‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
Drug Name
Family
Actions
Indications
Chapter:
Digoxin
Adverse Effects:
Headache, weakness,
drowsiness, visual
disturbances,
arrhythmias, GI upset.
‫ﻓﻲ اﻟﻌﻼج اﻟﺷﻌﺑﻲ واﻟﺑدﯾل‬
(St. John’s wort )and
(psyllium )decrease the
effectiveness of digoxin;
this combination should
be
avoided.
ginseng, hawthorn,
and licorice increased
digoxin toxicity.
Licorice (acts as a
pseudoaldosterone in
the body, leading to
loss of potassium and
retention of sodium and
water. ‫اﻟﺟﻣﻊ ﺑﯾﻧﮭم ﯾودي‬
‫ﻟﺗﺳﻣم ﯾﺟب ان ﻧﺗﺟﻧب اﻟﺟﻣﻊ‬
Digoxin Antidote:
Digoxin Immune
Fab
Cardiac
Glycosides◌ً
Increases
intracellular calcium
and allows calcium to
enter the myocardial
cell during
depolarization; this
causes a positive
inotropic effect
(increased force of
contraction),
increased renal
perfusion with a
diuretic effect and
decrease in renin
release, a negative
chronotropic effect
(slower heart rate),
and slowed
conduction through
the AV node.
Treatment of
HF, atrial
fibrillation.
Digoxin immune Fab
(DigiFab) is an
antigen-binding
fragment (Fab)
derived from specific
antidigoxin
antibodies.
Digoxin immune Fab
is used for the
treatment of lifethreatening digoxin
intoxication (serum
levels >1O ng/mL
with serum
potassium >5 mtq/L
in a setting of
digoxin intoxication)
and potential lifethreatening digoxin
overdose.
Pharmacokinetics
Route
Onset
Peak
Duration
Metabolism
Excretion
T1/2
, Drug Agents Acting on:
‫ﻣواﻧﻊ اﻻﺳﺗﻌﻣﺎل‬
Allergy –
Ventricular
tachycardia or
fibrillation, heart
block, or sick
sinus syndrome –
Idiopathic
hypertrophic
subaortic stenosis
– Acute MI, renal
insufficiency, and
electrolyte
abnormalities
‫اﻟﻛوﺷن‬
Pregnancy and
lactation –
Pediatric and
geriatric patients
Serum digoxin
levels will be
very high and
unreliable for
about 3 days
after the
digoxin
immune Fab
infusion
because of
the high levels
of digoxin in
the blood.
The patient
should not be
redigitalized
for several
days to 1
week after
30 to 40
hours;
largely
excreted
unchang
ed in
urine
, Rapidly
absorbed
and
widely
distribute
d
througho
ut the
body –
Primarily
excreted
unchang
ed in the
urine‫د‬
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
Lidocaine
Class I
Antiarrhythmic
Decreases
depolarization,
decreasing automaticity of the
ventricular cells;
increases ventricular
fibrillation threshold.
Management
of acute
ventricular
arrhythmias
during cardiac
surgery or MI.
Class II
Antiarrhvthmic
Competitively blocks
beta-adrenergic receptors
in the heart and kidney,
has a membranestabilizing effect, and
decreases the influence of
the sympathetic nervous
system.
Treatment of
cardiac arrhythmias,
espe- cially
supraventricular
tachycardia;
treatment of
ventric- ular
tachycardia induced
by digitalis or
catecholamines.
Class IV
Antiarrhythmi
c
Blocks the movement of
calcium ions across the cell
membrane, depressing the
generation of action
potentials, delaying phases 1
and 2 of repolarization, and
slowing conduction through
the AV node.
Treatment of
paroxysmal
supraventricular
tachycardia, atrial
fibrillation, and
atrial flutter.
HMG-COA
Inhibitors
Inhibits HMG-CoA,
causing a decrease in
serum cholesterol
levels, LDLS, and
triglycerides and an
increase in HDL
levels.
