Neurological System Flashcards
(108 cards)
1
Q
Baclofen is in what drug class?
A
Centrally Acting Muscle Relaxants
2
Q
What does baclofen treat?
A
Relieves skeletal muscle spasm in spinal cord injury, MS, and Cerebral palsy
3
Q
How does baclofen work?
A
Enhances GABA (the chill-out neurotransmitter) in the spinal cord to suppress reflexes
4
Q
Important adverse effects
A
Mainly CNS effects like dizziness and drowsiness
Urinary retention is rare but can happen
5
Q
What are some manifestations of withdrawal from a CNS acting drug?
A
Anxiety, restlessness, seizures, and hallucinations
6
Q
Name some patient education for using baclofen.
A
Don’t drive until you know how it will affect you.
Don’t stop the drug abruptly. Taper the dose to prevent withdrawal symptoms
Avoid alcohol or other CNS Depressants
7
Q
What can interact with baclofen?
A
Other CNS depressants like alcohol can increase sedative effects
8
Q
Phenytoin belongs to which drug class?
A
Hydantoin
9
Q
How do hydantoins like phenytoin work in the body?
A
Decreases seizure activity by reducing sodium influx in the brain
10
Q
What conditions does phenytoin treat?
A
Seizure disorders
11
Q
Gingival hyperplasia is an adverse effect of what drug?
A
phenytoin
12
Q
What can happen if you stop an anti-seizure medication like phenytoin abruptly?
A
Severe, prolonged seizure activity known as status epilepticus
13
Q
Phenytoin can reduce the effect of what?
A
Oral contraceptives.
14
Q
What adverse reaction would require the immediate discontinuation phenytoin?
A
Rash (can indicate Stevens Johnson syndrome)
15
Q
Valproic Acid belongs to which drug class?
A
Anticonvulsant
16
Q
How does valproic acid to treat seizure disorder?
A
Decreases seizure activity by reducing sodium influx in the brain and may have effects on GABA as well
17
Q
What is a serious side effect of valproic acid?
A
Bone marrow suppression: Bruising, bleeding, and decreased platelets
18
Q
What is the most serious adverse effect of valproic acid (BBW)?
A
Hepatotoxicity and pancreatic failure
19
Q
Describe manifestations of hyperammonemia.
A
Episodes of vomiting, confusion, and decreased level of consciousness
20
Q
What are some client instructions for someone taking valproic acid to treat seizure disorder?
A
Report any jaundice immediately
Watch for signs of bleeding, like bruising
21
Q
Valproic acid is a teratogenic medication. True or False?
A
True. Do not take if pregnant and use reliable contraceptive.
22
Q
How do benzodiazepines work when used for anesthesia?
A
They depress the CNS by enhancing GABA (the chill-out neurotransmitter)
23
Q
What drug class does donepezil belong?
A
Cholinesterase inhibitor
24
Q
What drug treats Alzheimer’s disease by increasing acetylcholine in the brain?
A
Donepezil
25
How does increased acetylcholine help relieve Alzheimer's symptoms?
Acetylcholine plays a major role in muscle contraction, memory, and attention. So, more of it helps control Alzheimer's symptoms.
26
What is a common side effect of donepezil and how can you prevent it?
Take donepezil with food to prevent GI upset.
27
What is a safety alert when taking donepezil?
Change positions slowly because it can cause bradycardia and syncope.
28
What are some more serious adverse reactions when taking donepezil?
Can increase risk of GI bleeding, so don't take with NSAIDs.
29
How should donepezil be administered?
At night and with food.
30
What is the drug classification for memantine?
NMDA receptor agonist
31
How do NMDA receptor agonists help treat Alzheimer's disease?
They decrease calcium influx in the brain cells which preserves and restores nerve transmission.
32
What drug can cause hyperammonemia?
Valproic acid
33
Name a dopamine replacement drug.
Levodopa/carbidopa
34
What does levodopa/carbidopa treat?
Parkinson's Disease
35
What is levodopa/carbidopa's mechanism of action?
It is converted into dopamine in the brain making more dopamine to relieve symptoms of Parkinson's disease
36
How long can it take to achieve the full therapeutic effect of levodop/carbidopa?
It can take up to 6 months
37
What type of food needs to be avoided when taking levodopa/carbidopa?
