barbituates, CNS stimulants, ADHD, insomnia, yadayadayada

Question 1

What are the two barbiturates used for epilepsy?

Answer 1

Phenobarbital, Primidone

Question 2

Why do barbiturates have a high abuse potential?

Answer 2

They cause tolerance and dependence by mimicking GABA.

Question 3

What are the CNS effects of barbiturates?

Answer 3

Drowsiness, sedation, depression, confusion, anxiety.

Question 4

What are signs of barbiturate toxicity?

Answer 4

Nystagmus, ataxia, respiratory depression, coma, pinpoint pupils, hypotension, death.

Question 5

How should barbiturate toxicity be managed?

Answer 5

Monitor vital signs, provide oxygen, and ventilatory support.

Question 6

What vitamins do barbiturates decrease?

Answer 6

Vitamin K and D (affect clotting).

Question 7

How do barbiturates affect warfarin?

Answer 7

Decrease its effects (monitor INR, calcium, and vitamin D).

Question 8

What are the CNS effects of phenytoin (hydantoin)?

Answer 8

Nystagmus, sedation, ataxia, diplopia, cognitive impairment.

Question 9

What oral side effect is associated with phenytoin?

Answer 9

Gingival hyperplasia (overgrowth of gums).

Question 10

How can gingival hyperplasia be managed?

Answer 10

Good dental hygiene, flossing, folic acid supplementation.

Question 11

What cardiovascular effects does IV phenytoin cause?

Answer 11

Dysrhythmias, hypotension.

Question 12

What endocrine effects does phenytoin have?

Answer 12

Facial coarsening, hirsutism, interferes with vitamin D metabolism.

Question 13

How does phenytoin affect newborns?

Answer 13

Interferes with vitamin K clotting factors.

Question 14

What are the CNS effects of carbamazepine?

Answer 14

Nystagmus, diplopia, ataxia, headache.

Question 15

What blood dyscrasias can carbamazepine cause?

Answer 15

Leukopenia, anemia, thrombocytopenia.

Question 16

What are signs of blood dyscrasias?

Answer 16

Bruising, bleeding gums, sore throat, fever, pallor, weakness, infection.

Question 17

What is a major fluid-related adverse effect of carbamazepine?

Answer 17

Hypo-osmolarity (edema, decreased UOP, HTN).

Question 18

What skin conditions are associated with carbamazepine?

Answer 18

Rash, Stevens-Johnson Syndrome (SJS), photosensitivity.

Question 19

What are the adverse effects of valproic acid?

Answer 19

GI issues, hepatotoxicity, pancreatitis, thrombocytopenia, hyperammonemia (CNS effects).

Question 20

What CNS effects does lamotrigine cause?

Answer 20

Dizziness, somnolence, aphasia, diplopia, blurred vision, headache, nausea/vomiting, depression.

Question 21

What serious CNS infection is associated with lamotrigine?

Answer 21

Aseptic meningitis (headache, fever, stiff neck, nausea/vomiting, rash, photophobia).

Question 22

What are the skin effects of lamotrigine?

Answer 22

Rash, Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN).

Question 23

What are the CNS effects of levetiracetam?

Answer 23

Dizziness, asthenia, agitation, anxiety, depression, suicidal ideation.

Question 24

What CNS effects does topiramate cause?

Answer 24

Somnolence, dizziness, ataxia, nervousness, diplopia, confusion, impaired cognitive function.

Question 25

What metabolic effect does topiramate cause?

Answer 25

Metabolic acidosis.

Question 26

What eye condition is associated with topiramate?

Answer 26

Angle-closure glaucoma.

Question 27

What CNS effects does oxcarbazepine cause?

Answer 27

Dizziness, drowsiness, diplopia, nystagmus, headache, nausea/vomiting, ataxia.

Question 28

What endocrine disorder can oxcarbazepine cause?

Answer 28

Hypothyroidism (lethargy, cold intolerance, dry skin, brittle hair, constipation).

Question 29

What serious hypersensitivity reaction is associated with oxcarbazepine?

Answer 29

Multiorgan hypersensitivity (fever, rash ± lymphadenopathy, hepatorenal syndrome, hematologic abnormalities).

Question 30

Why do gabapentin and pregabalin have abuse potential?

Answer 30

Due to their CNS effects (somnolence, dizziness, ataxia, fatigue, nystagmus, peripheral edema).

Question 31

What weight-related side effect does pregabalin cause?

Answer 31

Weight gain.

Question 32

What is the main nursing consideration for antiepileptic therapy?

Answer 32

Monitor therapeutic plasma levels to assess effectiveness.

Question 33

Why should antiepileptics never be stopped suddenly?

Answer 33

Risk of withdrawal seizures.

Question 34

What are the CNS effects of CNS stimulants?

Answer 34

Insomnia, restlessness.

Question 35

When should CNS stimulants be given?

Answer 35

In the morning before school.

Question 36

What effect do CNS stimulants have on appetite?

Answer 36

Decreased appetite, weight loss, growth suppression.

Question 37

What cardiovascular effects do CNS stimulants cause?

Answer 37

Dysrhythmias, chest pain, hypertension.

Question 38

What psychiatric effects do CNS stimulants cause?

Answer 38

Hallucinations, paranoia.

Question 39

What happens if CNS stimulants are stopped suddenly?

Answer 39

Tolerance & withdrawal symptoms (headache, nausea/vomiting, muscle weakness, depression).

Question 40

What are signs of CNS stimulant toxicity?

Answer 40

Dizziness, palpitations, hypertension, hallucinations, seizures.

Question 41

What substances interact with CNS stimulants?

Answer 41

MAOIs, caffeine, phenytoin, warfarin, phenobarbital, OTC cold/decongestants.

Question 42

What are the adverse effects of atomoxetine?

Answer 42

Appetite suppression, weight loss, growth suppression, GI issues, suicidal ideation, hepatotoxicity, seizures.

Question 43

What are the adverse effects of alpha-2 adrenergic agonists (guanfacine, clonidine)?

Answer 43

Sedation, drowsiness, fatigue, hypotension, bradycardia, weight gain.

Question 44

What should be avoided when taking alpha-2 adrenergic agonists?

Answer 44

CNS depressants, antihypertensives, high-fat foods.

Question 45

What is the goal of insomnia treatment with medication?

Answer 45

Use drugs for 2-3 weeks max.

Question 46

What are the "Z-drugs" used for insomnia?

Answer 46

Zolpidem, Zaleplon, Eszopiclone.

Question 47

What are the adverse effects of "Z-drugs"?

Answer 47

Daytime sleepiness, lightheadedness, headache.

Question 48

What are the risks of "Z-drugs" in pregnancy?

Answer 48

Neonatal respiratory depression.

Question 49

What is the melatonin agonist used for insomnia?

Answer 49

Ramelteon.

Question 50

What hormonal effects can ramelteon cause?

Answer 50

Amenorrhea, decreased libido, infertility, galactorrhea.

Question 51

What contraindications exist for ramelteon?

Answer 51

Severe liver disease, depression, sleep apnea, COPD.

Question 52

What are the orexin antagonists used for insomnia?

Answer 52

Suvorexant, Lemborexant, Daridorexant.

Question 53

What psychiatric effects can orexin antagonists cause?

Answer 53

Hallucinations, sleep paralysis, vivid/disturbing perceptions.