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NCLEX-RN (4) Pharmacology > Neuro Meds > Flashcards

Flashcards in Neuro Meds Deck (20)
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1
Indication:

Anticonvulsants

  • to prevent seizures
  • some are given as antipsychotics
  • some are given to treat nerve pain

2
Generic names:

Anticonvulsants to treat seizures

  • divalproex sodium, valproic acid
  • phenobarbital, phenytoin

3
Nursing considerations:

Anticonvulsants

  • seizure precautions
  • assess for mood changes and suicide
  • assess for sedation and drowsiness
    • implement safety and fall precautions

4
Most common side effect:

Anticonvulsant: phenytoin

gingival hyperplasia

5
Nursing considerations:

phenytoin: gingival hyperplasia

Teach to floss regularly and use a soft toothbrush

6
Most common adverse reaction:

Anticonvulsant: phenytoin

pancytopenia

7
Nursing considerations:

phenytoin: pancytopenia

Immediate complication

Monitor WBC and platelets - assess for bleeding and infection

Hold med and notify HCP for active bleeding or signs of infection.

8

What is the therapeutic level of phenytoin?

phenytoin therapeutic level: 10 - 20

9
Generic names:

Antiparkinsonian drug

  • benztropine
  • trihexyphenidyl
  • carbidopa/levodopa

10
Most common side effects:

Antiparkinsonian drug

Anticholinergic side effects (use caution if taking other anticholinergic meds):

  • causes blurry vision - implement safety / fall precautions
  • causes urinary retention - monitor intake and output
  • causes dry mouth - give candy or ice chips
  • causes constipation - encourage fluids/fiber/walking

"can't see, can't pee, can't spit, can't shit"

 

11
Indication:

neostigmine, pyridostigmine

Muscle stimulant to treat myasthenia gravis.

12
Mechanism of action:

neostigmine, pyridostigmine

Prevents breakdown of acetylcholine (a cholinesterase inhibitor)

This prevents muscle weakness.

13
Nursing considerations:

neostigmine, pyridostigmine

  • take at same time every day - to keep muscle strength consistent
  • assess for signs of overdose and underdose - can be a sign of over- or under-medicated

 

14

What are the symptoms of a cholinergic crisis (overmedicated) and myasthenic crisis (undermedicated)?

  • muscle weakness
  • dyspnea
  • dysphagia
  • bradycardia

The similar symptoms make it difficult to determine quickly if the client is undermedicated or overmedicated.

 

15

What is a myasthenic crisis?

Immediate complication

A myasthenic crisis is when the client doesn't get enough of their medication (undermedicated), causing muscle weakness.

It usually occurs about 3 hours after med administration.

16

What is a cholinergic crisis?

Immediate complication

A cholinergic crisis is when a client gets too much of their medicine (overmedicated), causing muscle weakness.

It usually occurs about 1 hour after med administration.

17

What is an edrophonium (Tensilon) test?

An edrophonium (Tensilon) test is used to determine if the client is in a myasthenic crisis or cholinergic crisis:

  1. it's a myasthenic crisis if edrophonium is given and strength improves
    • client needs more medicine
  2. it's a cholinergic crisis if edrophonium is given and the weakness gets worse.
    • client needs less medicine

18

What is the antidote to a cholinergic crisis?

Antidote to a cholinergic crisis: atropine sulfate (an anticholinergic)

19

Which medication is an osmotic diuretic used to treat increased intracranial pressure?

mannitol

20
Nursing considerations:

mannitol

  • assess neuro status
  • assess intake and output

Medication is used to get extra fluid off the brain.