Antiplatelets
Inhibits platelet
aggregation by
inhibiting platelet
Adjunct to diet in the treatment
of elevated levels of cholesterol,
triglycerides, and LDL; to
increase HDL cholesterol in
patients with primary
hypercholesterolemia;
treatment of boys and postmenarchal girls aged 10 to 17 years
with familial hypercholesterolemia and two or
more risk factors for CAD;
prevention of CAD in adults
without clinically evident heart
disease but with multiple risk
factors to reduce the risk for CV
events.
Reduction of risk of recurrent
TIAS or strokes in men with a
history of TIA due to fibrin or
platelet emboli; reduction of
death or nonfatal MI in patients
with a history of infarction or
unstable angina; MI prophylaxis;
also used for its
Adverse Effects:
Dizziness, lightheadedness, fatigue,
arrhythmias, cardiac
arrest, nausea, vomiting,
anaphy- lactoid
reactions, hypotension,
vasodilation.
Propranolol
Adverse Effects:
Bradycardia, heart
failure, cardiac
arrhythmias, heart
blocks, cerebrovascular
accident, pulmonary
edema, gastric pain,
flatulence, nausea,
vomiting, diarrhea,
impotence, decreased
exercise tolerance,
antinuclear antibody
development.
Diltiazem
Adverse Effects:
Dizziness, lightheadedness, head- ache,
asthenia, peripheral
edema, bradycardia, AV
block, flushing, nausea,
hepatic injury.
Atorvastatin
Adverse Effects:
Headache, flatulence,
abdominal pain,
cramps, constipation,
rhabdomyolysis with
acute renal failure.
Aspirin
Adverse Effects: Acute aspirin
toxicity with hyper- pnea,
possibly leading to fever, coma,
and CV col- lapse; nausea,
dyspepsia, heartburn, epigastric
discomfort, GI bleeding, occult
digoxin
immune
10
minutes,
then 1.5
to 3
hours;
metaboli
zed in
the liver
and
excreted
in the
urine.
3 to 5
hours;
metaboli
zed in
the liver
and
excreted
in the
urine
3.5 to 6
hours;
metaboli
zed in
the liver
and
excreted
in the
urine.
14 hours;
metaboli
zed in
the liver
and cells
and
excreted
the bile.
– Well absorbed
and bound to
plasma proteins
– Metabolized
in the liver and
15
minutes to
12 hours,
metabolize
d in the
liver and
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
blood loss, dizzi- ness, tinnitus,
difficulty hearing, and
anaphylactoid reaction.
Heparin
Adverse Effects: Loss of hair,
bruising, chills, fever,
osteoporosis, and
suppression of renal
function (with long-term
use). See "Anticoagulant
Adjunctive Therapy" for
information on lepirudin
(Refliudan), a drug
developed for the
treatment of rare allergic
reac- tion to heparin.
Anticoagulant
s
synthesis of
thromboxane A2.
Inhibits thrombus
and clot production
by blocking the
conversion of
prothrombin to
thrombin and
fibrinogen to fibrin.
Captopril
ACE Inhibitors
Adverse Effects:
Tachycardia, MI, rash,
pruritus, gas- tric
irritation, aphthous
ulcers, peptic ulcers,
dysgeusia, proteinuria,
bone marrow
suppression, cough.
Cause Renal impirment
( ‫وﻧﺣدده ﻋن طرﯾق‬serum
creatinine
Losartan
Angiotensin II
Receptor Blockers
‫اﻟﺧط اﻷول ﻟﻌﻼج ارﺗﻔﺎع‬
‫اﻟﺿﻐط وﺧﺎﺻﮫ ﻣرﺿﻰ‬
‫اﻟﺳﻛر واﺿطراب اﻟﻛﺑد‬
‫وﻣرﺿﻰ اﻟﻘﻠب‬
Selectively blocks the binding
of angiotensin II to specific
tissue receptors found in the
vascular smooth muscle and
adrenal glands; blocks the
vasoconstriction and release
of aldosterone associated
with the RAAS.
