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pharm final- neuro Flashcards

1
Q

Phenytoin (Dilantin) class

A

hydantoins

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2
Q

Phenytoin (Dilantin) MOA

A

Stabilize nerve membranes

Decrease conduction through nerve pathways

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3
Q

Phenytoin (Dilantin) SE

A

Adverse effects: gingival hyperplasia, hyperglycemia, bad acne, rash over abdominal/chest area
Overdose/toxicity: nystagmus (abnormal movement of the eyes), blurred vision, diplopia, slurred speech, dizziness, lethargy, coma, fever, respiratory depression

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4
Q

Phenytoin (Dilantin) nursing implications

A 
Metabolized in the liver, avoid alcohol 
Narrow therapeutic index: levels should be 10-20 mcg/ml
IV loading dose: 15-20 mg/kg
IV: no faster than 50mg/min or may have bradycardia, cardiac arrest, hypotension, v-fib
Cardiac suppressant 
Only given with .9NS or will precipitate
Very irritating-watch IV site
Onset 10-20 minutes, duration 24 hours
TAKE WITH FOOD
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5
Q

Xanax (alprazolam) class

A

benzodiazepines

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6
Q

Xanax (alprazolam) MOA

A

increase effects of GABA

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7
Q

Xanax (alprazolam) SE

A

CNS depression, constipation, hypotension, urinary retention, blurred vision, urinary retention

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8
Q

Xanax (alprazolam) nursing implications

A 
antianxiety 
Cause physical dependence
Withdrawal if abruptly stopped
Metabolized by liver
Smaller amounts for elderly patients
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9
Q

Versed (midazolam) class

A

benzodiazepines

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10
Q

Versed (midazolam) MOA

A

increase effects of GABA

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11
Q

Versed (midazolam) SE

A

CNS depression, constipation, hypotension, urinary retention, blurred vision, urinary retention

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12
Q

Versed (midazolam) nursing implications

A 
IV only, conscious sedation  
Cause physical dependence
Withdrawal if abruptly stopped
Metabolized by liver
Smaller amounts for elderly patients
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13
Q

flumazenil (Romazicon) uses

A

versed antidote

Low respirations, 02

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14
Q

Haldol (haloperidol ) class

A

nonphenothiazine
antipsychotic
for psychotic reactions/ICU psychosis

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15
Q

tardive dyskinesia

A

15% to 20% in patients during long-term use
Twisting, writhing worm-like movements of tongue and face.
Lip smacking
Fly catching
Interferes with swallowing, chewing, speaking
Treatment: decrease dosage
Symptoms irreversible if left untreated

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16
Q

akathesia

A

Characterized by pacing, squirming brought on by an uncontrolled need to be in motion
Treated with beta blockers
Develops within first two months of treatment

17
Q

acute dystonia

A

Develops within first few days of therapy
Severe spasm of muscles of tongue, face, neck or back
Oculogyric crisis: involuntary upward deviation of the eyes (medical emergency)
Treated with Benadryl

18
Q

parkinsonism

A 
Bradykinesia, drooling, tremor, rigidity
Shuffling gait, stooped posture
Cogwheeling or pill rolling
Develops within first month of therapy
Treated with Symmetrel, Cogentin-PRN 
No Levodopa
19
Q

Thorazine (chlorpromazine) class

A

phenothiazine

antipsychotic

20
Q

Thorazine (chlorpromazine) SE

A 
EPS 
tardive dyskinesia 
akathesia
acute dystonia 
parkinsonism
21
Q

Thorazine (chlorpromazine) nursing implications

A

Newer drugs more expensive but less side effects
Elderly: 30-50% less of a dose
Drugs metabolized by the liver
Oral: liquid form dilute prior to giving to reduce taste
Maintenance therapy
Promote compliance (usually lifetime treatment)
Manage side effects
Caffeine negates effects of drugs
Avoid alcohol
Therapeutic responses develop slowly
Should not abruptly stop taking meds

22
Q

lithium (lithium salts) class

A

Mood Stabilizers- Antimanic Drugs

23
Q

lithium (lithium salts) SE

A

As levels rise: lethargy, slurred speech, muscle weakness, polyuria
Toxic levels: Clonic movements, hyporeflexia, seizures, hypotension, renal toxicity, pulm toxicity

24
Q

lithium (lithium salts) nursing implications

A

Multiple drug interactions
Watch drug levels
Monitor symptoms
Give with food or milk to enhance absorption
Maintain adequate fluid intake
Monitor sodium intake (Too much salt decreases the effects of the lithium)
Limit caffeine (can also decrease the effects of lithium)
No ETOH

25
Q

Zoloft (Sertraline) class

A

SSRI

antidepressant

26
Q

Zoloft (Sertraline) MOA

A

MOA: Block reuptake of Serotonin with little to no effects on NE

27
Q

Zoloft (Sertraline) SE

A

CNS: headache, drowsiness, anxiety, tremors
GI: changes in taste, N/V, weight gain
GU: painful menstruation, cystitis, sexual dysfunction

28
Q

Zoloft (Sertraline) nursing implications

A 
Can’t give with an MAO inhibitor
Monitor LFTs- can be toxic to the liver
Suicide precautions
Takes 5 weeks to achieve full effects
May cause weight gain
Take once a day in the morning
Can’t be taken during pregnancy

pharm (16 decks)

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