can be delayed or even missed. Several different tests can be conducted to confirm the diagnosis of MG. Just like with most conditions, the nurse should first obtain an accurate history and physical examination. The assessment of the neurological system ... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Diagnostics**",
"token_count": 269,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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**Ptosis** (drooping of the eyelid) and **diplopia** (double vision) are the presenting symptoms in half of the clients diagnosed with MG. The cardinal feature of early MG is fluctuating skeletal muscle weakness and muscle fatigue. Many times, muscle strength is strongest in the morning hours and will decrease througho... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Clinical Manifestations**",
"token_count": 298,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The main pharmacological class to treat MG is acetylcholinesterase (AChE) inhibitors. These indirect-acting cholinergic agonists react chemically with AChE, the enzyme responsible for breaking down ACh in the synaptic cleft. The presynaptic neuron continues to release ACh, while the synapse accumulates ACh because it i... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Pharmacological Management**",
"token_count": 487,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 10.2.1 Identify the characteristics of drugs used to treat myasthenia gravis.
- 10.2.2 Explain the indications, actions, adverse reactions, and interactions of drugs used to treat myasthenia gravis.
- 10.2.3 Describe nursing implications of drugs used to treat myas... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 392,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Direct-acting cholinergic agonists mimic the effects of ACh when they bind to cholinergic receptors. They are considered direct acting because they have **affinity** (attracted to a receptor) and **intrinsic activity** (ability to stimulate a receptor) to these receptors. Direct-acting cholinergic agonists mainly bind ... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Direct-Acting Cholinergic Agonists**",
"token_count": 282,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Indirect-acting cholinergic agonists bind reversibly to AChE. They inhibit the enzyme that destroys acetylcholine, making acetylcholine more available. The specific mechanism of action is to delay the splitting of ACh into choline and acetone. Because AChE must degrade the drug in order to become unbound, less of this ... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Indirect-Acting Cholinergic Agonists: Reversible Acetylcholinesterase Inhibitors**",
"token_count": 225,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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- Understand that MG is not curable, so treatment is lifelong.
- Be able to recognize signs of therapeutic failure (ptosis, difficulty swallowing) and toxicity (excess muscarinic responses).
- Maintain records of the times the drug was administered, times at which fatigue occurred, and level of muscle strength before a... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**The client taking an indirect-acting reversible AChE inhibitor should:**",
"token_count": 206,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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These drugs bind irreversibly to AChE. The effects of these drugs are prolonged—they will last until new molecules of cholinesterase are synthesized. Another method of reversing the inhibition of AChE, especially at the NMJ, is to administer pralidoxime, a cholinesterase reactivator. This drug is a specific antidote to... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Indirect-Acting Cholinergic Agonists: Irreversible AChE Inhibitors**",
"token_count": 399,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The U.S. Food and Drug Administration (FDA) has approved a new medication, rozanolixizumab-noli (Rystiggo), for generalized MG in adults who are anti-acetylcholine receptor (AChR) or anti-MuSK antibody positive, the two most common subtypes of generalized MG. Rozanolixizumab-noli is a humanized IgG4 monoclonal antibody... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "A New Medication for Myasthenia Gravis",
"token_count": 202,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 10.3.1 Describe the pathophysiology of Alzheimer's disease.
- 10.3.2 Identify the clinical manifestations related to Alzheimer's disease.
- 10.3.3 Identify the etiology and diagnostic studies related to Alzheimer's disease.
**Alzheimer's disease (AD)** is the mos... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 398,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
To fully understand how a drug alters symptoms, it is important to understand the pathophysiology of the disease being treated at the biochemical level. In most central nervous system disorders, the existing knowledge is limited. The brain is a complex structure, and the overall neuronal degeneration and cerebral atrop... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Pathophysiology**",
"token_count": 720,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
An underlying single cause for AD has yet to be discovered. There have been important theories and findings, but it is not known how these pieces fit together. Interestingly, the major pathologic findings begin to develop a decade or more before clinical manifestations are even observed. At this point, the etiology is ... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Etiology**",
"token_count": 284,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**The client using a rivastigmine transdermal patch should:**
• Apply the patch every 24 hours to clean, dry, hairless, and intact healthy skin in a place where clothes will not rub against it.