Calcium
Channel
Blockers
Adverse Effects:
Dizziness, headache,
diarrhea, abdominal
pain, symptoms of upper
respiratory tract
infection, cough, back
pain, fever, muscle
weakness, hypotension.
Diltiazem
Adverse Effects:
Dizziness, lightheadedness, head- ache,
peripheral edema,
bradycardia,
atrioventricular block,
flushing, nausea.
Furosemide
Adverse Effects: Dizziness,
vertigo, paresthesias,
orthostatic hypotension,
‫ ﻟذاﻟك‬cause hyperkalemia
‫ﻻزم ﻧراﻗب اﻟﺑوﺗﺎﺳﯾوم‬
Related to effects on
cardiac output
– GI symptoms –
Cardiovascular
symptoms
Diuretics
‫اﺳﺗﺧداﻣﮭﺎ اﻟﺷﺎﯾﻊ‬
– Congestive heart failure –
Hypertension – Renal
failure – Edema.
antiinflammatory, analgesic, and
antipyretic effects.
Prevention and
treatment of venous
thrombosis and PE,
treatment of AF
with emboliza- tion,
diagnosis and
treatment of DIC,
prevention of
clothing in blood
samples and
heparin lock sets.
Indications
Treatment of
hypertension, heart
failure, diabetic
nephropathy, and
left ventricular
dysfunction after an
MI.
excreted in the
urine
excreted
in the
urine.
. 30 to
180
minutes,
metaboli
zed in
the cells
and
excreted
in the
urine.
2
hours;
excret
ed in
the
urine.
•
Contraindicati
ons: Allergies
impaired
renal function
- Pregnancy
and lactation
• Caution:
CHF
(Congestive
Heart Failurek
Alone or as part of
combination therapy
for the treatment of
hypertension;
treatment of diabetic
nephropathy with an
elevated serum
creatinine and proteinuria in patients
with type 2 diabetes
and hypertension.
‫اﻟﻧﯾراﻧﻲ ﻛوﻧﺳدرﺷﯾن‬
allergy – Impaired
kidney function,
pregnancy and
lactation –
Salt/volume
depletion and heart
failure – Baseline
status before
beginning therapy,
including – VS, LS, BS,
weight, skin, ECG,
CBC with differential
and electrolytes
Contraindicati
ons - Allergy,
pregnancy,
and lactation
– History and Physical
Exam
– Known allergy
– Impaired renal and
hepatic
function, pregnancy and
lactation
– Hypovolemia, assess
baseline
status before beginning
therapy
including, skin, VS, LS,
baseline
ECG and renal and
function tests
2 hours,
then 6 to 9
hours;
metabolize
d in the
liver and
excreted
in urine
and feces.
Inhibits the movement of
calcium ions across the
membranes of cardiac and
arterial muscle cells.
depressing the impulse and
leading to slowed conduction, decreased myocardial
contractility, and dilation of
arterioles, which lowers BP
and decreases myocar dial
oxygen consumption.
Treatment of
essential
hypertension in the
extended-release
form.
Contraindi
cations Allergy,
heart
block or
sick sinus
syndrome,
renal or
hepatic
dvsfunctio
n,
pregnancy
, and
lactation
‫اﻟﺗﻔﺎﻋﻼت‬
‫اﻟﻐذاﺋﯾﮫ اﻟدواﺋﯾﮫ‬
5 to 7
hours;
metaboli
zed in
the liver
and
excreted
in the
urine.
Inhibits the reabsorption of
sodium and chloride from the
distal renal tubules and the
loop of Henle, leading to a
Treatment of edema
associated with HF,
acute pulmonary
Blocks ACE from converting
angiotensin I to angiotensin
II, leading to a decrease in
BP, a decrease in aldosterone
production, and a small
increase in serum potassium
levels along with sodium and
fluid loss.
