Pharmacology Neurology

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Author:
jwhughes
ID:
304599
Filename:
Pharmacology Neurology
Updated:
2015-06-30 21:13:15
Tags:
nurse
Folders:
ATI
Description:
neuro/psych/eye&ear
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  1. Name 9 categories of medications that fall under the nervous system (category NOT class)
    • Anxiety
    • Bipolar
    • Depressive
    • Psychotic
    • Children/Adolescents
    • Substance abuse
    • Chronic Neuro
    • Eye & ear
    • Sedative-Hypnotics
  2. Name the 2 classes of drugs that fall under anxiety disorders
    • Benzodiazepine
    • Atypical Anxiolytic
  3. Name 4 classes of Antidepressants
    • SSRI
    • Atypical
    • TCA
    • MAOI
  4. Name three meds that fall under the benzo class
    • Diazepam
    • Lorazepam
    • Alprazolam
  5. Name the 3 main side effects of benzo drugs
    • CNS depression
    • Anterograde amnesia
    • Acute toxicity
  6. What medication should be administered to counteract benzo toxicity
    Flumazenil
  7. What 3 conditions is diazepam contraindicated in
    sleep apnea, glaucoma, respiratory depression
  8. Name an atypical anxiolytic
    Buspirone
  9. What are 3 side effects of Buspirone
    • HA
    • Dizziness
    • Nausea
  10. How should you instruct the patient to take buspirone
    with food to prevent GI irritation
  11. Name 4 meds that are SSRIs
    • Sertaline
    • Paroxetine
    • Escitalopram
    • Fluoxetine
  12. What are 4 early adverse effects of SSRIs
    • Nausea
    • Diaphoresis
    • Tremor
    • Fatigue
  13. What are 5 main late adverse effects of SSRIs
    • Sexual dysfunction
    • Weight gain
    • Bruxism
    • Hyponatremia
    • Serotonin Syndrome
  14. What are symptoms of serotonin syndrome
    • Fever
    • Agitation
    • Confusion
  15. What medication is an atypical antidepressant
    Bupropion
  16. Name 3 adverse effects of bupropion
    • Anticholinergic effects
    • Appetite suppression
    • Seizures
  17. What two conditions is the use of bupropion contraindicated in
    • seizures (or traumatic head injury)
    • anorexia
  18. What are two possible problems for a client on trazadone
    • Sedation
    • Priapism
  19. Name 3 meds that fall under the TCA class
    • Amitriptyline
    • Imipramine
    • Doxepin
  20. Name 4 common side effects of TCA
    • Anticholinergic
    • Toxicity
    • Orthostatic hypotension
    • Sedation
  21. What are signs of TCA toxicity
    • Dysrhythmias
    • Confusion
    • Seizures
  22. How much TCA meds are prescribed at a time due to the risk of fatal toxicity
    1 week worth
  23. Name 2 meds that are MAOIs
    • phenylzine
    • isocarboxazid
  24. Name 3 side effects of MAOI
    • Orthostatic hypotension
    • Hypertensive crisis
    • CNS stimulation
  25. When should a client be educated to take a TCA
    at night
  26. What is the main symptom that first appears during a hypertensive crisis following too much tyramine with an MAOI
    HA
  27. What 2 meds can be given to treat a hypertensive crisis as a result of MAOI
    • Phentolamine
    • Nifedipine
  28. Name 2 classes of drugs that fall under treatment of bipolar disorder
    • Mood stabilizer
    • Antiepileptic (AED)
  29. What are adverse effects of lithium that occur and subside within a few weeks (dose is at therapeutic level)
    • GI (n/d)
