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NURS 305 - All Content > Neuro - Part 2 > Flashcards

Neuro - Part 2 Flashcards

1
Q

What is the drug class of amphetamine (Adderall)?

A

CNS stimulant

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2
Q

Describe the MOA of amphetamine (Adderall) (3)

A
  • Enhances norepinephrine and dopamine
  • Increases focus / alertness
  • Decreases appetite
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3
Q

What are the indications of amphetamine (Adderall)? (2)

A
  • ADHD
  • Narcolepsy
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4
Q

______ are important with the use of amphetamine (Adderall)

A

Drug holidays

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5
Q

What are the contraindications of amphetamine (Adderall)? (2)

A
  • Structural heart disease
  • MAOI use in previous 2 weeks
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6
Q

amphetamine (Adderall) can exacerbate what conditions? (4)

A
  • Anxiety
  • Hypertension
  • Tourette syndrome
  • Glaucoma
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7
Q

Avoid use of ______ with amphetamine (Adderall)

A

Caffeine / CNS stimulants

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8
Q

What are the black box warnings associated with amphetamine (Adderall)? (2)

A
  • High abuse potential / dependence with prolonged use
  • Stroke / MI with misuse
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9
Q

What are the side effects of amphetamine (Adderall)? (3)

A
  • Tachycardia
  • Insomnia
  • Increased metabolic rate
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10
Q

Parkinson’s disease is caused by an imbalance of which 2 neurotransmitters?

A
  • Dopamine - inhibitory
  • Acetylcholine - excitatory
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11
Q

______ is a precursor to dopamine - brain needs it to make dopamine

A

levodopa

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12
Q

Exogenous dopamine cannot …

A

Cross the blood-brain barrier

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13
Q

What occurs when levodopa is mixed with carbidopa?

A

Availability of levodopa increases - allows for lower doses

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14
Q

______ allows dopamine (levodopa) to cross the blood / brain barrier

A

carbidopa

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15
Q

What is primary the indication of carbidopa-levodopa (Sinemet)?

A

Parkinson’s disease

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16
Q

Describe the nursing considerations associated with carbidopa-levodopa (Sinemet) (2)

A
  • Best results if taken on empty stomach
  • Administer before breakfast to decrease dysphagia
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17
Q

What is the purpose of sinemet CR?

A

Increases “on” time / decreases “off” time

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18
Q

What is the drug class of pramipexole (Mirapex)?

A

Dopamine agonist

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19
Q

Describe the MOA of pramipexole (Mirapex)

A

Stimulates dopamine receptors

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20
Q

What are the indications of pramipexole (Mirapex)? (2)

A
  • Parkinson’s disease
  • Restless leg syndrome
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21
Q

What is the primary side effect of pramipexole (Mirapex)?

A

Orthostatic hypotension

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22
Q

What is the primary concern associated with pramipexole (Mirapex)?

A

Impulse control disorders

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23
Q

Describe the primary nursing implication associated with antiparkinson’s drugs

A

Ambulation assistance - fall risk due to orthostatic hypotension

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24
Q

Describe the nutritional considerations associated with antiparkinson’s drugs (2)

A
  • Avoid B6
  • Avoid high amounts of protein
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25
Q

Alzheimer’s disease is characterized by ______

A

Decreased acetylcholine

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26
Q

What is the drug class of donepezil (Aricept)?

A

Cholinesterase inhibitor

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27
Q

What is the primary indication of donepezil (Aricept)?