• Caution
Hepatic or
renal
dysfunction,
and
hypovolemia
Grapefruit
juice\‫اﻗﯾم‬
– History and
Physical Exam
– Known allergy
– The main use of
calcium-channel
blockers is for the
treatment of
angina.
‫اﻻﺛﺎر اﻟﺳﻠﺑﯾﮫ ﻟدﯾورﺗك‬
Hypokalemia
Hyponatremia –
Dehydration –
Postural
120
minutes;
metabolize
d in the
liver and
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
rash, urticaria, nausea,
anorexia, vomiting,
glycosuria, urinary bladder
spasm.
Pseudoephedrine
Adverse Effects: Anxiety,
restlessness, headache,
diz- ziness, drowsiness,
vision changes, seizures,
hyperten- sion,
arrhythmias, pallor,
nausea, vomiting,
urinary retention,
respiratory difficulty.
Theophylline
Adverse Effects: Fear,
anxiety, restlessness,
headache, nausea,
decreased renal
formation, pallor,
palpitation, tachycardia,
local burning and
stinging, rebound congestion with nasal
inhalation.
Ipratropium
Adverse Effects:
Nervousness, dizziness,
headache, nausea, GI
distress, cough,
palpitations.
Cimetidine
Adverse Effects: Gastric
rupture, systemic
alkalosis (headache,
nausea, irritability,
weakness, tetany, confusion), hypokalemia
excreted
in the
urine.
edema,
hypertension.
Oral
Decongestants
Sympathomimetic effects,
causes vasocon- striction
in mucous membranes of
nasal passages resulting in
their shrinkage, which
promotes drainage and
improvement in
ventilation.
Temporary relief of
nasal congestions
caused by the
common cold, hay
fever, sinusitis; promotion of nasal and
sinus drainage;
relief of eustachian
tube congestion.
Xanthines
Directly relaxes bronchial
smooth muscle, causing
bronchodilation and
increasing vital capacity; also
increases force of
diaphragmatic muscle.
Symptomatic relief
or prevention of
bron chial asthma
and reversible
bronchospasm
associated with
chronic bronchitis
and emphysema.
Sympathomimetics
Reacts at alpha- and betareceptor sites in the
sympathetic nervous system
to cause bronchodilation,
increased heart rate,
increased respiratory rate,
and increased blood
pressure.
Treatment of
anaphylactic
reactions, acute
asthmatic attacks;
relief from
respiratory distress
of COPD and
bronchial asthma
Anticholinergi
cs
Anticholinergic that
blocks vagally
mediated reflexes by
antagonizing the
action of
acetylcholine.
Maintenance
treatment of
bronchospasm
associated with
chronic obstructive
pulmonary disease;
treatment of
seasonal allergic
rhinitis as a nasal
spray.
Unknown
;
metaboli
zed by
neural
pathways
.
Histamime-2 (H2)
Antagonists
. Actions: Inhibits the
actions of histamine at Hz
recep- tor sites of the
stomach, inhibiting gastric
acid secre- tion and
reducing total pepsin
output.
Short-term treatment of
active duodenal or benign
gastric ulcers; treatment of
pathological
hypersecretory conditions;
prophylaxis of stressinduced ulcers; treatment
of erosive gastroesophageal reflux; relief of
hours,
metaboli
zed in
the liver
and
excreted
in the
urine.
Adverse Effects:
Irrtability, restlessness,
dizziness, pal pitations,
life-threatening
arrhythmias, loss of
appetite proteinuria,
respiratory arrest, fever,
flushing.
Epinephrine
hypotension –
Hyperglycemia
sodium-rich diuresis.
Pharmacokinetics:
Block the release of
hydrochloric acid in
response to gastrin
7 hours;
metabolize
d in the
liver and
excreted
in the
urine.
