Key Counseling Points - Neuro/Psych Flashcards
Benztropine counseling points
Drug may impair heat regulation. Advise patient to use caution with activities leading to an increased core temperature, such as strenuous exercise, exposure to extreme heat, or dehydration. Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Instruct patient to report sudden muscle weakness or stiffness, and signs/symptoms of tardive dyskinesia (tongue thrusting, facial grimacing/tics, random movements of extremities). Patient should not drink alcohol while taking this drug.
Carbamazepine counseling points
May decrease effectiveness of oral contraceptives; use an alternative form of birth control. Avoid activities requiring mental alertness or coordination until drug effects are realized. Take with food, but not alcohol, grapefruit, or grapefruit juice. Avoid abrupt discontinuation.
Carbidopa/Levodopa counseling points
If you are using the oral disintegrating tablets, place on top of the tongue; does not require water or swallowing.
Dexmethylphenidate counseling points
Avoid late evening doses due to resulting insomnia. If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as applesauce. Stir this mixture well and swallow it without chewing. Seek medical attention if chest pain, seizures, heart palpitations, change in behavior or personality, or hostility.
Divalproex counseling points
Avoid activities requiring mental alertness until drug effects are realized; drug may cause somnolence or dizziness. Seek medical attention for signs and symptoms of liver dysfunction (eg, dark-colored urine, light-colored stools, yellowing of skin or eyes, etc), especially during first 6 mo of therapy. Take with food to avoid GI irritation. Do not discontinue drug abruptly, as this may precipitate seizures. Avoid alcohol. Sprinkle capsules can be swallowed whole or opened and sprinkled onto soft food; do not chew.
Donepezil counseling points
Take at bedtime, with or without food. Allow disintegrating tablet to dissolve on tongue and follow with a glass of water. Adverse effects may be more frequent at dose escalation and tend to resolve with continued use. Report signs/symptoms of GI bleeding.
Eletriptan counseling points
Should avoid activities requiring mental alertness or coordination until drug effects are realized, as this drug may cause dizziness or somnolence.
Eszopiclone counseling points
Take immediately before bedtime and do not take with heavy/high-fat meal. Severe anaphylactic/anaphylactoid reactions, some fatal, have been reported. Be aware of the risk of “sleep-driving” and other complex behaviors (eg, preparing and eating food, making phone calls) when the patient is not fully awake. Risk is increased when drug is combined with alcohol or other CNS depressants. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report insomnia that worsens or persists longer than 7-10 d. Report abnormal thoughts or behavior (confusion, agitation, hallucinations, suicidal thoughts, new or worsening depression), memory loss, or anxiety. Take drug only when experiencing insomnia. This drug should not be taken on a regular schedule when insomnia is not present. Do not drink alcohol while taking this drug.
Gabapentin counseling points
First dose on 1st day should be taken at bedtime. ER formulation should be taken with the evening meal. Patient should avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause dizziness and somnolence. Report worsening depression, suicidal ideation, or unusual changes in behavior. Avoid sudden discontinuation of drug, as this may precipitate status epilepticus. Wait 2 h after antacid before taking medication.
Guanfacine counseling points
Avoid alcohol, CNS depressants. Caution with driving and other tasks requiring alertness. Swallow extended-release tablet whole, may be taken with or without food. Report signs/symptoms of hypotension, exacerbation of angina peripheral edema, fatigue, hypotension, or hepatic dysfunction with initial dosing and dose changes. Avoid abrupt discontinuation to avoid rebound HTN.
Lacosamide counseling points
May be taken without regard to food but at same time of day. Take with food if GI distress. For the oral solution, measure carefully with oral syringe. Seek medical attention if seizure frequency increases or seizures worsen, abnormal heartbeat, or extreme dizziness.
Lamotrigine counseling points
Seek medical attention if blistering rash develops or if yellowing of skin or eyes, unusual bruising or bleeding, shortness of breath, or suicidal thoughts occur. Slow titration necessary to minimize side effects. Avoid alcohol. Consult HCP if become or planning to become pregnant. Review driving restrictions for patients with seizures. Place oral disintegrating tablet formulation on tongue and allow to dissolve.
Levetiracetam counseling points
Swallow extended-release tablet whole; do not chew, break, or crush. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report mood swings, agitation, hostile behavior, suicidal ideation, or unusual changes in behavior. Avoid sudden discontinuation of drug; may increase seizure activity.
Lisdexamfetamine counseling points
Take dose in the morning with or without food. If capsule opened for administration, drug should be dissolved in water, yogurt, or orange juice and consumed immediately. Monitor growth rate and weight in children. Report new or worsened psychiatric problems (behavior and thought problems, bipolar illness, aggressive behavior or hostility). Also report chest pain, palpitations, dyspnea, or signs/symptoms of cardiac dysrhythmia, AMI, or cerebrovascular accident.
Memantine counseling points
May be taken with or without food. The oral solution is packaged with a dosing device that should be used to administer the medication.
Metaxalone counseling points
Patients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects.
Methylphenidate counseling points
Avoid late evening doses due to resulting insomnia. Swallow the extended-release capsule whole. Do not crush, break, or chew it. If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as pudding, yogurt, or applesauce. Stir this mixture well and swallow it without chewing. Avoid abrupt discontinuation. For the patch, apply same time each day, alternating hips. Remove after 9 h.
Modafinil counseling points
This drug may decrease effectiveness of hormonal or IUD contraception. Recommend additional form of birth control during therapy and 1 mo after last dose. Avoid activities requiring mental alertness or coordination until drug effects are realized. If using drug for daytime wakefulness, take in the morning; if using to maintain wakefulness during shift work, take drug 1 h prior to working. Do not drink alcohol while taking this drug. Practice good sleep hygiene. Does not replace need for CPAP machines in patients with obstructive sleep apnea.
Oxcarbazepine counseling points
Suspension should be shaken well and dose prepared immediately using oral dosing syringe. Suspension can be mixed in a small glass of water just prior to administration or may be swallowed directly from the syringe. Avoid activities requiring mental alertness or coordination until drug effects are realized. Advise patient to report signs/symptoms of serious dermatologic reactions, myelosuppression, or hepatotoxicity. Take with food, but not alcohol, grapefruit, or grapefruit juice. Avoid abrupt discontinuation to avoid risk of seizure.
Phenobarbital counseling points
Avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause dizziness, light-headedness, or somnolence. Advise patient against sudden discontinuation of drug. Do not drink alcohol or use other CNS depressant drugs while taking phenobarbital. Many drug interactions; check with HCP when starting new medications or OTC products.
Phentermine counseling points
May impair ability to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle; avoid. Take during day to avoid insomnia.
Phenytoin counseling points
Suspension requires extensive shaking before administration. Do not crush extended-release capsules. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report signs/symptoms of pancytopenia, hepatotoxicity, systemic lupus erythematosus, or severe skin reaction. Do not drink alcohol while taking this drug. Many drug interactions; check with HCP when starting new medications or OTC products.
Pramipexole counseling points
Take with food if nausea occurs. Avoid activities requiring mental alertness or coordination until drug effects are realized. Rise slowly from a sitting/lying-down position. Report new or increased gambling urges, sexual urges, compulsive eating or buying, as well as new-onset or worsening dyskinesia. Do not discontinue abruptly, as this may cause emergent hyperpyrexia and confusion. Do not drink alcohol, and avoid concomitant use of other CNS depressants.