A

Alzheimer’s disease

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28
Q

What are the side effects of donepezil (Aricept)? (2)

A
  • GI upset
  • Vivid dreams
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29
Q

donepezil (Aricept) is NOT for ______

A

Curative purposes - slows progression / improves functioning

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30
Q

Describe the nursing interventions associated with donepezil (Aricept) (2)

A
  • Administer with food to decrease GI upset
  • Administer in morning to decrease nightmares / sleep disturbances
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31
Q

Describe the education associated with donepezil (Aricept)

A

DO NOT stop abruptly

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32
Q

______ are naturally produced / released by human cells that were invaded by viruses

A

Interferons

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33
Q

______ are proteins with antiviral, antitumor, & immunomodulating properties

A

Interferons

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34
Q

Describe the MOA of interferons (2)

A
  • Prevent virus replication in cells
  • Stimulate non-invaded cells to produce antiviral proteins - prevents virus from entering
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35
Q

What are the 3 groups of interferons?

A
  • Alpha
  • Beta
  • Gamma
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36
Q

What is the route of interferon beta products?

A

Injectable only

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37
Q

What is the primary indication of interferons?

A

Relapsing multiple sclerosis

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38
Q

What are the side effects of interferons? (3)

A
  • Bone marrow suppression
  • Necrosis at injection site
  • Flu-like symptoms
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39
Q

Describe the education associated with interferons (2)

A
  • Self injection teaching
  • Supplement with acetaminophen to decrease flu-like symptoms
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40
Q

Describe the laboratory testing associated with interferons (3)

A
  • CBCs
  • LFTs
  • TSH
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41
Q

What is the drug class of sumatriptan (Imitrex)?

A

Serotonin agonist

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42
Q

Describe the MOA of sumatriptan (Imitrex) (2)

A
  • Increases serotonin
  • Vasoconstriction of cranial arteries
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43
Q

What is the primary indication of sumatriptan (Imitrex)?

A

Acute migraines / cluster headaches

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44
Q

What are the contraindications of sumatriptan (Imitrex)? (2)

A
  • CAD
  • Pregnancy
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45
Q

Side effects of sumatriptan (Imitrex) are due to ______

A

Vasoconstriction

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46
Q

What are the side effects of sumatriptan (Imitrex)? (3)

A
  • Dysphagia
  • Numbness
  • Hypertension
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47
Q

sumatriptan (Imitrex) can cause what condition?

A

Serotonin syndrome

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48
Q

Serotonin syndrome can be ______ if not treated

A

Fatal

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49
Q

Which drug class is associated with the highest risk of serotonin syndrome?

A

Antidepressants

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50
Q

What are the mild manifestations of serotonin syndrome? (5)

A
  • Diaphoresis
  • Hypertension
  • Tachycardia
  • Pupil dilation
  • Shivering / goose bumps
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51
Q

What are the severe manifestations of serotonin syndrome? (3)

A
  • High fever
  • Seizures
  • Unconsciousness
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52
Q

What is myasthenia gravis? (2)

A
  • Decreased muscle activity
  • Autoimmune response against acetylcholine
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53
Q

Describe the MOA of cholinesterase inhibitors (2)

A
  • Prevent cholinesterase from breaking down acetylcholine
  • Increase acetylcholine
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54
Q

What are the complications associated with cholinesterase inhibitors? (2)

A
  • Excessive muscarinic stimulation
  • Cholinergic crisis
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55
Q

What are the manifestations of excessive muscarinic stimulation? (3)

A
  • Increased GI secretions
  • Diaphoresis
  • Bradycardia
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56
Q

What the primary concern associated with a cholinergic crisis?

A

Respiratory depression

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57
Q

Cholinesterase inhibitor dosages are based on what therapeutic responses? (2)

A
  • Recovery of muscle strength
  • Improved cognition
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58
Q

What is the reversal agent for cholinesterase inhibitors?

A

Atropine - blocks acetylcholine receptors / counteracts bradycardia

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59
Q

Describe the primary nursing consideration associated with cholinesterase inhibitors

A

Start with low doses and titrate to therapeutic response

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60
Q

What is the drug class of neostigmine (Prostigmin)?

A

Cholinesterase inhibitor

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61
Q

neostigmine (Prostigmin) enhances ______ action

A

Cholinergic

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62
Q

What are the indications of neostigmine (Prostigmin)? (2)

A
  • Myasthenia gravis
  • Reversal of NMBDs
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63
Q

What is the drug class of pyridostigmine (Mestinon)?

