Week 8 - Neuro Part 2

Question 1

Benzodiazepines: Diazepam (Valium), Alprazolam (Xanax) - Use

Answer 1

• anxiety - skeletal muscle spasms (Diazepam) - seizure disorders / status epilepticus (Diazepam) - Acute Alcohol Withdrawal Symptoms (Diazepam) - induction of anesthesia (Diazepam)

Question 2

Benzodiazepines: Diazepam (Valium), Alprazolam (Xanax) - Adverse Effects

Answer 2

• paradoxical reaction (anxiety) - tolerance and physical dependence (esp. alprazolam)

Question 3

Non-Benzodiazepine: Buspirone - Use

Answer 3

• short-term treatment of anxiety disorders such as GAD

Question 4

Non-Benzodiazepine: Buspirone - Adverse Effects

Answer 4

• paradoxical effects - N&V

Question 5

Tricyclic Antidepressants: Amitriptyline - Use

Answer 5

• Major Depression

Question 6

Tricyclic Antidepressants: Amitriptyline - Adverse Effects

Answer 6

• orthostatic hypotension - anticholinergic effects (dry mouth, urinary retention etc.) - increased risk for suicide

Question 7

Selective Serotonin Reuptake Inhibitors: Fluoxetine (Prozac) - Use

Answer 7

• Major Depression - Bipolar Disorder - Panic Disorder - OCD - Premenstrual Dysphoric Disorder - Bulimia

Question 8

Selective Serotonin Reuptake Inhibitors: Fluoxetine (Prozac) - Adverse Effects

Answer 8

• weight gain - insomnia, nervousness - increased risk for suicide - serotonin syndrome - sexual dysfunction - hyponatremia

Question 9

Serotonin / Norepinephrine Reuptake Inhibitors - Venlafaxine - Use

Answer 9

• Major Depression - social anxiety disorder - GAD

Question 10

Serotonin / Norepinephrine Reuptake Inhibitors - Venlafaxine - Adverse Effects

Answer 10

• GI effects - hypertension - increased risk for suicide

Question 11

Serotonin / Norepinephrine Reuptake Inhibitors - Venlafaxine - Education

Answer 11

• take with food - take in morning

Question 12

MAOIs: Phenelzine (Nardil) - Use

Answer 12

• depression that has not responded to other classes of antidepressants - depression in Bipolar Disorder

Question 13

MAOIs: Phenelzine (Nardil) - Adverse Effects

Answer 13

• hypertensive crisis when consuming tyramine-containing foods - GI symptoms - suicidal ideation

Question 14

Atypical Antidepressants: Bupropion Hydrochloride (Wellbutrin) - Use

Answer 14

• depression - seasonal affective disorder - smoking cessation

Question 15

Bupropion Hydrochloride (Wellbutrin) - Adverse Effects

Answer 15

• increased risk for seizures - psychosis, hallucinations - suicidal ideation

Question 16

Lithium (Lithobid) - Use

Answer 16

• polyuria - goiter, hypothyroidism - toxicity due to narrow therapeutic range

Question 17

Lithium (Lithobid) - Education

Answer 17

• take with food - drink 2-3 l water per day to prevent dehydration - avoid caffeine - consume adequate amount of sodium

Question 18

Conventional Antipsychotics: Chlorpromazine - Use

Answer 18

• schizophrenia - acute manic phase of Bipolar Disorder - relieves N&V - intractable hiccups

Question 19

Chlorpromazine - Adverse Effects

Answer 19

• akathisia (first 2 months) - Parkinson-like symptoms (1st month) - acute dystonia (hours to days after first dose) - tardive dyskinesia - anticholinergic effects - sexual dysfunction - photosensitivity - neuroleptic malignant syndrome

Question 20

Chlorpromazine - Education

Answer 20

• wear gloves when handling phenothiazines - avoid sun exposure, use sunscreen / protective clothing

Question 21

Atypical Antipsychotics: risperidone (Risperdal) - Use

Answer 21

• treats both positive and negative symptoms of schizophrenia - bipolar disorder - irritability in clients with autism

Question 22

risperidone (Risperdal) - Adverse Effects

Answer 22

• extrapyramidal effects - weight gain - new or worsening diabetes - increased cholesterol levels

Question 23

Cholinergic agonists (Pilocarpine), Cholinesterase (echothiophate), and Beta-adrenergic blockers (betaxolol & timolol), ophthalmic drops - Use

Answer 23

Beta blockers: topical therapy that lowers IOP in open-angle glaucoma and acute closed-angle glaucoma - Cholinergic agonists and cholinesterase inhibitors: topical therapy that lowers IOP in glaucoma; adjunct to laser and other eye surgeries or procedures

Question 24

Cholinergic agonists (Pilocarpine), Cholinesterase (echothiophate), and Beta-adrenergic blockers (betaxolol & timolol), ophthalmic drops - Adverse Effects

Answer 24

• Beta blockers: stinging, burning, eye discomfort - systemic cardiac or respiratory effects (bradycardia, hypotension, bronchospasm)

Question 25

Cholinergic agonists (Pilocarpine), Cholinesterase (echothiophate), and Beta-adrenergic blockers (betaxolol & timolol), ophthalmic drops - Education

Answer 25

• client should not rub eyes - avoid driving and other activities at night if vision is affected - teach client to recognize symptoms of retinal detachment (dark floaters, flashes of light, feeling as if “curtain” has been pulled over part of vision in one eye)