Podcast
Questions and Answers
Which antiepileptic drug allows once-a-day dosing?
Which antiepileptic drug allows once-a-day dosing?
- phenobarbital sodium (correct)
- valproic acid (Depakene®)
- topiramate (Topamax®)
- gabapentin (Neurontin®)
During the nurse's assessment, the patient describes her seizures as initial muscular contractions throughout her body, then alternating between contractions and relaxation. What kind of seizure is she describing?
During the nurse's assessment, the patient describes her seizures as initial muscular contractions throughout her body, then alternating between contractions and relaxation. What kind of seizure is she describing?
- Partial seizure
- Simple seizure
- Generalized tonic-clonic seizure (correct)
- Convulsion
While teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, what information should the nurse emphasize?
While teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, what information should the nurse emphasize?
- Antacids can be taken with the AED to reduce gastrointestinal adverse effects.
- Regular consistent dosing is important for successful treatment. (correct)
- Driving will be allowed after 2 weeks of therapy.
- If seizures recur, the patient should take a double dose of the medication.
A patient has a 9-year history of a seizure disorder that has been managed well with phenytoin therapy. He is to receive nothing by mouth because he has surgery in the morning. What should the nurse do about his morning dose of phenytoin?
A patient has a 9-year history of a seizure disorder that has been managed well with phenytoin therapy. He is to receive nothing by mouth because he has surgery in the morning. What should the nurse do about his morning dose of phenytoin?
A patient has been taking carbamazepine (Tegretol®) for several months and is worried because the physician has increased the dose twice since the beginning of therapy. Which is the nurse's best explanation to the patient?
A patient has been taking carbamazepine (Tegretol®) for several months and is worried because the physician has increased the dose twice since the beginning of therapy. Which is the nurse's best explanation to the patient?
Which intravenous (IV) solution is the only solution to be used with phenytoin?
Which intravenous (IV) solution is the only solution to be used with phenytoin?
Which teaching tips is appropriate for the nurse to give a patient taking topiramate (Topamax®)?
Which teaching tips is appropriate for the nurse to give a patient taking topiramate (Topamax®)?
What is the drug of choice for the immediate treatment of status epilepticus?
What is the drug of choice for the immediate treatment of status epilepticus?
Phenytoin (Dilantin) has a narrow therapeutic index. Which statement defines this characteristic?
Phenytoin (Dilantin) has a narrow therapeutic index. Which statement defines this characteristic?
A patient has been taking gabapentin (Neurontin®) for several years as part of the treatment for partial seizures. His wife has called because he ran out of medication this morning, and she wonders whether he can go without it for a week until she can go to the drugstore. Which statement is true in this situation?
A patient has been taking gabapentin (Neurontin®) for several years as part of the treatment for partial seizures. His wife has called because he ran out of medication this morning, and she wonders whether he can go without it for a week until she can go to the drugstore. Which statement is true in this situation?
A patient has been taking selegiline (Anipril) for a month and says he understands the "cheese effect" that the doctor explained to him. When the nurse questions him about it, he tells her (correctly) that the cheese effect results in which symptom?
A patient has been taking selegiline (Anipril) for a month and says he understands the "cheese effect" that the doctor explained to him. When the nurse questions him about it, he tells her (correctly) that the cheese effect results in which symptom?
A patient newly diagnosed with Parkinson's disease has been given a prescription for levodopa-carbidopa (Sinemet®). The patient comments, however, that a friend was given a prescription for "plain levodopa." What should the nurse explain to this patient about her prescription?
A patient newly diagnosed with Parkinson's disease has been given a prescription for levodopa-carbidopa (Sinemet®). The patient comments, however, that a friend was given a prescription for "plain levodopa." What should the nurse explain to this patient about her prescription?
When a patient is taking an anticholinergic, such as benztropine, as part of treatment for Parkinson's disease, what important information should the nurse give the patient as part of the teaching plan?