A

Cholinesterase inhibitor

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64
Q

What is the primary indication of pyridostigmine (Mestinon)?

A

Myasthenia gravis

65
Q

Describe the nursing considerations of pyridostigmine (Mestinon) (2)

A
  • Taken PO 4 times a day - compliance can be difficult
  • ER version taken daily / BID - improves compliance
66
Q

What are the adverse effects of pyridostigmine (Mestinon)? (3)

A
  • Abdominal pain
  • Fasciculations
  • Diarrhea
67
Q

______ are the most frequently used anxiolytic drugs

A

Benzodiazepines

68
Q

benzodiazepines are harmful when taken with ______

A

Alcohol

69
Q

benzodiazepines have a ______ response (especially in older adults)

A

Paradoxical

70
Q

What are the manifestations of benzodiazepine toxicity? (4)

A
  • Respiratory depression
  • Diminished reflexes
  • Somnolence
  • Coma
71
Q

What is the reversal agent for benzodiazepine toxicity?

A

flumazenil (Romazicon)

72
Q

Describe the primary education associated with benzodiazepines

A

DO NOT stop abruptly

73
Q

Use benzodiazepines as a ______

A

Last resort - opioids

74
Q

What is the drug class of hydroxyzine (Vistaril)?

A

1st generation antihistamine / anxiolytic

75
Q

Describe the MOA of hydroxyzine (Vistaril)

A

Produces calming effect in the brain to decrease anxiety

76
Q

What is the primary indication of hydroxyzine (Vistaril)?

A

Anxiety

77
Q

What are the side effects of hydroxyzine (Vistaril)? (4)

A
  • Blurred vision
  • Dry eyes
  • Dry mouth
  • Urinary retention
78
Q

What is the therapeutic dosage of hydroxyzine (Vistaril)?

A

50 - 100 mg PO Q6 hrs

79
Q

What is the drug class of amitriptyline (Elavil)?

A

Tricyclic antidepressant (TCA)

80
Q

Describe the MOA of amitriptyline (Elavil)

A

Increases serotonin and norepinephrine

81
Q

What are the indications of amitriptyline (Elavil)? (3)

A
  • Insomnia
  • Depression
  • Neuropathic pain
82
Q

What is the primary side effect of amitriptyline (Elavil)?

A

Orthostatic hypotension

83
Q

amitriptyline (Elavil) produces ______ effects

A

Anticholinergic

84
Q

amitriptyline (Elavil) overdose is especially lethal if ingested with ______

A

Alcohol - death from dysrhythmia / seizure

85
Q

It takes ______ to see a clinical response to amitriptyline (Elavil)

A

2 - 4 weeks

86
Q

Describe the primary nursing consideration associated with amitriptyline (Elavil)

A

Take at night - sedation effects

87
Q

What is the drug class of mirtazapine (Remeron)?

A

Norepinephrine / serotonin modulator

88
Q

Which antidepressant is least likely to cause sexual dysfunction?

A

mirtazapine (Remeron)

89
Q

Describe the primary nursing consideration associated with mirtazapine (Remeron)

A

Take at night - sedation effects

90
Q

What are the side effects of mirtazapine (Remeron)? (2)

A
  • Weight gain
  • Increased appetite
91
Q

What are the interactions of mirtazapine (Remeron)? (2)

A
  • phenytoin
  • -azole antifungals
92
Q

What is the drug class of phenelzine (Nardil)?

