Neuro Meds

Question 1

Levodopa

Answer 1

IND: parkinson’s disease
SE: psychosis, orthostatic hypotension
Toxicity S/Sx: dyskinesia
CI: protein, pregnancy
OK to use with MAOIs (selegiline)

Question 2

Carbidopa

Answer 2

IND: Parkinson’s disease
CI: protein
increase carb intake

Question 3

Neostigmine

Answer 3

cholinergic med for myasthenia gravis or anticholinergic toxicity (physostigmine)
SE: visual disturbance, pupil constriction
AE: cholinergic crisis
antidote: ATROPINE
CI: asthma
effectiveness: no diplopia or muscle cramps

Question 4

Atropine

Answer 4

anticholinergic med –> bradycardia, cholinergic crisis, tremors d/t parkinson’s or EPS
SE: decreased secretions, urinary retention, tachycardia, visual disturbance, constipation, orthostatic hypotension
antidote: Physostigmine
CI: bowel obstruction, fluid retention or BPH, glaucoma
- do not overheat (d/t inability to sweat)

Question 5

Phenytoin

Answer 5

long-term anticonvulsant
SE: bradycardia, hypotension, gingival hyperplasia
AE: hepatotoxicity, suicidal ideation, Steven-Johnson syndrome (rash), toxicity, dyspnea, fatigue
Toxicity (10-20) S/Sx: ataxia, hand tremor, slurred speech
- monitor blood levels routinely (liver & therapeutic range)
- take at same time every day
- increase folic acid, calcium, vit D intake (milk, cantaloupe, kale) - tube feedings can decrease absorption and increase risk of seizure –> stop feeding 1-2 hours prior to administration.
CI: oral contraceptives

Question 6

Levetiracetam

Answer 6

prevent seizures d/t increased ICP risk (surgery, trauma, etc)
SE: bradycardia, hypotension, drowsiness, fatigue
AE: suicidal thoughts, Stevens-Johnson syndrome
- no driving while taking meds, esp for 4-6 wks

Question 7

Sumatriptan

Answer 7

vasoconstricts cerebral blood vessels to decrease migraines
SE: HTN
AE: embolism, CVA, MI
CI: CAD, uncontrolled HTN
- monitor for angina while on med

Question 8

ergotamine

Answer 8

migraine headaches
- take one tablet with onset of headaches
AE: pale extremities = decreased perfusion

Question 9

Mannitol

Answer 9

osmotic diuretic –> increased ICP (meningitis, head trauma, glaucoma)
SE: edema
AE: HF
- assess LOC every hour
- IV admin only

Question 10

Succinylcholine

Answer 10

NM blocking agent, muscle relaxant - intubation & mechanical ventilation procedures
NO SEDATION
SE: muscle rigidity
AE: respiratory arrest, malignant hyperthermia
- administer with benzodiazepines or midazolam (sedation)
antidote: DANTROLENE

Question 11

Treatment for malignant hyperthermia

Answer 11

1. notify HCP
2. administer IV dantrolene
3. administer O2

Question 12

Risk factors of malignant hyperthermia

Answer 12

hx of reaction of general anesthesia
fhx of reaction to general anesthesia
hx alcohol use