question

pramipexole (Mirapex)

answer

Relieves symptoms of Parkinson's disease; restless leg syndrome

question

Drug classification for pramipexole (Mirapex)

answer

direct-acting dopamine receptor agonists

question

Side effects of pramipexole (Mirapex)

answer

Nausea and other GI symptoms; drowsiness; "SLEEP ATTACKS"; muscle weakness; orthostatic hypotension; DYSKINESIAS (abnormal muscle movements)

question

Precautions for pramipexole (Mirapex)

answer

renal dysfunction; existing compulsive behaviors; children

question

Interactions with pramipexole (Mirapex)

answer

cimetidine increases levels; metoclopramide and phenothiaine antipsychotics decrease therapeutic effect; alcohol and other CNS depressants increase risk for adverse effects

question

Interventions for pramipexole (Mirapex)

answer

monitor for nausea; monitor for drowsiness or sudden sleepiness and keep patient safe from accidents; monitor for muscle weakness and prevent falls; monitor blood CPK levels if weakness occurs; monitor cardiac status; observe for abnormal muscle movement/dyskinesia (tremors, etc)

question

Patient instructions for pramipexole (Mirapex)

answer

Take with food if nausea occurs; if taking once daily, take before bedtime; report muscle weakness to provider; notify provider if dyskinesias occur; if pramipexole is discontinued, taper dosage slowly over 1 week

question

thiopental (Pentothal)

answer

rapid induction of anesthesia and hypnosis for brief procedures; adjunct anesthesia with other agents for procedures less than 15 minutes

question

Drug classification of thiopental (Pentothal)

answer

general anesthesia/barbiturate

question

Administration of pramipexole (Mirapex)

answer

Give 3 hr before bedtime for restless leg syndrome; when increasing dosage, allow 4 to 7 days between each increase

question

Administration of thiopental (Pentothal)

answer

available for IV injection or infusion only; assure that intra-arterial or vein extravasation do not occur

question

Side effects of thiopental (Pentothal)

answer

respiratory depression (apnea with large doses); cardiovascular toxicity--tachycardia, hypotension

question

Contraindications for thiopental (Pentothal)

answer

hepatic porphyria; history of paradoxical excitation with use of CNS depressants; STATUS ASTHMATICUS

question

Interventions for thiopental (Pentothal)

answer

monitor respiratory status carefully during/after use; monitor VS before/during/after use

question

Precautions for thiopental (Pentothal)

answer

hepatic or renal disease; myasthenia gravis; chronic respiratory d/o's; severe anemia; cardiac disease

question

Patient Instructions for thiopental (Pentothal)

answer

Advise patient that frequent monitoring will occur before, during, and following procedure

question

Interactions with thiopental (Pentothal)

answer

Use with other CNS depressants may increase respiratory depression; use with probenecid may increase length of anesthesia; herbal kava kava and valerian increase sedative properties; multiple incompatibilities in solution with other drugs; use with general benzodiaepine anesthetics, such as midazolam (Versed), is considered duplicate therapy, resulting in prolonged anesthesia

question

midazolam (Versed)

answer

sedation before general anesthesia; conscious sedation with induction of amnesia during procedures, such as endoscopy; supplement to inhalation anesthesia for surgeries

question

Classification of midazolam (Versed)

answer

general anesthesia/benzodiazepine

question

Administration of midazolam (Versed)

answer

may administer IM into large muscle mass for conscious sedation; Give IV bolus or infusion for induction of anesthesia or conscious sedation; DO NOT GIVE BOLUS TO NEONATES; may combine with an opioid for conscious sedation

question

Side effects of midazolam (Versed)

answer

AMNESIA (memory loss from time prior to injection); cardiac or respiratory arrest

question

Contraindications for midazolam (Versed)

answer

pregnancy category D; lactation; obstetric delivery; glaucoma

question

Precautions for midazolam (Versed)

answer

Parkinson's disease, other neuromuscular disorders; cardiac, pulmonary, or renal disorders

question

Interventions for midazolam (Versed)

answer

To prevent cardiac/respiratory arrest, inject IV bolus slowly and wait at least 2 minutes before giving a second dose; have resuscitation equipment at hand; monitor VS carefully during and after procedure

question

Patient instructions for midazolam (Versed)