    • Fine hand tremors
    • Polyuria, mild thirst
    • Weight gain
    • Renal toxicity
    • Hypothyroidism
  30. What level is an early indication of lithium toxicity? What symptoms would you expect to see?
    • <1.5
    • N/V/D
    • Polyuria
    • Muscle weakness
    • Slurred speech
  31. What level is an advanced indication of lithium toxicity and what symptoms would you expect to see?
    • 1.5-2
    • GI distress
    • Confusion
    • Poor coordination
    • Coarse tremors
  32. What level is an indication of severe toxicity and what symptoms would occur?
    • 2.0-2.5
    • Dilute urine
    • Tinnitus/blurred vision
    • Seizures/ataxia
    • Hypotension
  33. Once lithium level reaches over 2.5, what can occur? How should it be reversed?
    • coma & death
    • Hemodialysis
  34. What 3 meds should be avoided or carefully monitored with patients on Lithium
    • Anticholinergics
    • NSAIDs
    • Diuretics
  35. Name 3 AED's
    • Carbamazepine
    • Valproic Avid
    • Lamotrigine
  36. What are 3 side effects of carbamazepine
    • Blood dyscrasias
    • Fluid overload
    • Vision disturbances (HA)
  37. When should carbamazepine be administered
    at bedtime
  38. What are 3 major side effects of Valproic acid
    • Pancreatitis
    • Hepatotoxicity
    • Thrombocytopenia
  39. Name 2 classes of antipsychotics
    • Conventional
    • Atypical
  40. Name 2 conventional antipsychotics
    • Chlorpromazine
    • Haloperidol
  41. What are the MAJOR adverse effects of conventional antipsychotics
    • EPS
    • Neuroleptic malignant syndrome
    • Anticholinergic
    • Seizures
    • Agranulocytosis
  42. What EPS has symptoms of severe spasms of tongue, neck, face, back and requires rapid treatment
    Acute dystonia
  43. What EPS has symptoms of bradykinesia, rigidity, shuffling gait, drooling?
    Parkinsonism
  44. What EPS has symptoms of pacing and inability to sit or stand still
    Akathisia
  45. What EPS has symptoms of lip-smacking, involuntary movements of extremities or trunk
    Tardive dyskinesia
  46. What drug is given to induce muscle relaxation for a client with neuroleptic malignant syndrome
    Dantrolene
  47. What 3 medications can be given to control early EPS
    • Anticholingergic
    • Beta Blocker
    • Benzos
  48. Name 3 medications that are atypical antipsychotics
    • Risperidone
    • Olanzapine
    • Aripiprazole
    • Clozapine
  49. What symptoms do conventional antipsychotics treat
    positive
  50. What are 4 side effects of atypical antipsychotics
    • New onset diabetes
    • Weight gain
    • Hypercholesterolemia
    • Anticholinergic
  51. What 3 atypical antipsychotics has a HIGH risk for weight gain, DM, and dyslipidemia
    • Clozapine
    • Olanzapine
    • Paliperidone
  52. Which atypical antipsychotic requires eye exams q 6 months
    Quetiapine
  53. Which 2 atypical antipsychotics has a LOW risk for DM, weight gain, and dyslipidemia
    • Aripiprazole
    • Ziprasidone
  54. What atypical antipsychotic was developed first and why is it rarely used
    • Clozapine
    • Risk for agranulocytosis
  55. Name 2 classes of CNS stimulants used to treat adolescents for ADHD or conduct disorder