Contraindication
s: - GI problems,
coronary
disease,
respiratory
dysfunction,
renal or hepatic
disease,
alcoholism, or
hyperthyroidism
About 8
hours for
oral but
may vary
per
population and
type of
formulati
on.
Unknown
;
metaboli
zed by
normal
neural
pathways
.
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
symptoms of heartburn
and acid indigestion.
(secondary to
intracellular shifting of
potassium), gastric acid
rebound.
Sodium
Bicarbonate
Adverse Effects: Gastric
rupture, systemic
alkalosis (headache,
nausea, irritability,
weakness, tetany, confusion), hypokalemia
(secondary to
intracellular shifting of
potassium), gastric acid
rebound.
Omeprazole
Adverse Effects:
Headache, dizziness,
vertigo, insom- nia,
rash, diarrhea,
abdominal pain,
nausea, vomiting,
upper respiratory
infection symptoms,
cough.
Insulin
Adverse Effects:
Hypersensitivity
reaction, local
reac- tions at
injection site,
hypoglycemia,
ketoacidosis.
Antacids
group of
inorganic
chemicals that
neutralize
stomach acid
Protom Pump
Inhibitors
Suppress the
secretion of
hydrochloric acid
into the lumen of
the stomach
Neutralizes or
reduces gastric
acidity, result- ing in
an increase in gastric
pH, which inhibits
the proteolytic
activity of pepsin.
Actions: Specifically
inhibits the H*, K*ATPase enzyme system
on the secretory
surface of gastric parietal cells, blocking the
final step in acid
production and
decreasing gastric acid
levels.
Hypoglycemic Actions:
Medications#1 Replacement of
endogenous insulin.
.
Glyburide
Diabeta)
Sulfonylureas
Actions: Stimulates insulin release
from functioning beta cells in the
Symptomatic relief
of upset stomach
from hyperacidity;
prophylaxis for GI
bleeding and stress
ulcers; adjunctive
treatment of severe
diarrhea; also used
for treatment of
metabolic acidosis;
may also be used to
treat certain drug
intoxications to
minimize uric acid
crystallization.
Short-term
treatment of active
duode- nal ulcer or
active benign gastric
ulcer; treatment of
heartburn or
symptoms of
gastroesophageal
reflux; treatment of
pathological
hypersecretory
syndromes;
eradication of
Helicobacter pylori
infection as part of
combination
therapy.
Treatment of type 1
diabetes; treatment
of type 2 diabetes
when other agents
have failed; shortterm treatment of
type 2 diabetes
during periods of
stress; management
of diabetic
ketoacidosis,
hyperka- lemia, and
marked insulin
resistance.
.
Indications: Adjunct to diet
and exercise in the man-
Caution Any
condition
that can
be
exacerbat
ed by
electrolyte
imbalance
GI
obstructio
n
Unkno
wn;
excret
ed
uncha
nged
in the
urine
30 to 60
minutes
;
metabol
ized in
the liver
and
excrete
d in the
urine
and bile.
T/2:
Varies
with
each
prepara
tion;
metabol
ized at
the
cellular
level.
.
4 hours;
metabolized
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
pancreas; may improve insulin
bind- ing to insulin receptor sites
or increase the number of insulin
receptor sites.
agement of type 2
diabetes; with metformin
or insulin for stabilization
of diabetic patients.
Antidiabetic
Agents
in the liver
and
excreted in
the bile and
urine.
Actions: DPP-4 inhibitor,
slows the breakdown of
GLP-1 which leads to
increased insulin release,
decresed glucagon release
and slowed Gl absorption.
Pharmacokinetics:
Indications:
Adjunct to diet
and exercise for
the treatment of
type 2 diabetes.
12.4
hours;
metaboli
zed in
the liver
and
excreted
in the
urine.
Antidiabetic
Agents
Actions: May
increase the
peripheral use of
glucose, increase
production of insulin,
decrease hepatic
glucose production,
and alter intestinal
absorption of
glucose.