- Avoid skin areas where cream, lotion, or powder has recently been applied.
- Press down firmly for 30 seconds when apply... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "CLIENT TEACHING GUIDELINES",
"token_count": 222,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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- Use the patch if the pouch seal is broken or the patch is cut, damaged, or altered in any way.
- Apply to skin that is red, irritated, or cut.
- Use the same site for a period of 14 days.
[Table 10.5](#page-303-0) lists common AChE inhibitors and typical routes and dosing for adult clients.
| Drug ... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**The client using a rivastigmine transdermal patch should not:**",
"token_count": 578,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Memantine (Namenda, Namenda XR) is indicated for clients with moderate to severe dementia of the Alzheimer's type. This drug has been shown to exhibit neuroprotective action (slows the neurotoxicity). Memantine is an antagonist of the NMDA receptor subtype of the glutamate receptor. The drug blocks the influx of calciu... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**NMDA Receptor Antagonist**",
"Header 3": "**Memantine**",
"token_count": 688,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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This is a fixed combination dose of a cholinesterase inhibitor and an NMDA receptor antagonist (Namzaric). The agent combines donepezil and memantine. Combining these drugs can be beneficial because each drug has a different mechanism of action. The cholinesterase inhibitors address the cholinergic defect, and the NMDA... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**AChE Inhibitor/NMDA Receptor Antagonist**",
"token_count": 229,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The nurse should do the following for clients receiving medications for AD:
- Emphasize that treatment is not a cure and will not reverse signs or symptoms and usually will only produce modest benefits.
- Obtain baseline data, such as orientation, mood/affect, and ability to carry out activities of daily living.
- As... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**AChE Inhibitor/NMDA Receptor Antagonist**",
"Header 3": "**Nursing Implications**",
"token_count": 210,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
In July 2023, a new intravenous medication, lecanemab-irmb (LEQEMBI), received full FDA approval as a treatment for the mild dementia stage of Alzheimer's disease. The classification of this medication is an amyloid beta-directed antibody. The drug works by targeting harmful amyloid proteins and reducing existing amylo... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "Intravenous Alzheimer's Disease Treatment",
"token_count": 285,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- **acetylcholine (ACh)** major neurotransmitter of the cholinergic system
- **adrenergic receptors** mediate responses to epinephrine and norepinephrine; include alpha and beta receptors
- **affinity** strength of the attraction between a drug and its receptor
- **Alzheimer's disease (AD)** most common neurodegenerati... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Key Terms**",
"token_count": 411,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- **myasthenia gravis (MG)** a progressive autoimmune neuromuscular disorder characterized by fluctuating muscle weakness and the onset of rapid fatigue
- **neurotoxic** drugs that alter the proper functioning of the nervous system
- **norepinephrine** neurotransmitter released by almost all of the postganglionic neuro... | {
"Header 1": "CHAPTER 10 Drugs to Treat Myasthenia Gravis and Alzheimer's Disease",
"Header 2": "**Key Terms**",
"Header 3": "nutrients/substances within cells",
"token_count": 339,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- 11.1 [Introduction to Parkinson's Disease](#page-312-2)
- 11.2 [Anti-Parkinsonian Drugs](#page-316-0)
- 11.3 [Introduction to Multiple Sclerosis](#page-339-0)
- 11.4 [Drugs Used in the Treatment of Multiple Sclerosis](#page-342-0)
**INTRODUCTION** The brain, nerves, and skeletal muscles—collectively known as the ne... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**CHAPTER OUTLINE**",
"token_count": 202,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 11.1.1 Describe the pathophysiology of Parkinson's disease.
