Neurological Drugs Part 1 – Flashcards
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Non-benzodiazepines
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Short term tx of insomnia
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Benzodiazepines
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Relief of insomnia, esp when pt wakes up during the night
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Centrally acting muscle relaxants
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Relieves skeletal muscle spasm in: -spinal cord injury -multiple sclerosis -cerebral palsy
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Peripherally acting muscle relaxant
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Relaxes skeletal muscle spasm +SMC -cerebrovascular accident, stroke Prevent & tx malignant hyperthermia
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Hydantoins
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Tonic-clonic seizures Partial seizures
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Iminostilbenes
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Partial, Tonic-clonic seizures Mood stabilizer for bipolar disorder Reduces pain of trigeminal neuralgia
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Valproic acid
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Tx all seizure types Controls mania in bipolar disorder Prevents migraines
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General anesthesia/barbiturate
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Rapid induction of anesthesia & hypnosis for brief procedures Adjunct anesthesia with other agents for procedures less than 15 mins
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Local anesthesia
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Provides local anesthesia IV regional anesthesia Blocks nerves near surgical field Injected for epidural or spinal anesthesia
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General anesthesia/benzodiazepines
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Sedation before general anesthesia Conscious sedation w/induction of amnesia during procedures Supplement to inhalation anesthesia for surgeries
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General anesthesia/opioids
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Supplement to general anesthesia Used w/droperidol and nitrous oxide for neuroleptanesthesia Used w/skeletal muscle relaxant as anesthesia for high risk patient sin selected situations
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Immunomodulators
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Multiple sclerosis
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Dopamine-replacement drugs
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Relieves symptoms of Parkinson's Disease
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Direct-acting Dopamine Receptor Agonists
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Relieves symptoms of Parkinson's Disease Restless leg syndrome
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Cholinesterase Inhibitors
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Improved cognitive function in mild-moderate Alzheimer's Disease
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Amphetamines
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ADHD Narcolepsy
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Serotonin Agonist
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Relieve symptoms of existing migraines or cluster headaches
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Indirect-acting dopamine receptor agonists/MAOI
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Symptoms of Parkinson's disease as adjunct to levodopa/carbidopa MDD
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Methylphenidate
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ADHD Narcolepsy
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NMDA Receptor Antagonist
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Slows decrease in functioning for -Moderate/severe Alzheimer -Mild/moderate dementia
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Non-amphetamines
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Promotes wakefulness in Narcolepsy Shift-work sleepiness Obstructive sleep apnea
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A health care professional is caring for a patient who is taking zolpidem (Ambein). The patient has a history of benzodiazpeine abuse and reports insomnia. The health care professional should caution the patient that the drug can cause A) hearing loss B) memory impairment C) joint pain D) constipation
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B) memory impairment Rationale: non-benzodiazepine can cause antergrade amnesia, or memory impairment, particularly an inability to recall activities patients carry out just before or during sleep
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While talking with a patient and his family about taking memantine (Namenda) or Alzheimer's disease, the health care professional should include which of the following instructions? A) Increase fluids to improve renal excretion B) Report memory loss or confusion C) Watch for signs of liver impairment, such as jaundice and abdominal pain D) Notify the health care professional before taking OTC antacids
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D) Notify the health care professional before taking OTC antacids Rationale: Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity
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A patient is taking selegiline (Eldepryl) to treat Parkinson's disease. The provider is considering the use of analgesics for the patient but should be aware that a drug interaction between selegiline and meperidine (Demerol) can result in which of the following? A) Frequent urination B) Jaundice C) Cellulitis D) Muscle rigidity
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D) Muscle rigidity Rationale: A drug interaction between selegiline and opioids, especially meperidine, can result in a serious reaction resulting in rigidity, stupor, agitation, hypertension and fever.
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A health care professional is caring for a patient who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. The health care professional should recognize that which of the following laboratory tests requires monitoring? A) serum potassium B) liver function C) serum sodium D) thyroid function
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B) liver function Rationale: Liver toxicity is a serious adverse effect of dantrolene. The health care professional should monitor liver function prior to treatment and at regular intervals, and advise patients to report jaundice or abdominal pain.
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For which of the following should a health care professional monitor a patient who is taking donzepezil (Aricept) for Alzheimer's disease? A) Confusion B) Dry mouth C) Nausea D) Double vision
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C) Nausea Rationale: The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking the drug with food can help minimize adverse effects.