answer

Advise patient that memory loss was caused by the drug; advise patient that frequent monitoring will occur before, during, and after procedure

question

Interactions with midazolam (Versed)

answer

CNS depressants, anticonvulsants increase sedation from midazolam; cimetidine may cause midazolam toxicity; smoking decreases sedative effect herbal products may increase or decrease effect of midazolam

question

fentanyl (Sublimaze)

answer

supplement to general anesthesia; used with droperidol, and nitrous oxide for neuroleptanesthesia; used with skeletal muscle relaxant as anesthesia for high risk patients in selected situations

question

Administration of fentanyl (Sublimaze)

answer

available in multiple forms for surgical premedication, including IV and stick lozenges; Place a stick lozenge between cheek and gum of child or adult; patient should suck (NOT CHEW) on lozenge longer than 15 minutes

question

Side effects of fentanyl (Sublimaze)

answer

sedation; nausea; respiratory and/ or circulatory depression

question

Contraindications for fentanyl (Sublimaze)

answer

substance abuse; obstetric delivery; myasthenia gravis

question

Interventions for fentanyl (Sublimaze)

answer

monitor LOC during use; monitor for nausea; monitor VS carefully; have resuscitation equipment at hand; have the opioid antagonis, NALOXONE (NARCAN) available

question

Patient instructions for fentanyl (Sublimaze)

answer

advise patient that drowsiness is expected; instruct patient to report nausea; advise patient that frequent monitoring will occur before, during, and after procedure

question

Precautions for fentanyl (Sublimaze)

answer

patients with increased intracranial pressure; older adults or young children; debilitated patients; cardiac or respiratory disorders liver or kidney disorders

question

Interactions for fentanyl (Sublimaze)

answer

MAOI antidepressants given within 2 weeks of fentanyl can cause hypertensive crisis; CNS depressants increase risk for sedation, respiratory depression

question

lidocaine (Xylocaine)

answer

Use: provides local anesthesia-topical application to skin to relieve burns or during suturing of wounds-relives pain in mucous membranes of nose, mouth-relieves pain of hemorrhoids; IV regional anesthesia; blocks nerves near surgical field; injected for epidural or spinal anesthesia

question

classification of lidocaine (Xylocaine)

answer

local anesthesia

question

Administration of lidocaine (Xylocaine)

answer

avoid eyes with topical form; do not apply to broken skin (increase risk of toxicity); assure that correct concentration and form are used for specific procedure; addition of epinephrine to lidocaine increases time of anesthesia but may cause GANGRENE in end-artery sites, such as fingers, toes, nose; some forms contain preservatives which are contraindicated for certain procedures

question

Side effects of lidocaine (Xylocaine)

answer

hypotension (spinal anesthesia); CNS stimulant effects-dizziness, restlessness, tremors, confusion, paresthesias, convulsions, and cardiac conduction disorders; CNS depressant effects-respiratory arrest

question

Interventions for lidocaine (Xylocaine)

answer

monitor VS carefully during/after procedure; if hypotension occurs, lower the head of bed; prepare to administer ephedrine or phenylephrine if hypotension occurs; monitor for CNS effects during/following procedure monitor respiratory status carefully

question

Patient instructions for lidocaine (Xylocaine)

answer

Advise patient to expect careful monitoring of VS during and after procedure; advise patient to report dizziness, paresthesia, breathing difficulty during/after procedure

question

Contraindications for lidocaine (Xylocaine)

answer

sepsis or severe trauma; bradycardia or heart block

question

Precautions for lidocaine (Xylocaine)

answer

older adults; myasthenia gravis; respiratory depression; history of malignant hyperthermia

question

Interactions with lidocaine (Xylocaine)

answer

beta blockers, cimetidine, quinidine increases lidocaine levels; phenytoin increases risk of cardiac effects procainamide increases risk for CNS and cardiac effects

question

memantine (Namenda)

answer

Use: slows decrease in functioning for-moderate/severe Alzheimer's disease; mild/moderate vascular dementia

question

Administration of memantine (Namenda)

answer

available orally in tablets or liquid solution; give with or without food

question

Side effects of memantine (Namenda)

answer

CNS effects: dizziness, headache, increased confusion; constipation

question

Interventions for memantine (Namenda)

