Neuro Meds

Question 1

Indication:

Anticonvulsants

Answer 1

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

Question 2

Generic names:

Anticonvulsants to treat seizures

Answer 2

• divalproex sodium, valproic acid
• phenobarbital, phenytoin

Question 3

Nursing considerations:

Anticonvulsants

Answer 3

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

Question 4

Most common side effect:

Anticonvulsant: phenytoin

Answer 4

gingival hyperplasia

Question 5

Nursing considerations:

phenytoin: gingival hyperplasia

Answer 5

Teach to floss regularly and use a soft toothbrush.

Question 6

Most common adverse reaction:

Anticonvulsant: phenytoin

Answer 6

pancytopenia

Question 7

Nursing considerations:

phenytoin: pancytopenia

(Immediate complication)

Answer 7

Monitor WBC and platelets - assess for bleeding and infection.

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

Question 8

What is the therapeutic level of phenytoin?

Answer 8

10 - 20

Question 9

Generic names:

Antiparkinsonian drug

Answer 9

• benztropine
• trihexyphenidyl
• carbidopa/levodopa

Question 10

Most common side effects:

Antiparkinsonian drug

Answer 10

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”

Question 11

Indication:

neostigmine, pyridostigmine

Answer 11

Muscle stimulant to treat myasthenia gravis.

Question 12

Mechanism of action:

neostigmine, pyridostigmine

Answer 12

Prevents breakdown of acetylcholine (a cholinesterase inhibitor).

This prevents muscle weakness.

Question 13

Nursing considerations:

neostigmine, pyridostigmine

Answer 13

• 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

Question 14

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

Answer 14

• muscle weakness
• dyspnea
• dysphagia
• bradycardia

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

Question 15

What is a myasthenic crisis?

(Immediate complication)

Answer 15

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.

Question 16

What is a cholinergic crisis?

(Immediate complication)

Answer 16

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.

Question 17

What is an edrophonium (Tensilon) test?

Answer 17

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

Question 18

What is the antidote to a cholinergic crisis?

Answer 18

Atropine sulfate (an anticholinergic)

Question 19

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

Answer 19

mannitol

Question 20

Nursing considerations:

mannitol

Answer 20

• assess neuro status
• assess intake and output

Medication is used to get extra fluid off the brain.

Question 21

Generic names:

Anticonvulsants to treat nerve pain

Answer 21

• gabapentin
• pregabalin

Question 22

Generic names:

Antialzheimer

Answer 22

donepezil, memantine

Question 23

Mechanism of action:

Antialzheimer

Answer 23

Increases synaptic transmission.