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A health care professional is talking to a patient about beginning sumatriptan (Imitrex) therapy to treat migraine headaches. The health care professional should advise the patient to watch for which of the following adverse effects? A) Chest pain B) Polyuria C) Joint pain D) Insomnia
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A) Chest pain Rationale: Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Patients should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for patients who have a history of coronary artery disease.
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A health care professional is talking to a patient who is newly diagnosed with Parkinson's disease about how levodopa/carbidopa (Sinemet) will help her control her symptoms. With which of the following mechanisms is the drug effective in treating this disorder? A) Increases available acetylcholine in the brain B) Inhibits norepinephrine metabolism in the brain C) Inhibits serotonin metabolism in the brain D) Increases available dopamine in the brain
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D) Increases available dopamine in the brain Rationale: Levodopa/carbidopa, a dopaminergic agent, can act by increasing dopamine in the extra-pyramidal center of the brain, reducing involuntary motion.
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A health care professional is reviewing the medical record of a patient who has newly diagnosed seizure disorder. The patient is to begin taking both valproic acid (Depakote) and phenytoin (Dilantin). The heal care professional should recognize that which of the following can occur as aresult of a drug interaction between valproic acid and phenytoin? A) Hyperammonemia B) Phenytoin toxicity C) Hypertension D) Peptic ulcer disease
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B) Phenytoin toxicity Rationale: Valproic acid can cause an increase in phenytoin blood levels, causing phenytoin toxicity. The primary care provider should monitor serum phenytoin levels and reduce the dosage if levels begin to exceed the therapeutic range.
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A health care professional is talking to a patient and her family about how methylphenidate (Ritalin) will help manage ADHD. Which of the following effects should they expect? A) Reduced pain B) Improved mood C) Increased focus D) Decreased anxiety
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C) Increased focus Rationale: Stimulants, such as methylphenidate, regulate levels of dopamine and norepinephrine in the brain to produce calmness, reduce hyperactivity, and increase focus for patients who have ADHD.
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When talking to a patient about taking modafinil (Provigil) to treat narcolepsy, which of the following instructions should the health care professional include? A) Take the drug in the morning B) Take the drug 30 min before bedtime C) Anticipate daytime drowsiness D) Expect urinary frequency
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A) Take the drug in the morning Rationale: Modafinil is a non-amphetamine stimulant. Taking it in the morning helps improve wakefulness for patients who have narcolepsy. Patients taking the drug for shift-work sleepiness should take it 1 hr before work.
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A health care professional is caring for a patient who is about to begin taking amphetamine sulfate (Adderall). The health care professional should monitor the patient who which of the following adverse effects? A) Hypotension B) Tinnitus C) Tachycardia D) Bronchospasm
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C) Tachycardia Rationale: Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. Patients should notify the health care professional if they develop palpitations or chest pain.
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Which of the following findings should alert a health care professional that a patient is developing a potentially serious adverse reaction to interferon beta-1B (Betaseron)? A) Tinnitus B) Twitching eyelids C) Blue-green discoloration D) Fatigue
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D) Fatigue Rationale: Because of the potential for bone marrow suppression and decreased platelet count, patients should report unexplained bruising, bleeding, or fatigue.
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A health care professional administers fentanyl (Sublimaze) to a patient to reduce pain. Which of the following drugs should she have available to reverse the effects of fentanyl? A) Neostigmine (Bloxiverz) B) Succinycholine (Anectine) C) Naloxone D) Dantrolene (Dantrium)
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C) Naloxone Rationale: Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. Health care professionals administering fentanyl should also have resuscitation equipment available.
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A health care professional is caring for a patient who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. The health care professional should tell the patient to report which of the following adverse effects? A) slow pulse rate B) cough C) diarrhea D) hearing loss
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C) Diarrhea Rationale: Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea is an adverse effect of dantrolene, as are nausea and vomiting. Patients should report these effects so the health care professional can monitor fluid balance and intervene accordingly.
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Because of the potential for adverse effects, which of the following should a health care professional recommend for patients who begin taking carbamazepine (Tegretol)? A) Begin taking the drug at a low dosage B) Discontinue the drug immediately if diarrhea occurs C) Have serum glucose levels checked regularly D) Take the drug on an empty stomach
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A) Begin taking the drug at a low dosage Rationale: Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, an iminostilbene that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects.