answer

monitor for CNS effects; keep patient safe if dizziness occurs; monitor for constipation

question

Contraindications for memantine (Namenda)

answer

renal failure

question

Patient instructions for memantine (Namenda)

answer

Report presence of CNS effects to provider; Increase fluids and fiber in diet; Report constipation to provider

question

Precautions for memantine (Namenda)

answer

liver disorders; renal disorders; seizure disorders; older adults

question

Interactions with memantine (Namenda)

answer

OTC antacids and other drugs that increase pH of urine cause increased levels of memantine and possible toxicity; memantine with levodopa/carbidopa can enhance the adverse effects of levodopa/carbidopa; other NMDA antagonists, such as amantadine or ketamine may increase memantine levels

question

dantrolene (Dantrium)

answer

Use: relaxes skeletal muscle spasm in CVA, stroke, spinal cord injury, MS, cerebral palsy; used to prevent and treat malignant hyperthermia

question

Administration of dantrolene (Dantrium)

answer

available in oral and IV preparations; for prophylaxis of malignant hyperthermia, give orally for 1 to 2 preoperatively; IV form is used to treat malignant hyperthermia

question

Side effects of dantrolene (Dantrium)

answer

muscle weaknss; drowsiness, dizziness; diarrhea; liver toxicity

question

Classification of dantrolene (Dantrium)

answer

peripherally acting muscle relaxants

question

Interventions of dantrolene (Dantrium)

answer

assess muscle strength frequently during treatment; monitor for CNS effects, such as drowsiness; oral dantrolene may be started at low doses and gradually increased to prevent CNS effects; monitor for diarrhea, especially early in treatment; monitor liver function tests

question

Patient instructions for dantrolene (Dantrium)

answer

instruct patient to inform provider if muscle weakness occurs; instruct patient to avoid driving and activities that require mental alertness if drowsiness occurs; advise patients to avoid CNS depressants, such as alcohol, while taking dantrolene; Contact provider if diarrhea occurs; report signs of liver dysfunction, such as abdominal pain, jaundice to provider

question

Contraindications for dantrolene

answer

liver disease

question

Precautions for dantrolene

answer

cardiac disease; pulmonary disease; neuromuscular disorders; patients older than 35 years

question

Interactions with dantrolene

answer

estrogen use increases risk of liver toxicity in women older than 35 years; CNS depressants, such as alcohol, increases risk for excessive sedation; IV use: calcium channel blockers increase risk for severe cardiac dysrhythmias

question

Classification of sumatriptan (Imitrex)

answer

serotonin agonist

question

sumatriptan (Imitrex)

answer

Use: relieve symptoms of existing migraine or cluster headache

question

Administration of sumatriptan (Imitrex)

answer

give orally, SC, or by nasal spray; use nasal spray by spraying once into a single nostril; may repeat every 2 hours; single dose ranges from 5 to 20 mg; maximum dose is 40 mg in 24 hr; give one SC injection repeat once after 1 hr if no relief; no more than 2 doses in 24 hr; give one oral tablet; repeat once after 2 hr if no relief; singe dose ranges from 25 to 100 mg; maximum dose is 200 mg in 24 hr

question

Side effects of sumatriptan (Imitrex)

answer

CHEST PRESSURE OR "HEAVINESS" may progress to angina pain caused by coronary vasospasm; CNS effects: tingling sensation, vertigo

question

Interventions for sumatriptan (Imitrex)

answer

monitor for chest pressure; monitor VS closely after first dose; monitor for CNS effects

question

Patient instructions for sumatriptan (Imitrex)

answer

Notify provider at once for chest pressure or tightness/heaviness in back, jaw, throat that does not spontaneously resolve; instruct patient to report CNS symptoms to provider at next visit

question

Contraindications for sumatriptan (Imitrex)

answer

CAD, angina, previous MI, severe HTN; PVD; older adults; older adults; stroke; use of MAOI within last 2 weeks; use of another triptan within last 24 hrs

question

Precautions for sumatriptan (Imitrex)

answer

liver or kidney insufficiency; CAD risk factors; seizure d/o; BP elevation; serotonin syndrome; chest, jaw, or neck tightness; fertility impairment

question

Interactions with sumatriptan (Imitrex)

