Neuro Drugs

Question 1

What do you always monitor with antiseizure meds?

Answer 1

Plasma levels

Question 2

Why do you have to monitor plasma levels when giving antiseizure drugs?

Answer 2

Identify toxicity
Monitors patient adherence
Guide for dosage adjustment
Determines cause of lost seizure control

Question 3

Phenytoin (Dilantin)
Disease-
Used for- 
MOA-
Adverse Effects- CNS (2) Skin (1) Cardio (2) Other (2)
Drug interactions- Decreases (3) 
Admin-

Answer 3

Antiseizure
Most widely used against tonic-clonic 
Selectively inhibits sodium channels 
Involuntary movement and cognitive impairment
Rash
Gingival Hyperplasia Teratogenic
Cardiac dysrhythmias and hypotension
Birth control, warfarin, glucocorticoids
Administer with food

Question 4

Carbamazepine (Tegretol)
MOA-
Used for- (3)
Adverse effects- (2)
Special admin-

Answer 4

Selective inhibition of sodium channels
Epilepsy, Bipolar disorder and trigeminal neuralgia
Bone marrow suppression and teratogenic
Never take with grapefruit juice

Question 5

Valproic Acid (Depakene, Depakote)
MOA-
Used for- Seizure type (2) other (2)
Adverse effects- (3)

Answer 5

Suppression of sodium channels
Partial and generalized seizures, bipolar disorder and migraine prevention
hepatotoxicity and pancreatitis and teratogenic

Question 6

Phenobarbital 
Pros: (3)
Cons: (2)
Drug interactions: (2)
Adverse effects- (2)

Answer 6

Effective and inexpensive and lowers seizures without sedation
can cause physical dependence and toxicity
lowers effects of warfrin and birth control
drowsiness and interferes with vitamin D and K

Question 7

Oxcarbazepine (Trileptal)
MOA- 
Used for-
Adverse Effects- (2)
Avoid-

Answer 7

blockage of sodium channels
partial seizures
Dizziness, drowsiness
driving

Question 8

Lamotrigine (Lamictal)
Used for- (2)
MOA-
Adverse Reactions- (2)

Answer 8

Broad spectrum antiseizure and bipolar disorder
Blocks sodium and calcium channels
Life threatening rash and suicide risk

Question 9

Gabapentin
used for-
Side effects- (6)

Answer 9

adjunct for partial seizures

somnolence, dizziness, ataxia, fatigue, Nystagmus, peripheral edema

Question 10

Pregabalin (Lyrica)
Used for- (3)
Special- (1)
Adverse reaction- (1)

Answer 10

neuropathic pain, postherpetic neuralgia, partial seizures
regulated under Controlled Substance Act
Life threating angioedema

Question 11

Levetiracetam

Used for-

Answer 11

Antiseizure

Question 12

Topiramate

Used for- (2)

Answer 12

Broad-spectrum antiseizure and migraines

Question 13

Lorazepam (Ativan)

Used for-

Answer 13

FIRST drug for status epilepticus

Question 14

Diazepam (Valium)

Used for-

Answer 14

SECOND drug for status epilepticus

Question 15

Riluzole 
Used for-
Helps by-
MOA-
Adverse Effects- (8)

Answer 15

ALS
Slows progression and delays trach
asthenia, GI, Dizziness, vertigo, somnolence, decreased lung function, neutropenia, liver injury

Question 16

Memantine
Used for-
MOA-

Answer 16

Alzheimer’s

Protects nerve cell against glutamate

Question 17

Cholinesterase Inhibitors
Names- (2)
Used for-

Answer 17

Donepezil, rivastigmine

Alzheimer’s

Question 18

Baclofen
Used for/after- (3)
MOA- 
Adverse Effects- (3)
Biggest Concern-

Answer 18

Muscle spasms, MS, spinal post-op
suppress hyperactive reflexes
CNS, GI, Urinary retention
No antidote for overdose

Question 19

Interferon Beta
Class-
Used for-
Contains what properties- (3)
Therapeutic use- (3)
Adverse Effects- (4)

Answer 19

Immunomodulators
MS
antiviral, antiproliferative, immunomodulatory
reduces frequency and severity of attacks, reduces the number of lesions, delays progression
flu-like, hepatotoxicity, myelosuppression, depression

Question 20

Mitoxantrone
Class-
Used for-
Biggest concern- (3)

Answer 20

Immunosuppressant
MS in later stages to lower relapses
Myelosuppression (infection risk), cardiotoxicity, fetal harm

Question 21

Levodopa
Used for- 
Admin Considerations-
MOA- 
\_\_\_\_ but \_\_\_\_\_

Answer 21

Parkinson’s
Protein delays absorption
Converts to dopamine
Highly effective but loses power over time

Question 22

Levodopa/carbidopa
MOA: levodopa then carbidopa
Adverse Effects- (4)

Answer 22

Converted to dopamine, prevents destruction of Levodopa

N/V, involuntary movement, hypotension, mental changes

Question 23

What is the first drug of choice for mild to moderate symptoms of Parkinson’s?

Answer 23

Dopamine Agonists

Question 24

Pramipexole
Class-
Used for-
Adverse effects- (1 major, 5 minor)

Answer 24

Dopamine Agonist
Early stage PD
Sleep attacks, nausea, dizziness, insomnia, weakness, hallucinations

Question 25

``` Trihexyphenidyl and Benztropine Class- Used for- MOA- Adverse Effects- (7) ```

Answer 25

Anticholinergic Parkinson's Blocks ACh receptors dry mouth, urinary retention, tachycardia, blurred vision, constipation, photophobia, confusion, hallucinations

Question 26

Entacapone and Talcapone Class- MOA- Major Adverse effect-

Answer 26

COMT Inhibitor Make sure levodopa is not broken down before it gets to the brain liver failure

Question 27

Selegiline and Rasagiline Class- MOA- Major adverse effect and intervention-

Answer 27

MAO-B inhibitor Inhibits breakdown of dopamine insomnia, only take at breakfast and lunch

Question 28

Nimodipine Class- Used for- Adverse Effect-

Answer 28

Calcium Channel blocker Cerebral vasospasm Low blood pressure

Question 29

``` TPA (thrombolytic therapy) Used for- Special Tx necessity- Major side effect- Major nursing priorities- (2) ```

Answer 29

Ischemic stroke Must be started within 3 hours of the onset of symptoms (with no GI bleeding or surgery within last 14 days) High bleeding risk must control BP for 24 hours and have type and cross done with blood ready