Topic 5: Drugs that Affect the neurological system Flashcards

Question

Benzodiazpenes Midazolam (Versed) toxicity/management

Answer 1

same for all benzos

Answer 2

same for all benzo

Answer 3

Same for all benzos

Answer 4

decrease anxiety by reducing over activity in CNS, benzos increase action of GABA (blocks nerve transmission on CNS), benzos depress activity in brainstem and limbic system

Answer 5

uses for anxiety, alcohol withdrawal, and agitation

Answer 6

known drug allergy, narrow-angle glaucoma, and pregnancy due to their sedative properties and risk for teratogenic effects

Answer 7

CNS depression and rebound disinhibition (sedation for 1-2 hours followed by agitation and confusion), increase risk for falls in older adults. Amnesia, anorexia, sedation, lethargy, fatigue, confusion, drowsiness, dizziness, ataxia, headache, visual changes, hypotension, weight gain or loss, nausea, weakness

Answer 8

- alcohol and CNS depressants can result in additive CNS depression and even death - Serious consequence more likely to occur in patients with renal or hepatic compromise, oral contraceptives, azole antifungals, SSRIs

Answer 9

assess for cautions, contraindications, and drug interactions - prescriber may order lab studies; CBC, serum electrolyte levels, and hepatic/renal function - assess blood pressure, alertness, orientations, sensory/motor functioning, thorough medication profile, give med cautiously under very close supervision if patient is suicidal; may be associated with suicidal attempts

Answer 10

frequent monitoring of vitals with special attention to BP and postural BP readings, encourage use of elastic compression stocks and change positions to minimize dizziness, check for possibilities of patient holding drugs in mouth, create a therapeutic environment for discussing any disturbing thoughts such as suicidal thoughts

Answer 11

encourage patients to avoid operating machinery and driving, educate development of tolerance, instruct patient not to take OTC or herbal supplements w/o taking to prescriber, advise to not use drugs that contradict, advise patients to wear medical alert or other ID with their diagnosis and list of their drugs/allergies updated every 3 months, meds need to be taken as order avoiding withdrawal

Answer 12

central nervous system depressant

Answer 13

common use for relief of anxiety, stress, restlessness, and promotion of sleep

Answer 14

in patients with Parkinson’s disease, liver disease, depression, or alcoholism, in those operating heavy machinery, and in pregnant and breastfeeding women

Answer 15

skin discoloration, possible accommodative disturbances and pupillary enlargement, scaly skin (with long term use)

Answer 16

alcohol, barbiturates, psychotic drugs. May increase the effect of barbiturates and alcohol

Answer 17

extended continuous intake can cause a temporary yellow discoloring of the skin, hair, and nails

Answer 18

central nervous system depressant

Answer 19

common use for relief of anxiety, restlessness, and sleep disorder

Answer 20

patients with cardiac disease, liver disease, or those operating heavy machinery including treatment of insomnia, moderate sedation, muscle relaxation, anticonvulsant therapy, and anxiety relief.

Answer 21

central nervous system depression, hepatotoxicity, nausea, vomiting, anorexia, headache, restlessness, insomnia

Answer 22

increases CNS depression if used with sedatives, monamine oxidase inhibitors, phenytoin, may have enhanced relative and adverse effects when taken with other drugs (including other herbal products) that have known sedative properties (including alcohol)

Answer 23

depression, anxiety, sleep disorders, nervousness

Answer 24

patients with bipolar depression, schizophrenia, Alzheimer’s disease, and dementia

Answer 25

GI upset, allergic reactions, fatigue, dizziness, confusion, dry mouth, possible, photosensitivity (especially fair skinned)

Answer 26

may lead to serotonin syndrome if used with other serotonergic drugs (selective serotonin reuptake inhibitors). May interact with many drugs, including antidepressants, antihistamines, digoxin, immunosuppressants, theophylline, and warfarin, benzodiazepines & other hypnotic drugs. Cyclosporin and other immunosuppressants, tyramine-containing foods, opioids, digoxin, HIV drugs, oral contraceptives

Answer 27

Flumazenil (Romazicon) Mechanism of action: short half-life and duration effects of 1-4 hours, therefore if used to reverse the effects of a long-acting benzo, the dose of the reversal drug may wear off and the patient may become sedated again-requiring more Flumazenil. Indications: used to acutely reverse the sedative effects of benzodiazepines. It antagonizes the action of benzo on the CNS but directly competing with the benzos for binding at the receptors. Used in cases of overdose or excessive IV sedation.