answer

MAOI taken within 2 weeks can cause sumatriptan toxicity; ergotamine or another triptan patients use within 24 hour of sumatriptan increases chance of angina; serotonin agonists with sumatriptan can cause serotonin syndrome; herbal St. John's wort can cause toxicity

question

interferon beta-1a (Avonex, Rebif); beta-1b (Betaseron): IMMUNOMODULATORS

answer

Use: Beta-1a: MS (relapsing-remitting type) Beta-1b: MS (relapsing and relapsing-remitting types)

question

Administration of interferon beta-1a

answer

Avonex: Give IM weekly Rebif: Give SC daily for 3 days each week; admin late in day; allow 48 hrs between injection

question

Administration beta-1b

answer

Betaseron: Give SC every other day; use within hours of reconstituting

question

Side effects of interferon beta-1a and beta-1b

answer

FLU-LIKE SYMPTOMS (decrease with prolonged treatment); MYELOSUPPRESSION (all blood cell types); liver toxicity; pain, redness at SC injection site

question

Interventions for interferon beta-1a and beta-1b

answer

begin with low dose and titrate to higher doses to prevent adverse effects; medicate with acetaminophen or other prescribed NSAID if symptoms are expected (flu-like symptoms); monitor CBC and liver function tests before treatment begins and periodically thereafter; monitor for injection site reactions

question

Patient instructions for interferon beta-1a and beta-1b

answer

instruct patient to pre-medicate with prescribed NSAID if flu-like symptoms occur; notify provider for easy bruising, bleeding, fatigue; report abdominal tenderness, anorexia, jaundice to provider; rotate injection sites, use cool compress prior to injection and warm, moist compress following injection; report skin ulceration to provider

question

Contraindications for interferon beta-1a and beta-1b

answer

previous allergy to interferon beta, human albumin, or mannitol

question

Precautions for interferon beta-1a and beta-1b

answer

SUICIDAL TENDENCIES; pre-existing or history or liver disorder; alcohol abuse; children younger than 18 years seizures; mental health disorder; thyroid disorders

question

Interactions with interferon beta-1a and beta-1b

answer

any drug which suppresses the immune system (prednisone) may increase risk for myelosupression

question

selegiline (Eldepryl, Zelapar ODT): Indirect-acting Dopamine Receptor Agonists/MAOI

answer

Uses: symptoms of Parkinson's disease as an adjunct to levodopa/carbidopa; major depression-transderma patch (Emsam)

question

Administration of selegiline

answer

Give with levodopa/carbidopa so that levodopa dosage may be reduced; give orally disintegrating form (Zelapar) by placing it on the top of the tongue; give before morning meal; don't eat or drink for 5 minutes before or after administration

question

Side effects of selegiline

answer

insomnia, HTN (as an interaction with other drugs), orthostatic hypotension; IRRITATION OF ORAL MUCOUS MEMBRANES (with orally-disintegrating form); HALLUCINATIONS

question

Interventions for selegiline

answer

monitor for insomnia; carefully monitor other drugs patient may be taking; monitor BP while taking this drug; monitor orthostatic BP and pulse; inspect tongue and oral cavity for irritation; monitor for hallucinations

question

Patient teaching for selegiline

answer

Take last dose of the day by noon to prevent insomnia; notify provider before taking any new medication; instruct patient about foods to avoid (tyramine foods); inform patient of drugs, including herbals, which may interact with selegiline; rise slowly from lying or sitting position; report oral irritation; educate patient about risk of hallucinations and report if this occurs

question

Contraindications for selegiline

answer

uncontrolled HTN; suicidal ideations; receiving meperidine for pain; concurrent use with dextromthorphan, other MAOIs, meperidine, methadone, or tramadol

question

Precautions for selegiline

answer

HTN; bipolar disorder or psychosis; lactation

question

Interactions with selegiline

answer

meperidine (Demerol) and other opioids, other MAOIs, TCA or SSRI antidepressants can cause high fever, HTN, rigidity; foods containing tyramine can cause HTN; herbal drugs, such as ephedra, St. John's wort, ginseng, or ma huang can cause severe HTN; antihypertensive drugs, diuretics or general anesthetics can cause hypotension

Neuro Additional ATI Charts – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards