NUR 2474 Rasmussen Pharmacology
Exam 1: Modules 1-3.
when should we complete blood testing with use of lithium?(Ans- early in therapy- every 2-3 days, until a therapeutic dose has been established, then long term-every 3 to 6 months
therapeutic level of lithium (Ans- 0.8-1.4 mEq/L
toxic level of lithium (Ans- greater than 1.5 mEq/L
when can we start to see side effects of lithium?(Ans- when the drug is at a therapeutic level. they are expected.
what are the side effects of lithium (therapeutic level)?(Ans- GI effects, tremors, polyuria, renal toxicity, goiter, hypothyroidism, teratogenesis.
what will happen to side effects when one has a toxic level of lithium?(Ans- the effects will be much worse and possibly life threatening i.e.tremor that becomes larger with muscle incoordination
what medications can we use to treat the cyclic effects of bipolar (mood- depression- psychosis)?(Ans- mood stabilizer (lithium)= control mood antidepressant (SSRI,TCA,MAOI)= control depression antipsychotic (Ist/2nd generation)= control the psychosis
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how does a benzodiazepine help with ETOH withdrawal?(Ans- it will decrease the withdrawal manifestations and intensity, while making one sleepy and having CNS depression. plus, it is easy to give IM and will work quickly.
what is a popular benzodiazepine that is used to treat anxiety?(Ans- alprazolam (think A-anxiety)
how does alprazolam work to reduce anxiety?(Ans- it inhibits GABA in the CNS, depressing the CNS.
what are the side effects of alprazolam use?(Ans- a. CNS depression, anterograde amnesia (patient cannot remember much), sleep driving (not safe), paradoxical effects (still anxious, stays up, rowdy), respiratory depression.
what drugs does alprazolam interact with?(Ans- CNS depressant medications (additive effects), ETOH
what are various treatments and drugs used to treat anxiety patients?(Ans- benzo's (pam/lam), atypical anxiolytic buspirone, SSRIs paroxetine/fluoxetine, TCAs, MAOIs, trazodone.
explain what a sedative hypnotic does (Ans- cause the patient to have sedation, sleepiness, CNS depression, anterograde amnesia (patient cannot remember much), sleep driving (not safe),respiratory depression
what things should we teach the patient using a drug to treat anxiety?(Ans- drug should be tapered only by the HCP, not patient no ETOH use what withdrawal effects may look like
what does anxiety medication PO withdraw look like?(Ans- drowsiness, lethargy, confusion 2 / 3
what does anxiety medication IV withdraw look like?(Ans- hypotension, respiratory arrest, cardiac arrest.
explain what methylphenidate does (Ans- increases attention and focus in children (Nothing Dealing W/ Behaviors)
other effects of methylphenidate use in children (Ans- decreased appetite insomnia if given late in the day
what things should we always do when giving methylphenidate to a child with ADHD?
(Ans- ALWAYS: give the drug in the morning, after breakfast, and give the
last dose before 4pm, or else the child will not sleep at night
which 3 drugs are controlled substances and highly abused?(Ans- amphetamines, barbiturates, methylphenidate
what is the purpose of drug treatment with Alzheimer Disease patients?(Ans- there is treatment to help slow down the progression of the disease, but to not cure it
how does donepezil works?(Ans- it slow the progression of Alzheimers disease by causing reversible inhibition of cholinesterase and the cholinergic receptors.
what should we do when discontinuing an antidepressant (or any medication)?(Ans- if antidepressant is stopped cold turkey, withdrawal syndrome can occur. we must gradually taper the drug slowly and have the HCP taper it.do not let patient taper drug by themselves.
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