When a patient is taking an anticholinergic, such as benztropine, as part of treatment for Parkinson's disease, what important information should the nurse give the patient as part of the teaching plan?
A patient has been treated with antiparkinsonian medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
A patient has been treated with antiparkinsonian medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
Which statement is true in regard to amantadine (Symmetrel) therapy?
Which statement is true in regard to amantadine (Symmetrel) therapy?
Which condition is a contraindication for the patient who will be taking levodopa-carbidopa (Sinemet)?
Which condition is a contraindication for the patient who will be taking levodopa-carbidopa (Sinemet)?
Which nursing diagnosis is appropriate for patients taking anticholinergic drugs?
Which nursing diagnosis is appropriate for patients taking anticholinergic drugs?
Which statement describes an advantage of catechol ortho-methyltransferase (COMT) inhibitors during the treatment of Parkinson's disease?
Which statement describes an advantage of catechol ortho-methyltransferase (COMT) inhibitors during the treatment of Parkinson's disease?
A patient taking a levodopa preparation for the first time calls the clinic to report dark discoloration of his urine. Which statement is true in this situation?
A patient taking a levodopa preparation for the first time calls the clinic to report dark discoloration of his urine. Which statement is true in this situation?
During drug therapy for Parkinson's disease, the nurse monitors for which signs of dyskinesia?
During drug therapy for Parkinson's disease, the nurse monitors for which signs of dyskinesia?
When administering an intramuscular injection of risperidone (Risperdal Consta®), the nurse tells the patient that this medication dosage will be effective for how long?
When administering an intramuscular injection of risperidone (Risperdal Consta®), the nurse tells the patient that this medication dosage will be effective for how long?
Before beginning therapy with fluoxetine (Prozac), the nurse should assess for concurrent use of which medication?
Before beginning therapy with fluoxetine (Prozac), the nurse should assess for concurrent use of which medication?
When the nurse is teaching the patient about monoamine oxidase inhibitors (MAOIs), which is important to emphasize?
When the nurse is teaching the patient about monoamine oxidase inhibitors (MAOIs), which is important to emphasize?
A patient has been taking haloperidol for 3 months for a psychotic disorder. Because the nurse is concerned about the development of extrapyramidal symptoms, the patient will be monitored for which symptom?
A patient has been taking haloperidol for 3 months for a psychotic disorder. Because the nurse is concerned about the development of extrapyramidal symptoms, the patient will be monitored for which symptom?
A patient has been taking the MAOI phenelzine (Nardil®) for 6 months. The patient says he's going out to the local bar to meet a few friends for a beer. What important information should the nurse tell this patient?
A patient has been taking the MAOI phenelzine (Nardil®) for 6 months. The patient says he's going out to the local bar to meet a few friends for a beer. What important information should the nurse tell this patient?
A 22-year-old female has been taking lithium (Carbolith®) for 6 months. She has blood work every month, and the nurse assesses her for signs of toxicity. What are the indications of toxicity?
A 22-year-old female has been taking lithium (Carbolith®) for 6 months. She has blood work every month, and the nurse assesses her for signs of toxicity. What are the indications of toxicity?
What is a common adverse effect of clozapine?
What is a common adverse effect of clozapine?
A 44-year-old patient has been taking sertraline (Zoloft®), a selective serotonin reuptake inhibitor (SSRI), for 4 months. The patient tells the nurse about having an interest in natural health products and wants to start taking St. John's wort. Which statement to the patient is an appropriate response from the nurse?
A 44-year-old patient has been taking sertraline (Zoloft®), a selective serotonin reuptake inhibitor (SSRI), for 4 months. The patient tells the nurse about having an interest in natural health products and wants to start taking St. John's wort. Which statement to the patient is an appropriate response from the nurse?
Which ethnic group often requires lower doses of benzodiazepines and tricyclic antidepressants?
Which ethnic group often requires lower doses of benzodiazepines and tricyclic antidepressants?