Indications:
Adjunct to diet
and exercise for
the treat- ment of
type 2 diabetics
older than 10
years of age;
extended release
form for patients
older than 17
years of age;
adjunct treatment
with polycystic
ovary syndrome.
6.2 and
then 17
hours;
metabol
ized in
the liver
and
excrete
d in the
urine.
Glucocorticoid
s
Actions: Enters target
cells and binds to
intracellular
corticosteroid
receptors, initiating
many complex reactions responsible for
its antiinflammatory
and immunosuppressive effects
Indications:
Replacement
therapy in adrenal
corti- cal
insufficiency,
short-term
management of
various
inflammatory and
allergic disorders,
hypercalcemia
associated with
cancer,
hematological
disorders, ulcerative colitis, acute
exacerbations of
multiple sclerosis,
palliation in some
leukemias,
trichinosis with
Adverse Effects: GI discomfort,
anorexia, nausea, vomiting, heartburn,
diarrhea, allergic skin reactions,
hypoglycemia.
Januvia
( Sitagipin)
Advere Efer.
Hypoglycemia,
headache, vomiting,
acute pancreatitis.
Glucophage
(Metformin)
Adverse Effects:
Hypoglycemia,
lactic acidosis, GI
upset, nausea,
anorexia,
diarrhea,
heartburn,
allergic skin
reaction.
Prednisone
Adverse Effects:
Vertigo,
headache,
hypotension,
shock, sodium
and fluid
retention,
amenorrhea,
increased
appetite, weight
gain,
immunosuppressi
on, aggravation
or masking of
infections,
Pharmaco
kinetics:
Well
absorbed
from
many
sites
Metaboliz
ed by
natural
systems;
mostly
within the
liver
Excreted
in the
Contraindic
ations:
Known
allergy
Acute
infection
Lactation
Caution:
Diabetes
Acute peptic
ulcerl ...
3.5
hours;
metab
olized
in the
liver
and
excret
ed in
the
urine
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
impaired wound
healing
systemic
involvement
Aspirin
Salicylates
Adverse Effects:
Nausea,
vomiting,
heartburn,
epigastric
discomfort,
occult blood
loss, dizziness,
tinnitus,
acidosis.
– Can block
the
inflammatory
response –
Have
antipyretic
properties
(feverblocking) –
Have analgesic
(pain-blocking)
properties
Acetaminophen
Nonsteroidal
Antiinflammatory
and Related
Agents‫ت‬
Adverse EffectsHeadache,
hemolytic
anemia, renal
dysfunction,
skin rash and
fever
Hepatotoxicity
usually
associated with
chronic use and
overdose
Diazepam
Adverse Effects: Mild
drowsiness, depression,
lethargy, apathy, fatigue,
restlessness, bradycardia,
tachycardia, constipation,
Actions: Inhibits the
synthesis of
prostaglandins;
blocks the effects of
pyrogens at the
hypothalamus
inhibits platelet
aggregation by
blocking
thromboxane A2.
Actions- - Acts directly on
the thermoregulatory
cells of the hypothalamus
Mechanism of action
unknown but related to
analgesic effects
• Used to treat pain and
fever- Treat pain and
fever associated with
conditions, variety of
including influenza
=Prophylaxis of children
receiving diphtheriapertussis-tetanus (DPT)
immunizations
.=Relief
associated with arthritis
of musculoskeletal pain
Benzodiazepines
diarrhea, incontinence,
urinary retention,
changes in libido, drug
dependence with
withdrawal syndrome
Actions: Acts in the limbic system and
reticular formation to potentiate the
effects of GABA, an inhibitory
neurotransmitter; may act in spinal
cord and supraspinal sites to produce
muscle relaxation.
Indications:
Treatment of
mild to
moderate
pain, fever,
inflammatory
conditions;
reduction of
risk of
transient
ischemic
attack or
stroke;
reduction of
risk of
myocardial
infarction.