A

MAOI – monoamine oxidase inhibitor

93
Q

Describe the MOA of phenelzine (Nardil) (2)

A
  • Blocks MAO
  • Increases norepinephrine, dopamine, serotonin, and tyramine
94
Q

phenelzine (Nardil) is used less frequently for depression due to …

A

Many interactions / dietary restrictions

95
Q

What foods / medications should be avoided when taking phenelzine (Nardil), due to the risk of hypertensive crisis? (4)

A
  • Tyramine rich foods
  • OTC decongestants
  • Sympathomimetics
  • Tricyclic antidepressants
96
Q

______ should be avoided when taking phenelzine (Nardil), due to the risk of serotonin syndrome

A

SSRIs

97
Q

What are some examples of foods high in tyramine? (5)

A
  • Yogurt
  • Coffee
  • Chocolate
  • Bananas
  • Beer
98
Q

What is the primary adverse effect associated with antidepressants?

A

Suicidal thoughts

99
Q

What are the general interactions associated with antidepressants? (2)

A
  • MOAIs
  • Alcohol / CNS depressants
100
Q

What is the drug class of citalopram (Celexa)?

A

SSRI

101
Q

When is the maximum clinical effectiveness of citalopram (Celexa) achieved?

A

6 - 8 weeks

102
Q

Describe the MOA of citalopram (Celexa)

A

Increases serotonin

103
Q

What are the indications of citalopram (Celexa)? (2)

A
  • Depression
  • OCD
104
Q

citalopram (Celexa) has a ______ causing withdrawal syndrome

A

Short half-life

105
Q

What are the side effects of citalopram (Celexa)? (2)

A
  • Insomnia
  • Sexual dysfunction
106
Q

Describe the education associated with citalopram (Celexa)

A

Take in morning to decrease insomnia

107
Q

What is the drug class of venlafaxine (Effexor)?

A

SNRI

108
Q

Describe the MOA of venlafaxine (Effexor)

A

Increases serotonin and norepinephrine

109
Q

What are the indications of venlafaxine (Effexor)? (2)

A
  • Depression
  • GAD
110
Q

What are the side effects of venlafaxine (Effexor)? (3)

A
  • Tachycardia
  • Hypertension
  • Serotonin syndrome
111
Q

What are the manifestations of serotonin syndrome? (4)

A
  • Nausea
  • Drowsiness
  • Headache
  • Dry mouth
112
Q

What are the interactions associated with venlafaxine (Effexor)? (4)

A
  • SSRIs
  • TCAs
  • Triptans
  • Grapefruit juice
113
Q

What is the drug class of bupropion HCL (Wellbutrin)?

A

DNRI

114
Q

Describe the MOA of bupropion HCL (Wellbutrin)

A

Increases dopamine and norepinephrine

115
Q

What are the indications of bupropion HCL (Wellbutrin)? (3)

A
  • Depression
  • Smoking cessation
  • Sexual dysfunction from SSRIs
116
Q

What are the side effects of bupropion HCL (Wellbutrin)? (2)

A
  • Decreased appetite
  • Weight loss
117
Q

What is the drug class of trazodone (Desyrel)?

A

Serotonin modulator

118
Q

trazodone (Desyrel) has minimal adverse effects on ______

A

The cardiovascular system

119
Q

trazodone (Desyrel) is a better choice for patients with what conditions? (2)

A
  • CHF
  • Hypertension
120
Q

What are the indications of trazodone (Desyrel)? (2)

A
  • Depression
  • Insomnia
121
Q

What are the side effects of trazodone (Desyrel)? (3)

A
  • Priapism
  • Sedation
  • Impaired cognitive function in older adults
122
Q

What is priapism?

A

Prolonged erections resulting in tissue death

123
Q

Describe the education associated with trazodone (Desyrel)

A

Take at bedtime - sedative effects

124
Q

Describe the general nursing considerations associated with antidepressants (2)

A
  • Require at least 6 weeks of therapy
  • May require increased dosages
125
Q

Antidepressants should be used in conjunction with ______

A

Psychotherapy

126
Q

What is the drug class of lithium (Lithobid)?

A

Mood stabilizing drug

127
Q

What is the primary indication of lithium (Lithobid)?

A

Bipolar disorder (drug of choice for mania)

128
Q

lithium (Lithobid) has a ______ therapeutic range

A

Narrow

129
Q

What lithium (Lithobid) levels begin to produce toxicity?

