NUR 2474 Module 2 Review

NUR 2474 Module 2 Review Pharmacology for Professional Nursing - Rasmussen

Chapters 21 – 25, 36

True or False/ You should watch for signs of jaundice and watch liver enzymes with administration of Carbamazepine (Tegretol)?

• True

True of False Should you limit sun exposure while taking Tegretol (carbamazepine)?

• Yes

Adverse effect of immunomodulators (dark thoughts)?

• Avonex and Betaseron can cause increase of depression and risk of

suicidal thoughts and actions

What side effect of Oxcarbazepine (Trileptal) should you report?

• Signs of hyponatremia (headache, nausea, drowsiness, or confusion)

Dyskinesias can be managed in three ways....

• dosage of levodopa can be reduced (dosage reduction may allow

PD symptoms to re-emerge)

• give amantadine which can reduce dyskinesias in some patients
• If all measures fail, surgery and electrical stimulation 1 / 4

Parkinson's disease is defined as?

• Shuffling gait, intention tremors caused by a lack of dopamine

When is the best time to give Valproic acid (Depakote) and what should be given with it?

• Give with food and at bedtime for sedation

Psychosis in Parkinson's disease is most likely drug induced (levodopa/carbidopa), amantadine, and anticholinergic drugs which can cause?

• Hallucinations

Postural hypotension is common is early treatment of PD associated with what medication and how can it be reduced?

• Levodopa
• Can be reduced by increasing intake of salt and water
• Alpha-adrenergic agonist can help also

Common site reactions of immunomodulators such as Avonex and Betaseron?

• Welts, redness use steroid cream or Benadryl to reduce welts

Phenytoin (Dilation) is a Na+ blocker used just for seizures and what other condition?

• Arrhythmias

Always check Rx compatibilities for what medication?

• Valproic acid (Depakote)

If develops, dopamine agonists, amantadine, and anticholinergic meds should be and the dosage of levodopa should be reduced to the lowest effective amount.

• Psychosis, stopped 2 / 4

Conversion of levodopa to dopamine in the periphery can cause excessive activation of beta 1 receptors in the heart which can lead to what in patients with heart disease?

• Dysrhythmias

Detrusor hyperflexia is a type of bladder dysfunction which is defined by:

• Detrusor hyperflexia (decreased inhibition of bladder reflex which

manifests by urinary frequency and urgency, nocturia and incontinence.

Benzodiazepine antidote

• Flumazenil (Romazicon)

Who are considered high risk in administering Interferon Beta drugs such as Avonex or Betaseron?

• Patients who abuse alcohol (think liver), have active liver disease, or

a history of liver disease.Patients taking drugs that can cause liver injury or suppress bone marrow

Valium should be given IV push and Dilantin given IVPB drip (Never in D5W)

• For status epilepticus

Adrenergic used in shock include Dobutamine which .................. the heart beat Dopamine which elevates your ................. but helps your kidneys at lower doses

• Strengthens, elevates 3 / 4

Treatment of Detrusor hyperflexia bladder dysfunction associated with MS:

• Anticholergenics (help relax the detrusor and permit normal volume

of urine to accumulate before bladder emptying.(tolterodine Detrol, oxybutynin Ditropan Oxytrol, darifenacin Enablex, and solifenacin VESIcare.

Visual hallucinations, vivid dreams or nightmares, and paranoid ideation (fears of personal endangerment, sense of persecution, feelings of being followed or spied on) are all examples of an adverse effect of Levodopa known as?

• Psychosis

If antipsychotic medications need to be used in a Parkinson's patient, generation should be avoided because all of these drug’s receptors for dopamine and can intensify symptoms.

• 1st

Adverse effects of benzodiazepines and barbiturates?

• Drowsiness & Confusion
• Hypotension & Unsteadiness
• Amplification of other sedatives
• Psychological depression
• Respiratory depression
• Paradoxical agitation
• Rx dependency
• Tolerance (gateway effect)
• Seizures if suddenly withdrawn

What patient education should be used to educate a patient starting a new medication that is an Interferon Beta (Avonex, Betaseron)?

• Store drug under refrigeration
• Teach how to self-inject and rotate sites

Avonex: instruct to inject once a week into muscle (IM)

intramuscular

Betaseron: instruct patient to reconstitute powered Betaseron just

before use and inject SQ every other day.

• / 4