High-protein foods
38
When educating a client about taking levodopa/carbidopa, what are some important teaching points?
Change position slowly and carefully because it causes hypotension
Regulate doses according to the on/off effect
The drug can cause dark colored sweat and urine (normal)
39
Name some interactions that can occur with levodopa/carbidopa.
No MAOI within two weeks (hypertensive crisis risk)
Avoid 1st gen antipsychotics (haloperidol)
Avoid high-protein foods
40
What to watch for when taking levodopa/carbidopa.
Worsening dyskinesias, tremors, twitching
Hypotension/postural hypotension
Severe nausea/vomiting
41
What drug is classified as a NMDA receptor agonist?
hint: treats Alzheimer's disease.
Memantine
42
What does NMDA stand for and how does this drug work?
N-methyl-D-aspartate, and it slows progression of Alzheimer's by decreasing influx of calcium to preserve nerve transmissions.
43
Memantine should not be given to people with a hx of what?
Seizures or renal failure
44
What are the main side effects of memantine?
Headaches
Dizziness
Constipation/diarrhea
45
What other condition, besides Alzheimer's, can memantine treat?
Vascular dementia
46
Memantine can interact with what common OTC drug?
Sodium bicarbonate aka antacid
47
Name the serotonin agonist that treats migraines.
Sumatriptan
48
How does sumatriptan work?
It activates 5-HT receptors and causes vasoconstriction (the narrowing of blood vessels)
49
What are the two main side effects of sumatriptan?
Chest pain
Vertigo
50
When taking sumatriptan, which side effect requires immediate attention if doesn't resolve quickly?
Severe chest pain/tightness and jaw pain
51
Sumatriptan should not be given to people with a hx of what condition?
Myocardial infarction or peripheral vascular disease (because of the vasoconstriction)
52
How can sumatriptan be administered?
Nasal spray, oral tablet, or injection
53
What can Alprazolam prescribed for?
Anxiety disorders
54
Alprazolam belongs to which drug class?
Benzodiazepine
55
How do benzodiazepines work in the brain?
It works on the CNS by enhancing GABA (chill-out neurotransmitter).
Also works on the limbic system (norepinephrine, serotonin, and dopamine) to regulate emotions.
56
Name an unexpected or paradoxical reaction to alprazolam.
Increased anxiety
57
What is the number one risk of taking alprazolam?
Respiratory depression (CNS effects)
58
True or False:
When taking alprazolam, you can stop taking the medication abruptly if you feel better.
False
You need to taper down to prevent withdrawal manifestations such as insomnia, anxiety, tremors, diaphoresis, dizziness, panic, hypertension, seizures, paranoia, muscle twitching, and hallucinations.
59
What are some interactions known with alprazolam?
Do not take with other CNS depressants such as alcohol or other benzos.
Herbal supplements like kava kava, valerian root, and chamomile can enhance sedative effects
60
What does amitriptyline treat?
Major depression
61
Amitriptyline is in which drug classification?
Tricyclic antidepressant
62
How does a tricyclic antidepressant like amitriptyline work?
It blocks reuptake of serotonin (happy neurotransmitter) and norepinephrine (stress response)
63
Amitriptyline has many side effects and is not used as much as newer generation antidepressants. Name some of the adverse effects.
Anticholinergic effects like blurred vision, tachycardia, and urinary retention.
Drowsiness
Increased depression or suicidal thoughts
64
Name some safety alerts associated with amitriptyline
Increased risk of suicide
Severe arrhythmias
Risk of fatal overdose
65
What are some administration tips for amitripyline?
Give at bedtime to prevent daytime drowsiness
It takes several weeks to exert therapeutic effect
Don't stop taking abruptly
66
Amitriptyline would be contraindicated in what populations?
Young children
People who have had a Myocardial infarction
Mental illness or alcoholism
67
What can amitriptyline interact with?
Other CNS depressants
MAOIs
Other anticholinergic meds (like Benadryl)
St. Johns Wort
68
Fluoxetine belongs to which drug class?
SSRI
Selective Serotonin Reuptake Inhibitor
69
What does fluoxetine treat?
Depression, OCD, and Bipolar disorder
70
How do SSRI's work?
They block the reuptake of serotonin, which makes more available in the brain. Serotonin is the happy neurotransmitter.