A

> 1.5 – 2.5

130
Q

What are the manifestations of lithium (Lithobid) toxicity? (4)

A
  • Tremors
  • Confusion
  • Sedation
  • Seizures
131
Q

What factors increase the risk of lithium (Lithobid) toxicity? (2)

A
  • Dehydration
  • Hyponatremia
132
Q

Describe the monitoring associated with lithium (Lithobid) (2)

A
  • Sodium levels
  • Routine drug monitoring - maintain therapeutic levels
133
Q

Describe the education associated with lithium (Lithobid)

A

Maintain consistent sodium intake

134
Q

What are the side effects of lithium (Lithobid)? (3)

A
  • Increased thirst
  • Renal toxicity
  • Weight gain
135
Q

Long-term treatment using lithium (Lithobid) may cause ______

A

Hypothyroidism

136
Q

What are the indications of antipsychotics? (5)

A
  • Autism
  • Tourette’s
  • Schizophrenia
  • Extreme mania
  • Intractable hiccups
137
Q

Describe the MOA of antipsychotics (2)

A
  • Block dopamine receptors
  • Causes a tranquilizing effect
138
Q

What is the primary concern associated with antipsychotics?

A

Extrapyramidal syndrome (EPS)

139
Q

What is extrapyramidal syndrome (EPS)?

A

Involuntary muscle spasms similar to those of Parkinson’s disease

140
Q

What are the manifestations of extrapyramidal syndrome (EPS)? (4)

A
  • Akathisia
  • Acute dystonia
  • Tardive dyskinesia
  • Pseudoparkinsonism
141
Q

Describe the treatment of akathisia (2)

A
  • Lorazepam
  • Beta blockers
142
Q

Describe the treatment of acute dystonia (2)

A
  • Lorazepam
  • benztropine (Cogentin)
143
Q

Describe the treatment of tardive dyskinesia (3)

A
  • Benzos
  • Beta blockers
  • Calcium channel blockers
144
Q

What is the drug class of haloperidol (Haldol)?

A

Antipsychotic

145
Q

What is the primary indication of haloperidol (Haldol)?

A

Psychosis

146
Q

haloperidol (Haldol) can be given at a low dose to treat ______

A

Nausea

147
Q

What is the primary contraindication of haloperidol (Haldol)?

A

Patients on large doses of CNS depressants

148
Q

Describe the black box warning associated with haloperidol (Haldol)

A

Not approved for dementia related psychosis

149
Q

Why are atypical / second generation antipsychotics preferred over conventional antipsychotics?

A

They block SPECIFIC dopamine / serotonin receptors

150
Q

What is the drug class of risperidone (Risperdal)?

A

Atypical / second generation antipsychotic

151
Q

risperidone (Risperdal) is less likely to cause ______ than first generation antipsychotics

A

Tardive dyskinesia

152
Q

What is the primary indication of risperidone (Risperdal)?

A

Schizophrenia

153
Q

Describe the black box warning associated with risperidone (Risperdal) (2)

A
  • Not approved for dementia related psychosis
  • Increased risk of suicide in children, adolescents, and young adults
154
Q

What is the drug class of benztropine (Cogentin)?

A

Anticholinergic - crosses blood brain barrier

155
Q

Describe the MOA of benztropine (Cogentin)

A

Increases acetylcholine

156
Q

What are the indications of benztropine (Cogentin)? (2)

A
  • Extrapyramidal syndrome (EPS)
  • Parkinson’s disease
157
Q

Use caution with benztropine (Cogentin) in what conditions?

A

Extreme heat / exercise - risk of hyperthermia

158
Q

benztropine (Cogentin) causes ______ side effects

A

Anticholinergic

159
Q

Describe anticholinergic side effects (4)

A
  • Blurred vision
  • Urinary retention
  • Dry mouth
  • Constipation

NURS 305 - All Content (20 decks)

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