Answer 28

Drug Class: Non-Benzodiazepines, CNS Depressant Mechanism of action: Depresses activity in the CNS. Specifically the hypothalamic, thalmic, and limbic system Indications: Induces sleep & reduces agitation & anxiety related to depression and acute seizure disorders -Women maximum dose 5mg (This is strict) -Men maximum dose 5mg-10mg (Strict) Contraindications: If pt allergic to aspirin, they will be allergic to this

Answer 29

Known drug allergy, narrow angle glaucoma, and pregnancy

Answer 30

Headache, drowsiness, paradoxical excitement or nervousness, dizziness & vertigo, cognitive impairment and lethargy. May feel a “hangover” effect.

Answer 31

- CNS depressants (alcohol, opioids, muscle relaxants) - Herbal supplements: Kava & Valerian - Nograpefruit juice or grapefruit. (alters drug metabolism-inhibition of cytochrome)

Answer 32

Flumazenil

Answer 33

Perform assessment focusing on patient’s insomnia, with attention to onset, duration, frequency, and pharmacologic/non-pharmacologic measures. Concerns voiced by the family. Allergies, use of alcohol, smoking history & over the counter herbal supplements. Closely monitor those who are anemic, suicidal, or have history of abusing drugs, alcohol, or other substances.

Answer 34

If taking medication in hospital then patient must use safety precautions, such as side rails or bed alarm. Ambulation after medication is taken (bathroom) must have assistance from nurse.

Answer 35

Keep journal of sleep patterns. Caffeine should only be consumed in the morning, follow drug regimen, time restraints related to driving, drug interactions, hangover effects may occur, effect that grapefruit has on benzodiazepines

Answer 36

Works with in the CNS. Most are known as Centrally acting skeletal muscle because of their site of action. Effects of the drug come from the sedative effects and not the direct muscle relaxation. There is no direct effect on the muscle, itself.

Answer 37

Relief of muscle spasms often following injuries such as low back pain. Most effective when used with physical therapy.

Answer 38

Known drug allergies. Contraindications for some drugs may include severe renal impairment when used with muscle relaxants.

Answer 39

Euphoria, lightheadedness, dizziness, drowsiness, fatigue, confusion, and muscle weakness. Pt will grow tolerant to the drug. -Less Common: Diarrhea, GI upset, headache, slurred speech

Answer 40

Do not take with other depressant drugs (alcohol or benzodiazepines). Caution for overdosage must be taken. Will cause anxiety, tremors and mental confusion when overdose is happening.

Answer 41

Perform a complete head to toe assessment with a focus on the neurologic system. In the older adult, there is an increased risk for CNS toxicity with possible hallucinations, confusion, and excessive sedation.

Answer 42

Frequently monitor airway, breathing, and circulation. Closely monitor all vital parameters, level of consciousness, and presence of sedation. Encourage cautious ambulation. The greatest risk for hypotension is within 1 hour after dosing.

Answer 43

Patient must take drug as prescribed, keep out of reach from children, encourage assistance with ambulating, Do not abruptly discontinue using, and do not use with other CNS depressants.

Answer 44

Drug class: Benzodiazepines, CNS Depressant -Mechanism of action: Depresses activity in the CNS. Specifically the hypothalamic, thalmic, and limbic system. Specific receptors in the brain (GABA) are thought to be for benzodiazepine

Answer 45

Induces sleep & reduces agitation & anxiety related to depression and acute seizure disorders.

Answer 46

*Highly protein bound, do not quit quickly

Answer 47

Alters movement of sodium, potassium, calcium, and magnesium ions resulting in more stabilized and less excitable cell membranes.

Answer 48

-Tonic-colonic and partial seizures

Answer 49

Heart conditions that involve bradycardia

Answer 50

Lethargy, abnormal movements, mental confusion, and cognitive changes. Gingival hyperplasia (long term use), hirsutism

Answer 51

Azole Antifungals, benzodiazepines, proton pump inhibitors, sulfonamides, carbamazepine, cyclosporine, rifampin, warfarin

Answer 52

Educate the patient on the sedating effects of drug therapy so patient safety is put first. The patient is not allowed to drive, or operate heavy machinery. Report any suicidal thoughts. Avoid alcohol and caffeine.

Answer 53

Partial seizures and for prophylaxis of partial seizures

Answer 54

Dizziness, drowsiness, nausea, visual and speech changes, edema

Answer 55

Partial and secondarily generalized seizures, for generalized tonic-colonic seizures, and for drop attacks in Lennox Gastaut syndrome

Answer 56

Do not take during pregnancy, may lead to cleft palate in children

Answer 57

Dizziness, drowsiness, GI upset, ataxia

Answer 58

other Antiepileptic drugs (Carbamazepine, hydantoins, valproic acid) and oral contraceptives.

Answer 59

Partial seizures and generalized tonic-clonic seizures, was used for trigeminal neuralgia

Answer 60

Individuals with myoclonic and absence seizures, and bone marrow depression

Answer 61

Nausea, headache, dizziness, unusual eye movements, visual change, behavior changes, rash, abdominal pain, abnormal gait, GI upset

Answer 62

Azole, antifungals, isoniazid, macrolides, SSRIs, barbituates, acetaminophen, rifampin, valporic acid, theophylline

Answer 63

Generalized seizures (absence, myoclonic, and tonic-clonic) Also used for bipolar disorder, and shown to be affective with partial seizure treatment.

