Neuro and Anesthetics

Question 1

What is a seizure?

Answer 1

hyper excited neurons called a focus

Question 2

how many sides of the brain is a focal onset seizure?

Answer 2

on hemisphere

Question 3

Generalized onset seizures use what sides of the brain?

Answer 3

both sides

Question 4

Goal of seizure tx?

Answer 4

allow pt to live a near normal or normal life

Question 5

All seizure meds carry a risk of causing what?

Answer 5

suicide

Question 6

Phenytoin Loading Dose?

Answer 6

15mg/kg

Question 7

Mx dose of Phenytonin

Answer 7

300-400mg qd

Question 8

Phenytoin is the drug of choice for what?

Answer 8

Emergencies, status epilepticus

Question 9

Do not use Phenytoin if pat has what?

Answer 9

2nd or 3rd heart block, bradycardia or SA block

Question 10

What people may have tog et genetic testing because of mutation before using Phytnoin?

Answer 10

Asian

Question 11

Carbamazepine is also called what?

Answer 11

Tegretol

Question 12

What is Tegterol used for besides seizures?

Answer 12

Bi Polar, and trigeminal neuralgia

Question 13

What lab do you what to get a baseline of when giving Tegretol?

Answer 13

CBC

Question 14

What is a common side effect of Tegretol?

Answer 14

Tinnitus

Question 15

What should patients not drink when taking Tegretol?

Answer 15

Grapefruit Juice

Question 16

Valporate is also called what?

Answer 16

Depakote

Question 17

Depakote dose?

Answer 17

500mg-1g daily

Question 18

Do not give Depakote if someone has what?

Answer 18

liver condition

Question 19

What is a black box warning for Depakote?

Answer 19

Hepatotoxicity

Question 20

If patient is taking Depokote and Topiramate what should you assess for?

Answer 20

Hyperammonemia

Question 21

Oxycarbazepine daily dose?

Answer 21

300mg-600mg

Question 22

MOA of ocyarbazepine?

Answer 22

Blocks sodium channels

Question 23

Keppra Dose?

Answer 23

500mg BID

Question 24

What is the off label use for Keppra?

Answer 24

TBI, subarachnoid hemorrhage, and status epileptics

Question 25

What is a rare adverse effect Keppra can cause?

Answer 25

Neuropsychiatric sx

Question 26

Gabapentin common SE?

Answer 26

dizziness, fatigue, peripheral edema

Question 27

Baclofen dose?

Answer 27

15-20mg po bid/tid

Question 28

What to avoid with Baclofen?

Answer 28

alcohol and other CNS depressantas

Question 29

What can abrupt withdraw of this med cause?

Answer 29

seizures

Question 30

What drug is used to CP, malignant hyperthermia and spasticity?

Answer 30

Dantrolene

Question 31

Where does Dantrolene work?

Answer 31

the level of the muscle

Question 32

What can dantrolene cause?

Answer 32

Muscle Atrophy

Question 33

What is a serious SE of Dantrolene?

Answer 33

Hepatotoxicity

Question 34

Common SE of Dantrolene?

Answer 34

muscle weaknessm N/V, drowsiness

Question 35

Flexeril dose?

Answer 35

10mg TID

Question 36

Serious SE of Flexeril?

Answer 36

Cardiac rhythm disturbances

Question 37

What drugs should you not use with Flexeril and why?

Answer 37

MAOI because could cause serotonin syndrome

Question 38

Is Flexeril centrally acting?

Answer 38

Yes

Question 39

Sx of Serotonin Syndrome?

Answer 39

Tachy, Sweating, NVD, Fever CNS, ANS, Neuromuscular, GI

Question 40

Robin dose?

Answer 40

1000mg QID

Question 41

Rate to push IV Robin?

Answer 41

3mL/min

Question 42

What should you have patient do after giving Robin?

Answer 42

Have them laying on side for 10-15 min post administration

Question 43

Education to patients that are taking Robin?

Answer 43

May turn urine green, brown, black

Question 44

Valium dose?

Answer 44

2-10mg TID/QID

Question 45

What vS do you want to monitor the most when giving Valium?

Answer 45

Respiratory rate

Question 46

What is the MOA of Valium?

Answer 46

Makes GABBA activate at spinal cord

Question 47

What happens if you stop taking Valium quick?

Answer 47

Withdraw Sx

Question 48

MOA of local Anesthetics?

Answer 48

Blocks Na+ channel in the axonal membrane stoping Na from entry, stoping activity of neurons.

Question 49

Can kids under 2 get Benzocain and why or why not?

Answer 49

No because it can turn them blue with the methemoglobin.

Question 50

What do you want to monitor when giving someone local anesthetics?

Answer 50

VS, EKG, use least amount needed, and look for allergic reactions

Question 51

Ester is used for what?

Answer 51

Local anesthesia and pain suppression

Question 52

What delays absorption of Novocain Ester type?

Answer 52

Epinephrine

Question 53

Adverse effect of Novocaine Ester type?

Answer 53

Allergic reaction are very significant

Question 54

If a patient is allergic to what they should be considered allergic to all Ester anesthetics?

Answer 54

Procaine

Question 55

Novocaine is also called what?

Answer 55

Procaine

Question 56

What is an amide type anesthetic?

Answer 56

Lidocaine

Question 57

Adverse Effects of Lidocaine?

Answer 57

CNS effects, Cardio effects, and low risk to allergic reactions

Question 58

Serious AE to Lidocaine amide type anesthetic?

Answer 58

Cardiovascular toxicity

Question 59

What is Xylocaine?

Answer 59

Brand name of Lidocaine

Question 60

Lidocaine with Eli does what?

Answer 60

decreases blood flow by vasoconstriction delaying systemic absorption of anesthetic

Question 61

Why add Eli?

Answer 61

Reduces the potential for systemic toxicity

Question 62

Appy how much topical anesthetic?

Answer 62

smallest amount needed

Question 63

Avoid application of topical anesthetic to what?

Answer 63

Large areas, broken or irritated skin, heating site and strenuous exercise, or wrapping area