- 11.1.2 Identify the clinical manifestations related to Parkinson's disease.
- 11.1.3 Identify the etiology and diagnostic studies related to Parkinson's disease.
**Parkinson's disease (PD)** is a progr... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 416,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The exact cause of PD is still unknown. Theories exist related to the causes of the degeneration of the basal ganglia including viral infections, blunt head trauma, encephalitis, atherosclerosis, and exposure to certain drugs and environmental factors, such as pesticides. There is also most likely an interaction betwee... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Etiology**",
"token_count": 229,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
A part of the basal ganglia called the substantia nigra (see [Figure 11.2\)](#page-314-0) contains nerves that secrete dopamine; this secretion of dopamine progressively degenerates with PD. Because the basal ganglia works with the cerebral cortex and thalamus, it helps with both coordination of complex patterns of mot... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Pathophysiology**",
"token_count": 423,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Motor symptoms of PD occur late in the disease process. Usually 60%–80% of the dopamine-releasing neurons of the substantia nigra are already destroyed before the onset of motor symptoms (Parkinson's Foundation, 2023e).
The four primary motor manifestations of overt PD (shown in [Figure 11.3\)](#page-315-0) are (Capr... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Clinical Manifestations**",
"token_count": 787,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Nonpharmacologic strategies to slow the decline of motor function and/or manage the clinical manifestations of PD
include physical therapy to encourage clients to be as active as possible and prevent skeletal deformities, occupational therapy to teach clients how to use adapted tools and methods to make activities of... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Nonpharmacologic Management**",
"token_count": 210,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 11.2.1 Identify the characteristics of drugs used to treat Parkinson's disease.
- 11.2.2 Explain the indications, actions, adverse reactions, contraindications, and interactions of drugs used to treat Parkinson's disease.
- 11.2.3 Describe nursing implications of d... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 324,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
This drug classification can cause numerous adverse effects, which is why it is not used as commonly as it was in the past. Anhidrosis can occur from the decreased secretion from sweat glands. This can be dangerous because the body is unable to release heat, which can lead to hyperthermia or heat stroke. Dry mouth, due... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "Differences in Receptor Sensitivity",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 1483,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients who are taking anticholinergics:
- Assess for decreased rigidity and tremor.
- Monitor client's ability to engage in self-care tasks and walk independently.
- Assess for an increase in heart rate and/or blood pressure.
- Monitor for any signs of respiratory distress or mo... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "American Geriatrics Society Beers Criteria ®",
"Header 3": "**Nursing Implications**",
"token_count": 261,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Dopaminergic means related to dopamine. Dopamine constitutes approximately 80% of the **catecholamine** content within the brain. Dopamine is known to have an essential role in nearly all cognitive functions, including self-initiated motor control, motivation, and learning (Costa & Schoenbaum, 2022). Dopaminergic subst... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Dopaminergics**",
"token_count": 211,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Levodopa was introduced in the 1960s and has been a cornerstone of PD treatment for many years (Ovallath & Sulthana, 2017). Levodopa is a metabolic precursor of dopamine and is inactive until it undergoes conversion to its active state. This drug has proven to be extremely beneficial in the early stages of PD. Unfortun... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Dopaminergics**",
"Header 3": "**Levodopa**",
"token_count": 456,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Carbidopa is a dopamine decarboxylase inhibitor; combined with levodopa, levodopa's effects are enhanced. The drug inhibits decarboxylation of levodopa in the intestines and peripheral tissues. Therefore, less levodopa is converted into dopamine within the periphery, and more is available to cross the blood–brain barri... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Dopaminergics**",
"Header 3": "**Carbidopa/Levodopa**",
"token_count": 930,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Nausea and vomiting are common symptoms that usually disappear after a few months on levodopa/carbidopa. The symptoms are usually caused by activation of dopamine receptors in the chemoreceptor trigger zone, which contains receptors that detect emetic agents in the blood and relay that information to the vomiting cente... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Dopaminergics**",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 1675,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients who are taking dopaminergics:
- Encourage slow position changes to minimize postural hypotension.
