Neurologic

Question 1

Parkinson’s meds

Answer 1

• Levodopa-carbidopa
  
  • main drug for Parkinsons
  • darkening of secreations is normal
• Ropinirole
  
  • also for restless leg syndrome

Question 2

Levodopa-carbidopa a/e

Answer 2

• orthostasis (BP) !!!
• mood instability
• paranoia
• sleep alterations
• vomiting

Question 3

Lorazepam

Answer 3

• benzo thats acts as anticonvulsant
• alcohol withdrawal

Question 4

Phenytoin

Answer 4

• anticonvulsant thats slower than other benzos
• used for long-term seizure control
• can take before surgery
• vesicant = requires large-bore peripheral vascular access device
• can cause cardiac dysrhythmias = continuous cardiac monitor
• avoid warfarin
• lab work to ensure therapeutic range
  
  • 10-20 mcg/mL

Question 5

Sumatriptan

Answer 5

• migraine treatment
• stops headaches after they start, not before
• warm, tingly feeling is normal
• nervous (normal)
• causes angina (concerning)
• monitor BP and mental status

Question 6

Succinylcholine

Answer 6

• induces muscle paraylsis
• given before intubation
• prolonged use causes hyperkalemia and hyperthermia
• can cause malignant hyperthermia (MH)
  
  • emergency caused by anesthesia

Question 7

Hydromorphone

Answer 7

• for pain
• causes
  
  • pupil constriction
  • urinary retention

Question 8

Naproxen

Answer 8

• NSAID
• causes adverse bleeding

Question 9

Phantom limb pain

Answer 9

• pregabalin
• gabapentin
• amitriptyline
• propranolol

Question 10

Mannitol

Answer 10

• indicated for increased intracranial pressure
• may crystallize at low temp
• IV tubing with filter

Question 11

Norepinephrine infusion

Answer 11

• neurotransmitter
• vasopressor
• released by postganglionic sympathetic neurons
• effects target organs via adrenergic receptors (SNS = flight or fight)

Question 12

Fosphenytoin

Answer 12

• preferred over phenytoin
• does not require a filter for administration
• fewer cardiovascular adverse effects

Question 13

Glaucoma meds

Answer 13

• Acetazolamide
• Timolol
• avoid
  
  • anticholinergic (diphenhydramine)
  • TCAs
    
    • Amitriptyline
    • Notriptyline
  • antihistamines
  • decongestants
    
    • phenylephrine

Question 14

Rivastigmine

Answer 14

• Alzheimer’s disease / dementia
• patch or tablet
• causes flu-like symptoms
• hypertension
  
  • dizziness
• bradycardia
• nausea/vommiting
  
  • weight loss!
  • monitor weight on this med

Question 15

Topiramate

Answer 15

• anticonvulsat
• all anticonvulsants contraindicated with ECT therapy

Question 16

Alteplase

Answer 16

• for ischemic stroke
• risk for internal bleeding
• dosage based on weight

Question 17

Codeine for children

Answer 17

• contraindicated
• dont give after tonsillectomy if child
• converted to morphine by liver
• can be lethal

Question 18

Propofol

Answer 18

• sedation before surgery

Question 19

Opioid intoxication

Answer 19

• pinpoint pupils
• altered LOC
• bradypnea
• hypotension

Question 20

Tramadol

Answer 20

• narcotic
• treats severe pain after surgery
• increases risk for serotonin toxicity

Question 21

Levetiracetam

Answer 21

• anti epileptic
• given for seizures