Answer 64

Liver impairment, and urea cycle disorders

Answer 65

Dizziness, drowsiness, GI upset, weight gain, hepatotoxicity, pancreatitis

Answer 66

Stimulate areas of the brain associated with mental alertness. Cerebral cortex and thalamus. Increase the release of norepinephrine and dopamine.

Answer 67

ADHD and narcolepsy

Answer 68

Known drug allergies or cardiac structural abnormalities. Anxiety or agitation can be exacerbated. Hypertension, glaucoma or Tourette’s syndrome.

Answer 69

Drug will speed up body systems. Increased HR & BP, anxiety, insomnia, angina, headache, tremor, decreased appetite.

Answer 70

Avoid MAOIs, caffeine, and CNS stimulants. Can cause dysrhythmias.

Answer 71

A continuous and very cautious patient assessment is needed. For each child gather a baseline, weight, BP, height, growth and development, and vital signs. Atypical behavior, such as loss of attention span, history of social behaviors in school are very important. Adult patients also need an excessive assessment of weight, height, and blood pressure.

Answer 72

Dosage should be individualized depending on patient, and well planned scheduling of meds is important. Do not take 6 hours prior to bed time.

Answer 73

Advice to take as ordered, advise client to be cautious when driving, and limit caffeine.

Answer 74

Stimulates areas of the brain associated with mental alertness

Answer 75

Correcting imbalance in the neurotransmitter concentrations of serotonin and norepinephrine at the nerve endings in the CNS. Blocks presynaptic reuptake of neurotransmitters.

Answer 76

Depression (more commonly used for insomnia and neuropathic pain)

Answer 77

Known drug allergy, pregnancy, and recent myocardial infraction

Answer 78

Anorexia, dry mouth, blurred vision, constipation, sexual dysfunction, altered blood glucose levels, urinary retention, anxiety, sedation, HA, insomnia, rash, photosensitivity, dysrhythmias.

Answer 79

Alcohol, CYP inhibitors (increase intoxicity)

Answer 80

inhibition of serotonin reuptake is the primary mechanism of action. SSRIs may have a weak effect on norepinephrine and dopamine reuptake

Answer 81

Depression, OCD, bulimia nervosa, panic disorder, premenstrual dysphoric disorder

Answer 82

Known drug allergy, concurrent MAOI therapy

Answer 83

Anxiety, dizziness, drowsiness, insomnia, HA, mild GI disturbances, sexual dysfunction, tumor

Answer 84

MAOIs, linezolid, lithium, buspirone, benzodiazepines, warfarin, phenytoin, propafenone

Answer 85

Weak effects on the brain serotonin activity, primarily dopaminergic and noradrenergic

Answer 86

Depression, smoking cessation, substance abuse, glaucoma, heart failure

Answer 87

Known drug allergy, seizure disorders, and those currently on an MAOI stroke

Answer 88

Dizziness, HA, sedation, nausea, blurred vision, tachycardia, dry mouth, tremor, agitation

Answer 89

Azole antifungals, phenothiazine, protease inhibitors, carbamazepine, alcohol, CNS depressants

Answer 90

Complete head to toe assessment, and mental status examination Thoroughly assess the patients neurologic functioning, including level of consciousness, mental alertness, and motor/cognitive functioning. Constantly assess the patient for suicidal ideation or tendencies. This must always be a potential risk with any depressed patient.

Answer 91

Nurse demonstrates a firm, calm, and empathic attitude with the use of therapeutic communication. Provide patient with short simple instructions and information about the drug, its action, and the length of time before effects are expected. -Administered exactly how medication is ordered.

Answer 92

Medication may take 4-6 weeks to reach full potential. Observe patient for improved mood, and affect and alleviation decrease in psychotic symptoms.

Answer 93

Consumption of fiber supplements must occur at least 2 hours before or after the dosing of medication to avoid interference with drug absorption. . Encourage patient to openly talk about their feelings.

Answer 94

Inhibit the MAO enzyme system in the CNS, therefore, dopamine, serotonin, & norepinephrine are not broken down and therefore higher levels of these substances occur

Answer 95

Used to treat parkinson’s disease

Answer 96

Meperidine

Answer 97

Can cause hypertensive crisis, dizziness, dsykinesias, nausea, syncope, and hypertension

Answer 98

Food: Aged cheese, smoked meats, yeast extracts, red wine, Italian broad beans Drugs: Meperidine, other opioids, other MAOIs, SSRIs, oral contraceptives, and buspirone

Answer 99

Complete assessment head to toe and a mental status evaluation. If patient has history of suicidal thoughts they must be monitored closely. Look for deterioration in health status.