- Assess neurological status, such as orientation, grip strength, gait, reflexes, tremors, or spasticity.
- Inform client that hallucinations and other psychotic behavior can... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Nursing Implications**",
"token_count": 328,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Dopamine agonists are first-line drugs in the treatment of mild to moderate PD. These drugs mimic the role of dopamine in the brain. Their duration is longer than compared with levodopa. They are relatively selective for D2 receptors. Activating these receptors causes increased dopamine levels in the nigrostriatal path... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Dopamine Agonists**",
"token_count": 892,
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Do not confuse ropinirole (dopamine agonist) with risperidone (antipsychotic).
(Source: ISMP, 2023)
[Table 11.5](#page-327-0) lists common dopamine agonists and typical routes and dosing for adult clients.
| Drug | Routes and Dosage Ranges ... | {
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"Header 2": "Similarly Named Drugs",
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Nonergot derivatives are known to produce unusual effects, such as compulsive gambling, hypersexuality, overspending, and overeating. These behaviors are dose related and will reverse when the drug is discontinued. Providers should screen for compulsive and addictive behaviors before starting medication. Also, clients ... | {
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"Header 2": "Similarly Named Drugs",
"Header 3": "**Adverse Effects and Contraindications**",
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The nurse should do the following for clients who are taking dopamine agonists:
- Measure blood pressure and heart rate in the supine and standing positions before and after dosing.
- Emphasize to the client/caregiver to maintain safety precautions because falling asleep can suddenly occur without feeling drowsy.
- M... | {
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"Header 2": "Similarly Named Drugs",
"Header 3": "**Nursing Implications**",
"token_count": 210,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Normally, the methylation of levodopa by COMT to 3-O-methyldopa is a minor pathway for levodopa metabolism; however, when peripheral dopamine decarboxylase is inhibited by carbidopa, the result is a significant increase of 3-O-methlydopa and the COMT pathway becomes more significant. This then competes with levodopa fo... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Catecholomethyltransferase (COMT) Inhibitors**",
"token_count": 689,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The nurse should do the following for clients who are taking COMT inhibitors:
- Monitor liver enzymes at baseline and throughout therapy as recommended.
- Monitor blood pressure with position changes due to the risk of orthostatic hypotension.
- Encourage and educate the client to be compliant with the required lab t... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**Catecholomethyltransferase (COMT) Inhibitors**",
"Header 3": "**Nursing Implications**",
"token_count": 217,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The nurse should do the following for clients who are taking dopamine antagonists:
- Ask about suicidal ideations, plan, and accessibility of their plan.
- Measure temperature for increases because client is at risk for infection due to reduction in white blood cell count, or it can indicate NMS.
- Monitor for an inc... | {
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"Header 2": "**Adverse Effects and Contraindications**",
"Header 3": "**Nursing Implications**",
"token_count": 204,
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- Immediately notify a support person or health care provider if having thoughts of harming self.
- Caregivers should be aware of indications that client is suicidal, such as giving treasured items away, social isolation, or increased happiness (because they have made the decision to carry out their plan).
- Move and c... | {
"Header 1": "CHAPTER 11 Drugs to Treat Parkinson's Disease and Multiple Sclerosis",
"Header 2": "**The client taking a dopamine antagonist should:**",
"token_count": 221,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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By the end of this section, you should be able to:
- 11.3.1 Describe the pathophysiology of multiple sclerosis.
- 11.3.2 Identify the clinical manifestations related to multiple sclerosis.
- 11.3.3 Identify the etiology and diagnostic studies related to multiple sclerosis.
