chronic neurological diseases

Question 1

pramipexole

Answer 1

unknown thought to stimulate dopamine receptors in the brain
relief from dyskinesias (slow walking, resting, tremors, and rigid muscles associated w parkinsons)
extreme drowsiness, falling asleep suddenly, nausea, orthostatic hypotension, psychosis, impulse control
monitor for s&s of orthostatic hypotension esp when drug dosage is inc
pt may fall asleep use caution w pts that require alertness
avoid alcohol
monitor cardiac status
may cause dizziness, hallucinations

Question 2

donepezil

Answer 2

prevents enzyme cholinesterase from inactivating ACH increasing the amount of ACH available at receptor sites
improves cognitive function (thinking and remembering) along w mild to moderate alzheimers
diarrhea, loss of appetite, nausea, trouble sleeping, vomiting, unusual bleeding or bruising

Question 3

lamotrigine

Answer 3

Unknown possibly inhibiting voltage sensitive sodium channels, stabilizing neuronal membranes
Stabilizes neuronal membranes, controls seizures
Treatment of prevention of seizures Dizziness, ataxia, diplopia, N/V, risk of suicide, aseptic meinigitis
Lab levels to ensure therapeutic dose of drug
Assess patient alertness while on drug
Monitor patients risk for suicide before beginning treatment and during
Assess for S/S aspetic meinigitis (HA, fever stiff neck, N/V, sensitivity to light)
Assess for skin rash if this occurs call HCP
May cause blurred vision, double vision, clumsiness, unsteadiness, drowsiness, do not drive
Do not stop medication suddenly
Notify HCP of HA, fever, stiff neck, skin rash or suddenly becoming suicidal

Question 4

phenytoin (dilantin)

Answer 4

stabilizes neuronal membranes, controls seizures
CNS - ataxia, drowsiness, lethargy, gingival hyperplasia
CV- dysrhythmias, hypotension
metabolic - interference w vit D metabolism, acne, hirsutism, coarsening of the facial features
give drug w/w/o food in a consistent matter, measure drug levels in pt for therapeutic effect, recommend that oral phenytoin prescription be filled same brand each time
lymph node enlargement
administer IV slowly, check w HCP if cardiac issues
consume enough calcium and vitamin D