Drug-Drug
Interactions…Oral
anticoagulants
increase
bleeding
…Hepatotoxic
ity with
barbiturates,
carbamazepin
e, hydantoins,
or rifampin
Indications: Management
of anxiety disorders, acute
alcohol withdrawal,
muscle relaxation.
preoperative relief of
anxiety and tension.
urine
palim .
15
minut
es to
12
hours;
metab
olized
in the
liver
and
excret
ed in
the
urine.
Contraindic
ationsKnown
allergy Use
with
caution
Hepatic
dysfunction
Pharmacokineti
cs Absorbed
from GI Peak ½
to 2 hours
Metabolized in
the - Excreted in
the urine
20 to 80
hours;
metabolized
in the liver,
excreted in
urine.
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
Barbiturates Used as
Anxiolytic-Hypnotics
Actions: Inhibits conduction in the
ascending RAS; depresses the cerebral
cortex; alters cerebellar function;
depresses motor output; can produce
excitation, sedation, hypnosis,
anesthesia, and deep coma; and has
anticonvulsant activity.
Indications: Sedation,
short-term treatment of
insomnia, long-term
treatment of tonic-clonic
seizures and cortical focal
seizures, emergency
control of certain acute
convulsive episodes,
preanesthetic.
79 hours;
metabolized
in the liver,
excreted in
urine.
Hydantoins
Actions: Stabilizes
neuronal membranes and
prevents hyperexcitability
caused by cardiac
antiarrhythmic effects
similar to those of
lidocaine.
Indications: Control of
6 to 24
hours;
metabolized
in the liver,
excreted in
the urine.
Direct-Acting Skeletal
Muscle Relaxants
Actions: Interferes with
the release of calcium
from the sarcoplasmic
reticulum within skeletal
muscles, preventing
muscle contraction; does
not interfere with
neuromuscular
transmission.
Indications: Control of
dinical spasticity resulting
from upper motor neuron
disorders, preoperatively
to prevent or attenuate the
development of malignant
hyperthermia in
susceptible patients, IV for
management of fulminant
malignant hyperthermia
. – Treatment of spasticity
directly
affecting peripheral muscle
contraction
– Management of
spasticity
associated with
neuromuscular
diseases
Morphine
Adverse Effects: Lightheadedness, dizziness,
sedation, nausea,
vomiting. dry mouth,
constipation, ureteral
spasm, respiratory
depression, apnea,
circulatory depression,
respiratory arrest,
shock, eardiae arrest.
Narcotic Agonists
Actions: Acts as an agonist at
specific opioid receptors in
the CNS to produce
analgesia, euphoria, and
sedation.
Naloxone
Narcotic Antagonists
Actions: Pure narcotic
antagonist; reverses the
effects of the opioids,
including respiratory
depression, sedation, and
hypotension.
Indications: Relief of
moderate to severe
acute or chronie
pain; preoperative
medication;
component of
combination
therapy for severe
chronie pain;
intraspinal to
reduce intractable
pain.
Indications:
Complete or partial
reversal of narcotic
depression;
diagnosis of
suspected opioid
overdose.
Phenobarbital
Adverse Effects: Somnolence,
agitation, confusion,
hyperkinesias, ataxia, vertigo,
CNS depression, hallucinations,
bradycardia, hypotension,
syncope, nausea, vomiting,
constipation, diarrhea,
hypoventilation, apnea,
withdrawal syndrome, rash,
Stevens- Johnson syndrome.
Phenytoin
Adrry Ffert: Nystaemus,
ataxia, dysarthria, slurred
speech, mental confusion,
dizziness, fatigue, tremor,
headache, dermatitis,
Stevens-Johnson syndrome,
nausea, gingival hyperplasia,
liver damage,
hematopoietic
complications, sometimes
fatal.