Multiple sclerosis (MS) is a debilitating,... | {
"Header 1": "CASE STUDY",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 415,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
MS is an **autoimmune** disorder that occurs when there is a malfunction of the immune system and the body mistakenly attacks its own tissue. In this case, it attacks the myelin sheath of the CNS. The exact cause of MS has not yet been fully determined; however, it is believed a combination of factors are involved. Ris... | {
"Header 1": "CASE STUDY",
"Header 2": "**Etiology**",
"token_count": 249,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Autoreactive lymphocytes mediate the destruction in MS. T-lymphocytes are sensitized and reactive to protein on the myelin sheath. These overactive immune cells cause inflammation, which begins to damage the myelin. The damage occurs in diffuse patches throughout the CNS. The damage mainly affects the white matter and ... | {
"Header 1": "CASE STUDY",
"Header 2": "**Pathophysiology**",
"token_count": 286,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The course of MS is unpredictable. Signs and symptoms vary depending on severity and the specific nerves affected by the plaque. Some clients will have very little disability, whereas others experience a steady decline with increasing disability. Fever, sun exposure, and stress can trigger exacerbations. Characteristic... | {
"Header 1": "CASE STUDY",
"Header 2": "**Clinical Manifestations**",
"token_count": 685,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
There is currently no cure for MS; however, the use of drugs has made a significant difference in the lives of those with MS. Most of the drugs target specific symptoms, reduce relapse rates, and delay progression. In the most common form (relapsing-remitting), early initiation of medications is highly recommended. Sev... | {
"Header 1": "CASE STUDY",
"Header 2": "**Pharmacologic Management**",
"token_count": 200,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Interferons are proteins that are released in response to pathogens. Synthetic interferons have been made to resemble naturally occurring ones. These agents are important for treating viral infections, neoplasms, and autoimmune diseases such as MS. They have antiviral, antiproliferative, and immunomodulatory actions an... | {
"Header 1": "CASE STUDY",
"Header 2": "**Interferons**",
"token_count": 397,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- Report any signs of infection, such as a fever or sore throat.
- Avoid injuries. If one occurs, direct pressure should be applied to the affected area to control bleeding.
- Promote a balance of rest and exercise.
- Have the ability to correctly reconstitute and prepare the medication using aseptic technique.
- Rot... | {
"Header 1": "CASE STUDY",
"Header 2": "CLIENT TEACHING GUIDELINES",
"Header 3": "**The client taking an interferon should:**",
"token_count": 202,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Immunomodulators work by blocking the activity of specific cytokines, which promote autoimmune reactions and inflammation in MS. Immunomodulators are used for treating relapsing forms of MS (RRMS and active SPMS) and reducing the frequency of relapses and slowing down the accumulation of disabilities. Common immunomodu... | {
"Header 1": "CASE STUDY",
"Header 2": "**Immunomodulators**",
"token_count": 805,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients who are taking immunomodulators:
- Monitor the following lab values at baseline and routinely during therapy: ALT, aspartate aminotransferase (AST), serum bilirubin levels, CBC with differential.
- Observe for any signs and symptoms of infection and teach the client ways ... | {
"Header 1": "CASE STUDY",
"Header 2": "**Immunomodulators**",
"Header 3": "**Nursing Implications**",
"token_count": 200,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Monoclonal antibodies are derived from a single B-cell source. Cloning of individual B lymphocytes results in the production of biologically identical antibody molecules. These drugs must be administered intravenously because they are proteins and would get destroyed in the GI system if taken orally. A mouse or hamster... | {
"Header 1": "CASE STUDY",
"Header 2": "**Monoclonal Antibodies**",
"token_count": 932,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Initiation of S1P drug therapy results in a decrease in heart rate, for which monitoring is recommended. The nurse should administer the first dose in a setting in which resources to appropriately manage symptomatic bradycardia are available. Before dosing and at the end of the observation period, an ECG should be obta... | {
"Header 1": "CASE STUDY",
"Header 2": "**Sphingosine 1-Phosphate Receptor Modulators**",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 1413,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following when administering S1P receptor modulators:
- Before starting treatment, obtain serum transaminases (ALT and AST), total bilirubin, CBC, and pulmonary function (e.g., spirometry) if indicated.
