Medications selecting

MS patients usually have upper motor neuron spasticity. This type of spasticity cannot be treated with muscle relaxants such as carisoprodol. MS patients must be treated with agents specific for upper motor neuron spasticity (Table 26—8).48 MS spasticity is classified as focal or generalized. If the spasticity primarily involves only one muscle group, it is focal and may benefit from botulinum toxin administration.11 Systemic medications are used for generalized spasticity. No clear conclusion can be reached regarding the superiority in efficacy of one antispasticity agent over another medication selection is usually based on adverse effects (see Table 26-8).11,48... 

Antidepressants have been shown effective in the treatment of major depression with response rates at approximately 60-70%. The only treatment for depression consistently shown to be more effective is ECT with response rates of 80-90%. There is no definitive means of predicting which medication will work best for a given patient nevertheless, the choice of a medication should not be made capriciously. Several factors can guide medication selection and thereby maximize the likelihood of a successful response. 

Obsessive-Compulsive Personality Disorder (OCPD). Despite the similarity in name, OCD and OCPD are not closely related. Therefore, the medications used to treat OCD are not necessarily helpful for OCPD. As a result, we also cannot offer any specific medication recommendations for the treatment of OCPD. The overall anxious nature of the illness and the likelihood that such patients have comorbid depression or anxiety disorders may, however, guide medication selection. 

It would be helpful if there were a peripheral measure of neurotransmitter function that could be used to guide medication selection and dosing, but unfortunately this has not yet been developed. Some measures can be obtained from the cerebro spinal fluid, but even these levels have not been established as a guide to treatment. Peripheral measures or related measures of neuroendocrine function (Birmaher et ah, 2000) may some day be useful guides. Likewise, pharmacogenetics may help select the most appropriate medication and dosage (Anderson and Cook, 2000, Chapter 7 in this volume). 

NIDA (National Institute on Drug Abuse). NIDA InfoFacts Prescription Pain and Other Medication, Prescription Medications, Selected Prescription Drugs with Potential for Abuse. Available online at http //www.drugabuse.gov/infofacts/PainMed.html. Accessed June 2, 2006. 

Virtually all opioids can be used as a preoperative medication. Selection of a specific type and dose can be individualized based on the needs of each patient. 

The medication use process is a complex system intended to optimize patient outcomes within organizational constraints. Quality medication use involves selection of the optimal drug, avoidance of adverse medication events, and completion of the therapeutic objective. Safe medication practices focus on the avoidance of medication errors. Medication use review and ongoing medication monitoring activities focus on optimizing medication selection and use. These two approaches are important means of assessing and optimizing the quality of medication use. 

This publication was groundbreaking, not only in its discussion of the lack of appropriate cancer pain management worldwide, but in its overall recommendations for managing cancer pain. The concept of the three-step analgesic ladder is introduced, which divides pain ratings into three categories mild, moderate, or severe, with medication selection based on a step-up approach. When this step approach to pain management is employed, up to 90% of all cancer pain can be relieved. 

Nonpharmacologic interventions alone are not always sufficient to prevent osteoporosis-related fractures, and drug therapy is often necessary. Table 88-6 describes the important aspects of the commonly prescribed medications for osteoporosis. The choice of pharmacotherapy depends on many individual patient-specific characteristics and preferences. Regardless of the medication selected, allpatients should receive adequate calcium and vitamin D intake. In order to optimally reduce fracture risk, all people should also implement lifestyle modifications that reduce faU risk. 

The nurse is preparing to administer the initial intravenous antibiotic to a client with an arterial ulcer on the right ankle. The client has a saline lock in the right forearm. In which order should the nurse prepare to administer the medication Select all that apply. Rank in order of performance. 

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