CNS/ neuro

Question 1

drug of choice for any seizure besides petit mal

Answer 1

phenytoin

Question 2

ADR of phenytoin

Answer 2

gingival hyperplasia, bone marrow suppression

Question 3

therapeutic level of phenytoin

Answer 3

10-20 mcg/mL

Question 4

phenytoin toxicity

Answer 4

nystagmus, ataxia, dysarthria, and encephalopathy

Question 5

nursing considerations for phenytoin administration

Answer 5

PO is safest route, CV collapse if IV not well diluted, do not exceed 50 mg/min, incompatible with dextrose

Question 6

other common anticonvulsants

Answer 6

valproic acid, carbamazepine, lamotrigine

Question 7

common ADR among all anticonvulsants

Answer 7

Steven-Johnson’s Syndrome

Question 8

Symptoms of SJS

Answer 8

flu like symptoms and painful rash

Question 9

what is the drug of choice for status epilepticus?

Answer 9

diazepam IV; do not give faster than 2 mg/min or 0.05 mg/kg

Question 10

what can be given for acute seizures in pregnancy?

Answer 10

magnesium sulfate

Question 11

what are neuromuscular blocking agents?

Answer 11

cause muscle paralysis; used in adjunct with anesthesia or maintain patients on ventilators

Question 12

common depolarizing NMBA?

Answer 12

succinylcholine (limits Ach effect at synapse)

Question 13

ADR of succinylcholine

Answer 13

malignant hyperthermia

Question 14

treatment for malignant hyperthermia?

Answer 14

dantrolene

Question 15

common non-depolarizing NMBA

Answer 15

-curonium IV meds (compete with Ach at synapse)

Question 16

ADR of -curonium drugs

Answer 16

cholinergic crisis

Question 17

common muscle relaxants

Answer 17

cyclobenzaprine, methocarbamol, dantrolene

Question 18

migraine drug of choice

Answer 18

-triptan drugs

Question 19

migraine prophylaxis

Answer 19

propanolol, TCAs, divalproex, lamotrigine, gabapentin, estrogen therapy for post-menopausal women, botox

Question 20

what is Parkinson’s Disease?

Answer 20

imbalance between dopamine and Ach; treatment increases dopamine and decreases Ach

Question 21

drug of choice for Parkinson’s?

Answer 21

levodopa/carbidopa

Question 22

drug interaction with Parkinson’s treatment

Answer 22

vitamin B6 increases GI and hepatic breakdown

Question 23

what is Myasthenia Gravis?

Answer 23

disease of reduced receptors for Ach resulting in muscle weakness

Question 24

treatment for MG?

Answer 24

cholinesterase inhibitors

Question 25

examples of MG treatment

Answer 25

edrophonium, pyridostigmine, neostigmine

Question 26

ADRs of cholinesterase inhibitors

Answer 26

SLUDGEM

Question 27

how to diagnose MG?

Answer 27

Tensilon Test; if IV edrophonium to watch for muscle strengthening within 1 minute

Question 28

cholinergic crisis antidote

Answer 28

atropine

Question 29

Alzheimer’s disease

Answer 29

decreased Ach

Question 30

common drugs for Alzheimer’s symptoms

Answer 30

rivastigmine, donepezil