    • Methylphenidate
    • Amphetamine
  56. What medication falls under methylphenidate? Amphetamine?
    • Ritalin
    • Adderall
  57. Name 3 side effects of CNS stimulants
    • Insomnia/restlessness
    • Weight loss
    • Cardiovascular issues
  58. When should the last CNS stimulant medication dose be administered
    no later than 4 pm
  59. Name a NSRI
    Atomoxetine
  60. Name 4 effects of NSRI
    • Appetite/growth suppression
    • GI upset
    • Suicide ideation
    • Hepatotoxicity
  61. When do effects of alcohol withdrawal begin? Peak? Subside?
    • 4-12 hrs after last drink
    • 24-48 hrs
    • 5-7 days
  62. Name a few main symptoms of alcohol withdrawal
    • N/V
    • Insomnia
    • Increased VS including Temp
    • Depressed
  63. When can alcohol delirium occur? (MEDICAL EMERGENCY)
    2-3 days after stopping alcohol
  64. Name a medication used for detox from alcohol and what precautions must be taken
    • Benzo
    • Seizures
  65. Name 3 medications used as abstinence maintenance from alcohol
    • Disulfiram
    • Naltrexone
    • Acamprosate
  66. What syndrome can occur if a patient is on disulfiram and they ingest alcohol
    Acetaldehyde Syndrome (n/v, sweating, weak, hypotension can lead to respiratory depression seizures and death)
  67. What maintenance medication used for alcohol suppresses craving and pleasurable effects of alcohol?
    Naltrexone
  68. What maintenance medication used for alcohol decreases anxiety and restlessness and can result in diarrhea
    Acamprosate
  69. Name medications that are used to treat chronic neurological disorders
    • Cholinesterase Inhibitors
    • Anti-Parkinson
    • Anti-epileptics
  70. What class of drug is neostigmine?
    Cholinesterase Inhibitors
  71. What 6 medication classes are used to treat Parkinson disease
    • Dopamine Synthesis
    • Dopamine Agonist
    • Dopamine releaser
    • MAO-B
    • Anticholinergic
    • COMT
  72. What medication promotes dopamine synthesis in the treatment of Parkinson disease
    Levodopa/Carbidopa (Sinemet)
  73. What medication serves as a dopamine agonist in the treatment of Parkinson?
    Bromocriptine
  74. What medication enhances the effect of levodopa by blocking its breakdown?
    COMT
  75. Name a medication that is a COMT used to treat Parkinson disease
    Entacapone
  76. What medication prevents dopamine breakdown
    MAO-B
  77. Name a medication that is an MAO-B used to treat Parkinson disease
    Selegine
  78. What dopamine releaser prevents dopamine reuptake for the treatment of Parkinson disease
    Amantadine
  79. Name 4 main side effects of Sinemet
    • N/V & drowsiness
    • Dyskiniseas (head bob, tics, grimace)
    • Psychosis
    • Discolored urine/sweat
  80. When do the beneficial effects of Sinemet wear off
    5 years
  81. Name 2 main effects or Dopamine agonists
    • Daytime sleepiness
    • Postural hypotension
  82. What kind of antipsychotics can be used to treat the side effect psychosis from Anti-Parkinson drugs
    Second-Generation! (Clozapine)
  83. What are 3 adverse effects of Amantadine
    • Confusion/Dizzy
    • Anti-Cholinergic
    • Discolored skin
  84. What are 2 side effects of COMT
    • GI (v/d/c)