Answer 100

Monitor periodic liver function tests and ongoing vital signs. Assess needed emotional support. Discontinue immediately with hypertensive crisis. Regitine should be on hand to control severe hypertension reaction

Answer 101

After stopping MAOI, instruct client to wait 2-3 weeks prior to taking another antidepressant. Advise patient while taking MAOI, not to take over the counter cold and flu products. Foods and beverages high in tyramine are to be avoided. Contact immediately if any blurred vision, agitation, urinary retention, or ataxia occur. Encourage wearing a medical alert necklace.

Answer 102

Depresses cerebral cortex, hypothalamus, limbic system, which control activity, aggression; blocks neurotransmission produced by dopamine at synapse

Answer 103

Psychotic illnesses, schizophrenia, depression. Anxiolytic and antianxiety effects, ADHD, Tourette’s, & behavioral problems

Answer 104

Known drug allergies, significant CNS depression, brain damage, liver or kidney disease, blood dycrasias, uncontrolled epilepsy, seizures

Answer 105

Parkinson’s, hypotension, HA, confusion, edema, rash, weight gain, urinary retention, dry mouth, neuroleptic malignant syndrome, photosensitivity, gynecomastia

Answer 106

Alcohol, other CNS depressants, anticholinergic, antihypertensive, beta blockers, opioids, levodopa/carbidopa, thiazine diuretics

Answer 107

Blocks dopamine receptors to the brain, which decreases dopamine concentration in the CNS. Blocks serotonin.

Answer 108

Used in patients with Schizophrenia who are non-adherent with their drug regimen, long term treatment, low doses for nausea, ADHD, & Tourette’s

Answer 109

Known hypersensitivity, Parkinson’s disease, and patients taking large amounts of CNS depressants, children less than 3, coma

Answer 110

Parkinson’s, hypotension, HA, confusion, edema, rash, weight gain, urinary retention, dry mouth, neuroleptic malignant syndrome, photosensitivity, gynecomastia

Answer 111

Alcohol, other CNS depressants, anticholinergic, antihypertensive, beta blockers, opioids, levodopa/carbidopa, thiazine diuretics

Answer 112

Functions as an antagonist at multiple neurotransmitter receptors in the brain.

Answer 113

Bipolar disorder, bipolar 1 disorder, depression, mania, schizophrenia, recurrent suicidal behavior

Answer 114

Hypersensitivity, breastfeeding mothers, children, dementia patients, suicidal patients

Answer 115

Anorexia, nausea, constipation, orthostatic hypotension, back pain, fever, Parkinson’s, leukopenia, dizziness, HA, seizures, anxiety

Answer 116

Alcohol, CNS drugs, erythromycin, fluconazole, levodopa, lithium

Answer 117

Blocks dopamine receptors to the brain, which decreases dopamine concentration in the CNS

Answer 118

Psychotic illness, schizophrenia, depression. Anxiolytic and antianxiety effects

Answer 119

Known drug allergies, significant CNS depression, brain damage, liver or kidney disease, blood dycrasias, uncontrolled epilepsy, seizures

Answer 120

Parkinson’s, sedation, tachycardia, agitation, seizures, dyskinesia, dizziness, drowsiness, and headache

Answer 121

Alcohol, other CNS drugs, antihypertensive, anticholinergic, ketoconazole, and carbamazepine

Answer 122

Head to toe assessment of all body systems and a careful psych evaluation. Assess for suicidal thoughts and mental alertness. Assessment of baseline motor, sensory, and neurologic functioning is very important.

Answer 123

Must be taken exactly how the medication is described. Patient avoids hot showers. If serum levels of Haloperidol are less than 4ng/mL, the patient may show symptoms of the mental disorder, and high levels of 22ng/mL will result in toxicity. Risperidone is to be given as ordered and administered by injection into deep muscle mass. Drug therapy must be monitored closely (serum levels and med compliance)

Answer 124

Improvement of mood, and affect, and alleviation or decrease in psychotic symptoms (hallucinations, paranoia, delusions, garbled speech). Look for tic like trembling movements of hands, face, neck, and head

Answer 125

Urine may turn pink or reddish brown. Medication could take 6 weeks or longer to show effects. Daily dose 1-2 hours before bedtime. Avoid sun exposure, and advise client to wear medication ID bracelet.

Answer 126

Advise client about orthostatic hypotension and how to handle rising from sitting or lying. Recommend avoiding hot tubs, hot showers, and tubs due to hypotension. Avoid abruptly withdrawing the drug. EPS mat result. Avoid hazardous activities if drowsy or dizzy. Report impaired vision, tremors, muscle twitching.

Topic 5: Drugs that Affect the neurological system Flashcards

(152 cards)