- Before starting treatment, determine whether clients are taking drugs that could slow the... | {
"Header 1": "CASE STUDY",
"Header 2": "**Nursing Implications**",
"token_count": 228,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Dantrolene acts peripherally on the muscle itself. The drug inhibits the release of calcium from the sarcoplasmic reticulum directly within skeletal muscle cells. This action prevents the muscle fibers from contracting. Dantrolene does not interfere with neuromuscular transmission but does impair muscle strength. This ... | {
"Header 1": "CASE STUDY",
"Header 2": "**Muscle Relaxants**",
"Header 3": "**Peripherally Acting Muscle Relaxant**",
"token_count": 421,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Seizures may be slightly more common in people with MS due to the way the condition affects the brain. MS damages several parts of the brain, which can lead to disruptions in signal transmission. The scar tissue of an MS lesion creates a barrier to the transmission of nerve signals down a path. The flow of the nerve si... | {
"Header 1": "CASE STUDY",
"Header 2": "FDA BLACK BOX WARNING",
"Header 3": "**Gamma-Aminobutyric Acid Structural Analogs**",
"token_count": 736,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Hypersensitivity reactions have occurred with GABA structural analogs. Angioedema is characterized by swelling of the face, tongue, lips, gums, throat, and larynx. The drug should immediately be discontinued at the first sign of angioedema or other hypersensitivity reaction, such as hives, rash, wheezing, or dyspnea. W... | {
"Header 1": "CASE STUDY",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 741,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- **akathisia** psychomotor restlessness; an intense sensation of uneasiness or inner restlessness that usually involves the lower extremities and results in a compulsion to move
- **alpha-synuclein** neuronal protein that regulates synaptic vesicle coordination and subsequent neurotransmitter release
- **anhidrosis** ... | {
"Header 1": "CASE STUDY",
"Header 2": "**Key Terms**",
"token_count": 2023,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- 12.1 [Epilepsy and Anticonvulsant Drugs](#page-365-0)
- 12.2 [Migraine Headaches and Migraine Headache Drugs](#page-383-0)
- 12.3 [Intracranial Emergencies and Intracranial Emergency Drugs](#page-390-0)
**INTRODUCTION** The brain, one of the most important organs of the body, controls and coordinates all bodily fun... | {
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Seizures can have various causes such as fever, head injury, brain infection, drug or alcohol withdrawal or overdose, electrolyte imbalances, and metabolic disorders. Seizures may also result from brain tumors or masses, stroke, or other neurological conditions. Sometimes the cause of a seizure cannot be identified—a c... | {
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A **seizure** occurs when there is a sudden and abnormal burst of electrical activity in the brain. This activity can
disrupt normal brain function and lead to a variety of symptoms, such as **convulsions**, loss of consciousness, and sensory or motor disturbances (Centers for Disease Control and Prevention, 2020a, 2... | {
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Clinical manifestations of seizures can vary depending on the type of seizure a person is experiencing. There are several types of seizures, but they are generally classified into two groups: **generalized seizures** and **focal seizures**.
