دخلوااااااا ضروريييييي
 

رد: دخلوااااااا ضروريييييي
 

olanzapine :
ACTION
Antagonizes dopamine and serotonin type 2 in the CNS
Also has anticholinergic, antihistaminic, and anti–alpha1-adrenergic effects.
Therapeutic Effects:
Decreased manifestations of psychoses.



carbamazepine
ACTION
Decreases synaptic transmission in the CNS by affecting sodium channels in neurons.
Therapeutic Effects:
Prevention of seizures
Relief of pain in trigeminal neuralgia.


gabapentin
Actions :
Adjunctive treatment of adults with partial seizures with and without secondary generalization.
Unlabelled Uses:
Treatment of chronic pain.
Prevention of migraine headache


topiramate
ACTION
Action may be due to:
Blockade of sodium channels in neurons
Enhancement of gamma-aminobutyrate, an inhibitory neurotransmitter
Prevention of activation of excitatory receptors.
Therapeutic Effects:
Decreased incidence of seizures.



NURSING IMPLICATIONS
ASSESSMENT

General Info: Assess patient's mental status (orientation, mood, behavior) before and periodically throughout therapy.
Monitor blood pressure (sitting, standing, lying), ECG, pulse, and respiratory rate before and frequently during the period of dosage adjustment.
Observe patient carefully when administering medication to ensure that medication is actually taken and not hoarded.
Assess fluid intake and bowel function. Increased bulk and fluids in the diet may help minimize constipation.
Monitor patient for onset of akathisia (restlessness or desire to keep moving) and extrapyramidal side effects (parkinsonian—difficulty speaking or swallowing, loss of balance control, pill rolling, mask-like face, shuffling gait, rigidity, tremors; and dystonic—muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs) every 2 mo during therapy and 8–12 wk after therapy has been discontinued. Report these symptoms if they occur, as reduction in dosage or discontinuation of medication may be necessary. Trihexyphenidyl or diphenhydramine may be used to control symptoms.
Monitor for tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities; lip smacking or puckering; puffing of cheeks; uncontrolled chewing; rapid or worm-like movements of tongue). Report immediately; may be irreversible.
Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, convulsions, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control). Notify physician or other health care professional immediately if these symptoms occur.
Lab Test Considerations: CBC, liver function tests, and ocular examinations should be evaluated periodically throughout therapy. May cause decreased platelets. May cause elevated bilirubin, AST, ALT, GGT, CPK, and alkaline phosphatase.
POTENTIAL NURSING DIAGNOSES

Thought process, altered (Indications).
Knowledge deficit, related to medication regimen (Patient/Family Teaching).
Noncompliance (Patient/Family Teaching).
IMPLEMENTATION

PO: May be administered without regard to meals.
For orally disintegrating tablets, peel back foil on blister, do not push tablet through foil. Using dry hands, remove from foil and place entire tablet in mouth. Tablet will disintegrate with or without liquid.
PATIENT/FAMILY TEACHING

Advise patient to take medication exactly as directed and not to skip doses or double up on missed doses. May need to discontinue gradually.
Inform patient of possibility of extrapyramidal symptoms and tardive dyskinesia. Instruct patient to report these symptoms immediately to health care professional.
Advise patient to change positions slowly to minimize orthostatic hypotension.
Medication may cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to the medication is known.
Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication.
Advise patient to use sunscreen and protective clothing when exposed to the sun. Extremes of temperature (exercise, hot weather, hot baths or showers) should also be avoided because this drug impairs body temperature regulation.
Instruct patient to use frequent mouth rinses, good oral hygiene, and sugarless gum or candy to minimize dry mouth. Consult health care professional if dry mouth continues for >2 wk.
Advise patient to notify health care professional of medication regimen before treatment or surgery.
Instruct patient to notify health care professional promptly if sore throat, fever, unusual bleeding or bruising, rash, weakness, tremors, visual disturbances, dark-colored urine, or clay-colored stools occur.
Emphasize the importance of routine follow-up exams and continued participation in psychotherapy as indicated.
EVALUATION

Effectiveness of therapy can be demonstrated by:

Decrease in excitable, paranoic, or withdrawn behavior.



:119: هذا اللي اعرف
اما البقية فاغلبها اسماء تجاريه ما حصل البرنامج لها بحث

رد: دخلوااااااا ضروريييييي
 

مشكوووووووووووووووورة اخوووووووووووووي
قواك الله
ويعطيك الف عافيه