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Nursing Pharmacology > C8- Central Nervous System Medications > Flashcards

C8- Central Nervous System Medications Flashcards

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1
Q

What are some positive symptoms of schizophrenia?

A

hallucinations
paranoia
delusions
speech abnormalities
affective problems

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2
Q

Mania is defined as?

A

associated with bipolar periods of extreme over activity and excitement

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3
Q

Narcolepsy is defined as?

A

Daytime sleepiness and sudden periods of loss of wakefulness

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4
Q

Typical antipsychotic (first generation) prototype name?

A

Haloperidol

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5
Q

Haloperidol typical antipsychotic action?

A

block dopamine receptors in the brain
-suppress symptoms of psychosis
lipid soluble highly protein bound

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6
Q

What are the therapeutic of using haloperidol typical antipsychotic?

A

Schizophrenia (onset 1-2 days, therapeutic 2-4 weeks)
Bipolar mania suppression
Prevention of emesis (low dose)

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7
Q

What are antipsychotic adverse effects?

A

extrapyramidal syndrome
neuroleptic malignant syndrome (NMS) ** MEDICAL EMERGENCY **
Sexual dysfunction
Seizures
Dermatologic effects
Agranulocytosis
Severe dysrhythmias
Anticholinergic effects
Orthostatic hypotension
Sedation
Neuroendocrine effects

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8
Q

Extrapyramidal syndrome symptoms include?

A

Tardive Dyskinesia (jerky irregular movements)
Akathisia (motor restlessness)
Dystonia (continuous spasms and contractions)
Parkinson’s like movements

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9
Q

Typical Antipsychotic drug interactions?

A

Anticholinergic drugs (intensify anticholinergic effects)
CNS depressants (including alcohol) (intensified CNS Depression)
Levodopa and direct dopamine receptor agonist (counteract antipsychotic effect)

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10
Q

Atypical antipsychotic prototype drug name?

A

Risperidone

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11
Q

Atypical antipsychotic risperidone uses?

A

Schizophrenia
BPD
Levodopa induced psychosis
Irritability from autistic disorder

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12
Q

Atypical antipsychotic risperidone action?

A

blocks SEROTONIN & DOPAMINE

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13
Q

Adverse effects of atypical antipsychotic risperidone?

A

weight gain
diabetes
seizures
low risk of EPS
low anticholinergic effets

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14
Q

What are depot antipschotics?

A

used for long term maintenence therapy (injectable)
may be court ordered
first or second generation
ideal for clients with poor compliance

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15
Q

What is the drug prototype for mood stabilizers?

A

Lithium

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16
Q

What is a pure manic episode?

A

Euphoric Mania

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17
Q

What is a hypomanic episode

A

hypomania

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18
Q

what is major depressive episode

A

depression

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19
Q

What are mixed episodes?

A

patients experience symptoms of mania and depression simultaneously
this combination puts them at high risk for suicide

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20
Q

What are the kinetics of Lithium?

A

absorbed rapidly through GI (water soluble)
not metabolized
excreted unchanged
short half life and high toxicity require divided daily doses (3-4/day)

21
Q

Lithium action is unknown, what are the known dynamics of lithium?

A

Increase NE & 5HT reuptake
reduce release of NE
inhibit action of NE

22
Q

Lithium is what pregnancy category?

A

D

23
Q

Side effects of lithium include?

A

diabetes insipidus
hypothyroidism
tremors
seizures
heart block

24
Q

What happens to the body in the presence of low sodium when taking lithium?

A

Can accumulate to toxic levels

low sodium = reduced lithium excretion

25
Q

Lithium drug interations

A

Increased by low sodium
loop and thiazide diuretics - use caution
NSAIDS
anticholinergic drugs - dehydration causes lithium retention
antihistamines
TCA
phenothiazine antipschotics

26
Q

Long term use of lithium can lead to _______ dysfunction?

A

thyroid dysfunction (hypo)

27
Q

Therapeutic levels of lithium are?

A

0.5-1.5 mEq/L

28
Q

What should a nurse monitor in a patient using lithium?

A

Regular lithium levels
sodium levels
renal and liver function tests
suicidal ideation and neuro status
glucose level in pt with diabetes

29
Q

What should a nurse do if toxic lithium levels appear?

A

withhold one dose and notify prescriber

30
Q

When should lithium be taken?

A

with meals

31
Q

Lithium may cause excessive thirst, what should the nurse advise to the patient about this?

A

patient should maintain normal diet
fluid intake of 2000-3000 m during the dose stabilization period ad 1500ml afterward
expect transient thirst
advise patient to report continued thirst and dilute urine to provider

32
Q

What are the toxic levels of lithium?

A

> 2.0mEq/L

33
Q

What is parkinsons disease?

A

chronic progressive neurologic disorder that affects the extrapyramidal motor tract responsible for controlling posture, balance, and locomotion.

34
Q

What is pseudoparkinsonism

A

Occurs as an adverse reaction to various drugs, carbon monoxide, manganese, or disorders.
combination of similar symptoms; rigidity, bradykinesia, gait disturbances, and tremors

35
Q

What causes parkinson’s?

A

Low dopamine
-creates an imbalance of dopamine and acetylcholine

36
Q

Parkinson’s disease treatment?

A

symptomatic relief
dopaminergics - dopamine cannot cross blood brain barrier
anticholinergics

37
Q

Anti-parkinson’s medications

A

Levodopa-Carbidopa

38
Q

What does levodopa do?

A

crosses BBB and is converted to dopamine in the brain tissue
** CANNOT BE USED ALONE **

39
Q

What does Carbidopa do?

A

** CANNOT BE USED ALONE **
in combination with levodopa, allows more levodopa to cross BBB more effectively with lower dosages. Carbidopa prevets peripheral/intestinal breakdown of levodopa to reach the brain.

40
Q

How does a provider dose Levodopa-Carbidopa?

A

Variable depending on severity
short duration of action (on-off phenomenon)
-extended release capsules decrease “off” frequency
dosing changes as disease progresses

41
Q

What are levodopa side effects?

A

Nausea (administer with food)
Othrostatic hypotension (teach precautions)
psychosis (teach symptoms to report)
discoloration of urine and sweat

42
Q

Interactions of levodopa include?

A

MAOI
Vitamin B6 (reverses levodopa effects)
Antipsychotics
Benzodiazepines

43
Q

What are the three common generalized seizure types?

A

Tonic Clonic (grand mal)
Absence (petit mal)
Common partial seizure

44
Q

What happens in a tonic clonic seizure?

A

unconsciousness, convulsions, muscle rigidity
(usually involve both hemispheres of brain)

45
Q

What happens in an absence seizure?

A

brief loss of consciousnes

46
Q

What is the target goal for antiepileptic drugs?

A

stabilize nerve cell membrane.
suppress abnormal electric impulses in cerebral cortex

47
Q

Antiepileptic drugs action

A

suppress sodium influx
suppress calcium influx
enhance action of GABA
promote GABA release

48
Q

Hydantoin

A

Phenytoin

49
Q

Hydantoin/Phenytoin therapeutic range

A

10-20 mcg/ml

Nursing Pharmacology (11 decks)

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