Generalized seizures involve abnormal activity in both sides of the brain fro... | {
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"Header 2": "**Clinical Manifestations**",
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Drugs that are used to treat epilepsy and seizures are generally termed **anticonvulsant drugs**. Anticonvulsant drugs are used to either control acute seizures or as maintenance to prevent seizures from occurring. Other drug classifications, such as some central nervous system depressants and mood stabilizers, have al... | {
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Hydantoins are a class of anticonvulsant drugs that are used to prevent or control seizures. Hydantoins can reduce the occurrence and severity of seizures by stabilizing the neuronal membrane in the brain. Some commonly prescribed hydantoins include phenytoin and fosphenytoin. Although hydantoins can be effective in co... | {
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"Header 2": "**Hydantoins**",
"token_count": 1016,
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Barbiturates are a class of drugs that act as central nervous system depressants, leading to sedation and relaxation. Barbiturates work by enhancing the actions of **Gamma-aminobutyric acid (GABA)**, the neurotransmitter that slows down brain activity. GABA is boosted by barbiturates, making them useful as sedatives, h... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "**Hydantoins**",
"Header 3": "**Barbiturates**",
"token_count": 847,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Benzodiazepines are a class of drug that act on the benzodiazepine receptors (BZ-Rs) in the central nervous system. They work by enhancing the activity of the neurotransmitter GABA, which is inhibitory and slows brain activity. Dosing is individualized and depends on the drug being used. Benzodiazepines such as clonaze... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "**Hydantoins**",
"Header 3": "**Benzodiazepines**",
"token_count": 967,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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The [National Institute on Drug Abuse \(NIDA\)](https://openstax.org/r/nidanih) (https://openstax.org/r/nidanih) is the leading federal agency supporting scientific research on substance use disorders. The NIDA provides research, education, and training resources and plays a role in the [National Institute of Health HE... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "(Source: Jahan & Burgess, 2022)",
"token_count": 212,
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Iminostilbenes are a class of anticonvulsant drug in which the compounds are structurally related to cyclic antidepressants. This class of drug shows efficacy in the first-line treatment for seizures. Iminostilbenes inhibit neuronal excitability by enhancing GABA; this drug requires therapeutic monitoring. Adverse reac... | {
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"Header 2": "(Source: Jahan & Burgess, 2022)",
"Header 3": "**Iminostilbenes**",
"token_count": 1180,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Valproates are anticonvulsants and mood stabilizers used in the treatment of seizures and bipolar disorder. Valproates act on GABA levels in the central nervous system, blocking voltage-gated sodium, potassium, and calcium ion channels causing decreasing brain activity. Adverse reactions include headache, somnolence, d... | {
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"Header 2": "**Valproates**",
"token_count": 876,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Pyrrolidine derivatives are novel anticonvulsant drugs used to treat seizures that were FDA approved in 2000. Pyrrolidine derivatives come in IV and oral formularies. Adverse effects include abdominal pain, nausea, anorexia, leukopenia, headache, mood swings, fatigue, somnolence, confusion, and increased risk for suici... | {
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"Header 2": "FDA BLACK BOX WARNING",
"Header 3": "**Pyrrolidine Derivatives**",
"token_count": 1079,
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There are many other anticonvulsants on the market; novel drugs continue to appear as treatment options improve. [Table 12.9](#page-380-0) lists common anticonvulsant drugs and typical routes and dosing for adult and pediatric clients.
| Drug | Class and<br>Indication ... | {
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Triptans are **serotonin agonists** that target the pathophysiological mechanism of migraine headaches, effectively eliminating symptoms. By selectively binding to serotonin receptors 5-HT1B and 5-HT1D, triptans induce vasoconstriction of cranial arteries that are typically dilated during migraines. The vasoconstrictio... | {
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"Header 2": "**Triptans**",
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Adverse effects of triptans include dizziness, nausea, flushing, tingling, neck pain, chest tightness, and paresthesia. Triptans are contraindicated in clients with a history of myocardial infarction, coronary artery disease, stroke, uncontrolled hypertension, and peripheral vascular disease (Nicholas & Nicholas, 2023)... | {
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In adults, the brain has a constant volume, but the amount of **cerebrospinal fluid** and blood in the skull changes regularly to control pressure in the brain. Cerebrospinal fluid is produced by the brain and absorbed by the veins in the skull. Normal cerebrospinal fluid pressure varies with age but generally should n... | {
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"Header 2": "**Intracranial Emergency Overview**",
"token_count": 435,
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Intracranial hypertension and increased intracranial pressure are related conditions, but they have distinct differences. Intracranial hypertension refers specifically to an elevated pressure within the skull that may or may not cause symptoms. However, increased intracranial pressure refers to a rise in the pressure w... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "**Intracranial Emergency Overview**",
"Header 3": "**Intracranial Hypertension and Increased Intracranial Pressure**",
"token_count": 332,
"source_pdf": "datasets/websour... |
Intracranial hypertension and increased intracranial pressure can be diagnosed with these tests:
- Neurologic assessment: A physical examination of the client's neurological function can provide information about the presence of increased pressure or fluid within the skull and brain.
- Radiologic imaging: CT and MRI ... | {
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"Header 3": "**Diagnostic Testing**",
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Clinical manifestations of intracranial hypertension and increased intracranial pressure can vary depending on the underlying cause and the individual client factors. A thorough evaluation by a health care provider is necessary to accurately diagnose and manage these conditions.
Clinical manifestations of intracrania... | {
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"Header 2": "LINK TO LEARNING",
"Header 3": "**Clinical Manifestations**",
"token_count": 224,
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The health care provider selects drugs to treat intracranial hypertension and increased intracranial pressure based on the underlying cause and severity of the condition. For example, in some cases of **cerebral edema**, osmotic diuretics or carbonic anhydrase inhibitors (CAIs) may be used to reduce brain swelling and ... | {
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"Header 2": "**Drugs Used for Intracranial Emergencies**",
"token_count": 236,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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CAIs are a class of drugs that are commonly used to treat a range of conditions, including intracranial hypertension, altitude sickness, and glaucoma. In managing intracranial emergencies, CAIs work by blocking carbonic anhydrase on the luminal membrane and inside the proximal renal tubule, which results in a reduction... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "**Drugs Used for Intracranial Emergencies**",
"Header 3": "**Carbonic Anhydrase Inhibitors (CAIs)**",
"token_count": 271,
"source_pdf": "datasets/websources/Med_v1/med_te... |
Caution is advised for client's receiving concomitant high-dose aspirin and acetazolamide, as anorexia, tachypnea, lethargy, metabolic acidosis, and death have been reported.
The most common CAI prescribed for intracranial hypertension is acetazolamide (Farzam & Abdullah, 2022). [Table](#page-393-0) [12.15](#page-393... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "SAFETY ALERT",
"Header 3": "Aspirin and Acetazolamide",
"token_count": 614,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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Osmotic diuretics are a class of drugs that primarily function by inhibiting the reabsorption of water in the proximal convoluted tubule, the descending loop of Henle, and the collecting duct, all of which are regions of the kidney that are highly permeable to water. In addition to this mechanism, osmotic diuretics als... | {
"Header 1": "CHAPTER 12 Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies",
"Header 2": "SAFETY ALERT",
"Header 3": "**Osmotic Diuretics**",
"token_count": 985,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
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- 13.1 [Antidepressants](#page-401-0) 13.2 [Antipsychotics](#page-413-0) 13.3 [Mood Stabilizers](#page-422-0) 13.4 [Anxiolytics and Sedative-Hypnotics](#page-425-0)
- 13.5 [CNS Stimulants and Nonstimulants](#page-433-0)
**INTRODUCTION** Nursing care of clients includes physical, spiritual, cultural, psychosocial, and... | {
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"Header 2": "**CHAPTER OUTLINE**",
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By the end of this section, you should be able to:
- 13.1.1 Identify the characteristics of drugs used to treat depression.
- 13.1.2 Explain the indications, actions, adverse reactions, and interactions of drugs used to treat depression.
- 13.1.3 Describe nursing implications of drugs used to treat depression.
- 13.1... | {
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"token_count": 419,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Tricyclic antidepressants block acetylcholine (muscarinic) receptors; therefore, blurred vision, dry mouth,
constipation, and urine retention are common due to the anticholinergic properties. In addition, because they block histamine receptors, sedation and weight gain occur. Due to the blockade of alpha-1 adrenergic... | {
"Header 1": "CHAPTER 13 Psychopharmacologic Drugs",
"Header 2": "**Tricyclic Antidepressants (TCAs)**",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 777,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
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