71
Fluoxetine affects the CNS differently than other drugs prototypes, how so?
It causes excitation in the CNS instead of depression.
72
What are some side effects of fluoxetine?
Insomnia
Anxiety
Sexual dysfunction
Weight gain
Headaches
73
Confusion, fever, agitation, anxiety, hallucinations, incoordination, hyperreflexia, diaphoresis, and tremors can indicate what condition that is specific to SSRIs?
Serotonin Syndrome
74
True or False: You would want to take fluoxetine at night.
False. Take fluoxetine in the morning to avoid sleep disturbances and insomnia.
75
What can interact with fluoxetine?
MAOIs
Other SSRIs
NSAIDs can increase GI bleeding risk
St. Johns Wort
76
What is venlafaxine prescribed for?
It can treat depression AND generalized anxiety disorder
77
What drug class does venlafaxine belong to?
SNRI
Serotonin and norepinephrine reuptake inhibitor
78
What should you monitor patients for when taking venlafaxine?
Increased suicidal ideation or thoughts.
79
How does venlafaxine work?
It blocks the reuptake of serotonin AND norepinephrine to relive manifestations of depressions.
80
What are some side effects of venlafaxine?
Nausea is most common (take with food)
Insomnia
Nervousness
81
What is the medication prescribed for bipolar depression (especially manic phase treatment)
Lithium
82
Lithium belongs to what drug class?
Mood stabilizer
83
How does lithium work?
It affects sodium in cells and changes how the body responds to stress. It decreases the fight or flight response.
84
What is the number one safety issue for someone taking lithium?
Lithium has a very narrow therapeutic range.
0.8 mEq/L to 1.2 mEq/L
It can reach toxic levels quickly
85
What are manifestations of lithium toxicity?
Muscle hyperirritability, ECG changes, incoordination, ataxia, blurred vision, seizures, significant hypotension and coma.
86
What is a common side effect of lithium?
Fatigue and drowsiness
87
What type of clients should avoid taking lithium?
Dehydrated
Low sodium levels
People on diuretics
88
What is an early sign of lithium toxicity?
Muscle weakness and nausea
89
Chlorpromazine is the prototype drug for what drug class?
1st Generation traditional antipsychotic
90
How does chlorpromazine work?
Treats schizophrenic symptoms by blocking many CNS neurotransmitters such as norepinephrine, acetylcholine, dopamine, and histamine.
91
What condition does chlorpromazine treat?
Schizophrenia
92
What is a concerning adverse effect of chlorpromazine?
EPS or extra pyramidal symptoms
93
What are extra pyramidal effects?
Shuffling gait
Parkinsonism
Akathisia
Dystonia
Tardive dyskinesia
94
People taking chlorpromazine to treat schizophrenia need to be monitored for what?
Manifestations of Parkinsonism
Hyperthermia (Neuroleptic Syndrome)
95
What condition related to sun exposure can develop in clients taking chlorpromazine?
Photosensitivity
96
What is glaucoma?
Glaucoma is a disorder of the eye that causes the pressure within the eye, intraocular pressure (also called IOP), to increase. If untreated, it can cause blindness
97
Betaxolol and timolol are what type of drugs?
Beta adrenergic blockers
98
How do you administer ophthalmologic drops that treat glaucoma?
Hand hygiene
Place drops in the lower conjunctival sac
Place pressure on the lacrimal duct for one minute
99
Why is it important to place pressure on the lacrimal duct after instilling betaxolol, timolol, and pilocarpine?
To decrease system effects of the drug
100
How to beta adrenergic blockers decrease IOP?
They decrease production of aqueous humor.
101
What is the main side effect of betaxolol?
Bradycardia
102
What is the difference between betaxolol and timolol?
Betaxolol targets Beta 1 and timolol targets Beta 1 and 2 so it may carry a higher risk of respiratory effects.
103
How does pilocarpine treat glaucoma?
It causes the pupil to constrict and allows increased drainage of aqueous humor.
104
Pilocarpine belongs to what drug class?
Cholinergic agonist
105
What are manifestations of detached retina?
Dark floaters, flashes of light, or a curtain over eye feeling
106
How does pilocarpine affect eye sight?
It affects visual acuity and makes driving at night very difficult.
107
What do clients need to report to provider when using pilocarpine?
Wheezing
Signs of retinal detachment
108