    • Yellow/orange urine
  85. When COMT is used in combination with Sinemet, what do you teach the client?
    • Wear off effect is delayed
    • On times are extended
  86. Name 2 adverse effects of MAO-B drugs
    • Insomnia
    • Anti-hypertensive crisis
  87. Name a centrally acting anti-cholinergic used to treat Parkinson disease
    Benztropine
  88. Name 3 effects of benztropine
    • N/V
    • Anticholinergic
    • Sedation/drowsiness
  89. What food should be avoided when a patient is on benztropine
    High protein snacks
  90. Name 5 medications that are Barbiturates used for the treatment of seizures
    • Phenobarbital
    • Primidone
    • Valproic Acid
    • Phenytoin
    • Carbamazepine
  91. What two vitamins are decreased in a client on Phenobarbital and Primidone
    Vitamin K and D
  92. What two meds do Phenobarbital and Primidone decrease in effectiveness
    • Oral contraceptives
    • Warfarin
  93. What are the side effects of Barbituates in Adults? In children?
    • Drowsiness/depression
    • Irritability/Hyperactivity
  94. What are signs of barbituate toxicity
    • Nystagmus/pinpoint pupils
    • Ataxia
    • Respiratory depression
    • Hypotension
  95. What are 2 main side effects of phenytoin
    • Gingival hyperplasia
    • Hirsutism/coarse facial features
  96. What medication is only indicated for absence seizures
    Ethosuximide
  97. What are the 3 MAIN side effects of Topimamate
    • Metabolic acidosis
    • Glaucoma
    • Impaired cognitive function
  98. What information should the nurse provide the client on neostigmine
    • Medical alert bracelet
    • Take at same time q day
    • Urinary urgency
    • Modify dose based on response
  99. What is the difference between Primary angle glaucoma and Narrow angle glaucoma closure
    Primary is gradual, narrow is acute
  100. What level of IOP puts a patient at risk for primary angle closure glaucoma
    >21
  101. Name 7 classes of drugs used to treat POAG
    • Osmotic agent
    • Beta blocker
    • Alpha 2 agonist
    • Prostagandin Analog
    • Cholinergic agonist
    • Carbonic anhydrase inhibitors
    • Nonselective adrenergic agonist
  102. What ear disorder is caused by bacteria/virus that builds up fluid in the middle ear
    Acute otitis media
  103. What are the major findings of acute otitis media
    • Acute pain
    • Erythema
    • Bulging tympanic membrane
    • fever
  104. What ear disorder is also known as swimmers ear
    Otitis externa
  105. What two vaccines can reduce chances of otitis media occurring in children
    PCV and influenza
  106. What are two effects that can be caused by Prostaglandin analogs used in the treatment of POAG/HTN
    • Permanent increased brown pigmentation
    • Migraine
  107. What is a side effect of Pilocarpine
    retinal detachment
  108. Name 2 drugs that are Carbonic Anhydrase Inhibitors
    • Acetazolamide
    • Methazolamide
  109. What is a possible cross sensitivity to Carbonic Anhydrase Inhibitors
    Sulfonamides
  110. What are 5 side effects of Carbonic Anhydrase Inhibitors
    • GI (n/d)
    • Bone marrow depression
    • Na/K depletion (altered liver function)
    • Parethesias/fatigue/seizures
    • Glucose disturbance
  111. What steps would you educate the parent of a child who is prescribed ear drops to take
    • Place on unaffected side
    • Warm med by rolling between hands
    • Gently shake
    • Keep child on side for 5 min
  112. Name 2 neuromuscular blocking agents
    • Succinylcholine
    • Pancuronium
  113. What is the reversal agent of Pancuronium
    Neostigmine
  114. What is a major side effect of neuromuscular blocking agents
    Respiratory arrest
  115. Name 4 side effects of Succinylcholine
    • Prolonged apnea
    • Malignant hyperthermia
    • Hyperkalemia
  116. What steps should be taken for a patient who has malignant hyperthermia
    • Stop med
    • Oxygen
    • Iced 0.9% NaCl, cooling blanket, ice to groin
    • Dantrolene
  117. Name 2 centrally acting muscle relaxants
    • Dantrolene
    • Baclofen
  118. Name 2 side effects of Baclofen
    • N/C
    • Urinary retention
  119. Name 2 side effects of dantrolene
    • Hepatic toxicity
    • Muscle weakness
  120. What medication class does bethanechol fall under? What would it treat?
    • Muscarinic Agonist
    • Urinary retention
  121. Side effects of bethanechol
    • Sweating, tearing
    • Urinary urgency
    • Hypotension
  122. When would you instruct the client to take bethanechol
    1 hr before or 2 hr after meal
  123. What class does oxybutynin fall under? what would it be used to treat?
    • Muscarinic Antagonist
    • Overactive bladder
  124. Name 2 effects of muscarinic Antagonist
    • Anticholinergic
    • Confusion/Insomnia/Nervous
  125. What are two meds that fall under nonbenzos
    • Zolpidem
    • Trazodone
  126. What is the prototype of melatonin Agonist
    Ramelteon

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