Dantrolene
Adverse Efecs:
Drowsiness, dizziness,
weakness, fatigue,
diarrhea, hepatitis,
myalgia, tachycardia,
transient blood pressure
changes, rash, urinary
frequency.
Adverse Effects: Acute narcotic
abstinence syndrome (nausea,
vomiting, sweating, tachycardia,
fal i blod presre), hypotension,
hypertension, pulmonary edema.
‫ﻋﻼج ﻋﺷﺑﻲ‬
epilepsy should be
advised not to use the herb
evening primrose
increases the risk of having
.seizures
‫وﻛﻣﺎن ﻣﺎ اﺧﻠﯾﮭم ﯾﺳﺗﺧدﻣو ﻋﺷﺑﮫ‬
ginkgo
tonic-clonic and
psychomotor seizures,
prevention of seizures
during neurosurgery,
control of status
epilepticus. itexcessive
stimulation: limits the
spread of seizure
activity from an active
focus; has Prototype
Summary:Phenytoin
‫ﻛوﻧﺗرا اﻧدﯾﻛﯾﺷن‬
Known allergy –
Spasticity- that
contributes to
locomotion, upright
position, or
increased function –
Hepatic disease –
Lactation
‫ﻛوﺷن‬
Respiratory
dysfunction – GI or
GU surgery – Acute
abdomen or
ulcerative colitis
‫ﻛوﺷن‬
Women – All patients
older than 35 years –
Cardiac disease
: 9 hours
(oral), 4 to 8
hours (IV);
excreted in
the urine.
‫ﻛوﻧﺗرا اﻧد ﻛﯾﺷن‬
Known allergy –
Pregnancy, labor,
lactation – Diarrhea
caused by poisons
1.5 to 2
hours;
metabolized
in the liver,
excreted in
the urine
and bile.
‫ﻛوﻧﺗرا اﻧدﯾﻛﺷﯾن‬
30 to 81
minutes,
metabolized
in the liver,
excreted in
the urine.
Known allergy
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬
Lidocaine
Adverse Effects:
Headache,
backache,
hypotension,
urinary retention,
urinary
incontinence,
pruritus, seizures;
when locally
applied: Burning,
stinging, swelling,
tenderness.
Nerve Block
Side Effects & Precautions
Chapter:
, Drug Agents Acting on:
Succinylcholine
TAdverse Effects: Muscle pain, related to the
contraction of the muscles as a first reaction;
respiratory depression, apnea.
Actions: Blocks the
generation and conduction of
action potentials in sensory
nerves by reducing sodium
permeability, reducing the
height and rate of rise of the
action potential, increasing
the excitation threshold, and
slowing the conduction
velocity
Drug-Drug Interactions
10 minutes,
then 1.5 to 3
hours;
metabolized
in the liver,
excreted in
the urine
Indications:
Infiltration
anesthesia,
peripheral and
sympathetic nerve
blocks, central
nerve blocks, spinal
and caudal
anesthesia, topical
anesthetic for skin
or mucous
membrane
disorders
Drug-Nutrients Interactions
Special Precautions & Considerations
Nursing Assessment & Care
Indications: As an adjunct to
general anesthesia; to facilitate
endotracheal intubation; to
induce skeletal muscle relaxation
during surgery or mechanical
ventilation.
Actions: Combines with ACh
receptors at the motor endplate
to produce depolarization; this
inhibits neuromuscular
transmission, causing a flaccid
paralysis.
2 to 3 minutes; metabolized in the tissues, excreted unchanged in
the urine.
Depolarizing NMJ Blocker
‫اﻟﻧﯾرﺳﻧق‬
History and Physical Exam
– Known allergies
– Renal and hepatic dysfunction
– Pregnancy and lactation
– Impaired respiratory and
cardiac function personal or
family history of malignant
hyperthermia
– Narrow-angle glaucoma
‫ﺟدول ﻣذاﻛرة اﻷدوﯾﺔ‬