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A health care professional is talking with a patient who is to begin taking valproic acid (Depakote) to treat a seizure disorder. He should advise the patient to monitor for which of the following adverse effects? A) Hirsutism B) Depression C) Jaundice D) Gum irritation
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C) Jaundice Rationale: Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Patients taking the drug should report these symptoms, and health care professionals should monitor liver function studies prior to treatment and periodically during therapy.
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Which of the following information should a health care professional include when talking to a patient abotu taking baclofen (Lioresal)? A) Avoid drinking until the drug's effects are evident B) Stop taking the drug immediately if headache occurs C) Take the drug as needed for spasticity D) Take the drug with antacids to reduce gastric effects
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A) Avoid driving until the drug's effects are evident Rationale: Baclofen, a centrally acting muscle relaxant, causes CNS depression. Patients taking the drug should avoid alcohol and other CNS depressants and should not drive a vehicle until they know how the drug will affect them
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A health care professional is caring for a patient who is receiving thiopental (Penthothal). For which of the following should the health care professional monitor? A) Cardiac excitability B) Respiratory depression C) Hypothermia D) Hypotension
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B) Respiratory depression Rationale: Thiopental, a short acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for patients receiving the drug.
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A health care professional is talking to a patient about the adverse efects of interferon beta-1a (Avonex). To help minimize these effects, she should tell the patient to A) Premedicate with acetaminophen (Tylenol) B) Take the drug with food C) Increase his fluid intake D) Take the drug in the morning
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A) Premedicate with acetaminophen (Tylenol) Rationale: Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen or a NSAID can help minimize these symptoms
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Anesthetists often administer midazolam (Versed) during induction of anesthesia because of which of the followign pharmacological actions? A) produces analgesia B) induces muscle paralysis C) dries secretions D) causes amnesia
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D) causes amnesia Rationale: Midazolam, a benzodiazepine, is appropriate during induction because of its anti anxiety and amnesic properties
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An anesthetist is about to administer lidocaine (Xylocaine) as part of the protocol for spinal anesthesia for a patient who is undergoing a surgical procedure. The health care professional should be aware that the patient could develop which of the following potentially serious effects? A) Tachycardia B) Hypotension C) Hyperthermia D) Hemoptysis
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B) Hypotension Rationale: When systemially absorbed in sufficient amounts, lidocaine, a local anesthetic, can cause hypotension, particularly when used as spinal anesthesia.
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A health care professional is caring for a patient who is about to begin taking pramipexole (Mirapex) to treat Parkinson's disease. The health care professional should recognize that which of the following laboratory tests require monitoring? A) C-reactive protein B) Creatine phosphokinase (CPK) C) Thyroid function D) CBC
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B) Creatine phosphokinase Rationale: CPK is an enzyme found in the heart, brain, and skeletal muscles. Patients taking pramipexole can develop muscle weakness with a lack of energy, creating a situation that can be more problematic for patients than their original muscle dysfunction. Monitoring CPK can alert health care professionals to the possibility of skeletal muscle damage from the drug.
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A health care professional should include which of the following instructions when talking with a patient about taking levodopa/carbidopa (Sinemet) to treat Parkinson's disease? A) Change positions slowly to prevent orthostatic hypotension B) Eat a protein snack to increase absorption C) Take the drug at bedtime to avoid daytime drowsiness D) Expect eye twitching to develop with long term therapy
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A) Change positions slowly to prevent orthostatic hypotension Rationale: Levodopa/carbidopa can cause orthostatic hypotension
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A nurse is providing information about pramipexole (Mirapex) to a client who has early Parkinson's disease. Which of the following possible adverse effects should the nurse include in the information? A) Hallucinations B) Memory loss C) Diarrhea D) Discoloration of urine
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A) Hallucinations Rationale: Pramipexole may cause hallucinations within 9 months of the initial dose and may need to be discontinued.
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A nurse is reviewing food interactions with a client who is taking levodopa/carbidopa (Sinemet) for Parkinson's disease. Which of the following instructions should the nurse include? A) Eat large amounts of protein-rich foods with the medication B) May take the medication with whole-grain cereal C) Consider eating a banana with the medication D) May take the medication crushed in grapefruit juice
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D) May take the medication crushed in grapefruit juice Rationale: The client may crush a tablet or empty a capsule of levodopa/carbidopa in any type of juice if having difficulty swallowing
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A nurse is caring for a client who receives a local anesthetic of lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client? A) Seizures B) Tachycardia C) Hypertension D) Fever
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A) seizures Rationale: Seizure activity is an adverse effect that may occur as a result of local anesthetic injection
