Pharmacology Lecture: Neurological Medications

Introduction

• Professor D: Welcome back to the lecture on pharmacology, specifically focusing on neurological medications.
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Key Points

Urinary Retention Medication - Bethanechol (Urecholine)

• Correct Intervention: Have the client's urinal readily available.
  • Reason: Medication causes relaxation of the bladder sphincter and contraction of the detrusor muscle.
• Incorrect Interventions:
  • Limiting fluid intake can cause dehydration.
  • Monitoring serum creatinine is irrelevant here.

Atropine Usage

• Contraindication: Atropine is contraindicated in clients with glaucoma.
  • Reason: Causes pupil dilation, increasing intraocular pressure.
• Correct Uses:
  • For symptomatic sinus bradycardia.
  • Pre-surgery to dry secretions or control heart rate.
  • Does not cause issues with diarrhea.

Obesity and Appetite Suppressants

• Key Question: Ask if client has been taking over-the-counter appetite suppressants.
  • Symptoms: Nervousness, irritability, insomnia, heart palpitations.

Neuromuscular Blocker - Tubocurarine

• Important Data: Client's respiratory rate is 10, indicating need for intervention.
  • Reason: Medication relaxes skeletal muscles, may depress breathing further.

Epilepsy Medication - Phenytoin (Dilantin)

• Rash Alert: Measles-like rash requires immediate clinic visit for possible anaphylactic reaction.

Parkinson's Disease Medication - Amantadine (Symmetrel)

• Skin Discoloration: Mottled skin discoloration is expected, benign, resolves post-medication.

Alzheimer's Disease Management

• Medication: Antipsychotic like Haldol for agitation and delusions.
  • Not Recommended: Cholinesterase inhibitors (for early stages), SSRIs, TCAs.

Post-surgery Order - Selegiline (Eldepryl) and Meperidine (Demerol)

• Adverse Reaction: Selegiline and Demerol together cause hyperthermia, muscle rigidity, stupor.

Epilepsy Remission: Discontinuation

• Tapering Off: Gradual tapering of anti-epileptic drugs over six weeks, not abrupt cessation.

Aspirin for TIA in Clients with Gastric Ulcer

• Instruction: Take enteric-coated aspirin to prevent stomach dissolution and ulcer aggravation.

Severe Head Injury - Mannitol

• Ineffective Sign: Flaccid paralysis to pain indicates medication inefficacy.

Migraine Headache - Sumatriptan (Imitrex)

• Action: Administer after allergy check, regardless of patient's observable behavior.

Muscarinic Poisoning

• Atropine: Administered as antidote for suspected muscarinic poisoning from wild mushroom ingestion.

Serum Dilantin Level Low

• First Action: Ask the client when the last dose was taken to assess compliance.
  • Therapeutic Range: 10-20; current level is sub-therapeutic.

Post-CVA Headache Intervention

• Order of Actions: Assess neural status, ask pain level, confirm identity, administer medication.

Vertigo Medication - Meclizine (Antivert)

• Intervention: Question alcohol use due to CNS depressant effects.

Conclusion

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