St. John's wort is a natural health product that some people use for the treatment of mild to moderate symptoms of depression. Use of St. John's wort is contraindicated in patients with which conditions?
St. John's wort is a natural health product that some people use for the treatment of mild to moderate symptoms of depression. Use of St. John's wort is contraindicated in patients with which conditions?
A nurse is monitoring a depressed patient who has just started antidepressant therapy. During which time period does the patient have the highest potential for self-injury and suicide?
A nurse is monitoring a depressed patient who has just started antidepressant therapy. During which time period does the patient have the highest potential for self-injury and suicide?
Which is a reason that SSRIs are more widely prescribed today than are tricyclic antidepressants (TCAS)?
Which is a reason that SSRIs are more widely prescribed today than are tricyclic antidepressants (TCAS)?
A patient new to antidepressant therapy for depression, and there is no change! what is wrong with the nurse?
A patient new to antidepressant therapy for depression, and there is no change! what is wrong with the nurse?
A patient with a history of anxiety attacks is given a medication for these episodes. Which medication is appropriate for this problem?
A patient with a history of anxiety attacks is given a medication for these episodes. Which medication is appropriate for this problem?
Which breakfast choice by a patient taking an MAOI indicates the need for additional teaching?
Which breakfast choice by a patient taking an MAOI indicates the need for additional teaching?
Which statements are true regarding SSRIs? (Select all that apply.)
Which statements are true regarding SSRIs? (Select all that apply.)
Flashcards
Phenobarbital
Phenobarbital
Antiepileptic drug with the longest half-life, allowing once-a-day dosing.
Generalized tonic-clonic seizure
Generalized tonic-clonic seizure
Seizure with initial muscle contraction throughout the body, progressing to alternating contraction and relaxation.
AED Dosing
AED Dosing
Consistent medication taken regularly at the same time each day to successfully manage seizures.
IV Phenytoin
IV Phenytoin
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Narrow therapeutic index
Narrow therapeutic index
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Gabapentin Discontinuation
Gabapentin Discontinuation
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Cheese effect
Cheese effect
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Levodopa-Carbidopa Combo
Levodopa-Carbidopa Combo
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Anticholinergic Timing
Anticholinergic Timing
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Amantadine
Amantadine
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COMT Inhibitors
COMT Inhibitors
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Dyskinesia
Dyskinesia
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Risperdal Consta
Risperdal Consta
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Warfarin+Fluoxetine
Warfarin+Fluoxetine
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MAIO education
MAIO education
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Haloperidol symptoms
Haloperidol symptoms
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Lithium (Carbolith)
Lithium (Carbolith)
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S. John´s wort + sertraline
S. John´s wort + sertraline
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Asians in dose
Asians in dose
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St John´s in the conditions
St John´s in the conditions
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Depressed patients Self-harm/Suicide
Depressed patients Self-harm/Suicide
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SRRIS vs TCAS
SRRIS vs TCAS
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Patient with and effects are to
Patient with and effects are to
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Buspirone-HC
Buspirone-HC
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Breakfast and teaching
Breakfast and teaching
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Statements for and or time
Statements for and or time
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Diazepam
Diazepam
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Benzodiazepines
Benzodiazepines
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Topiramate Tips
Topiramate Tips
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Vitamin B
Vitamin B
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Study Notes
- Phenobarbital has the longest half-life of standard antiepileptic drugs, enabling once-a-day dosing.
- Generalized tonic-clonic seizures involve initial muscular contraction throughout the body and progress to alternating contraction and relaxation.
- Consistent antiepileptic drug (AED) dosing at the same time each day, at the recommended dose, and with meals to reduce gastrointestinal adverse effects is crucial for successful seizure management.
- Nonadherence is a major factor leading to treatment failure with AEDs.
- The physician should be contacted for an alternative dosage form of phenytoin if a patient is NPO for surgery.
- The route of administration for phenytoin should not be changed without a physician's order.
- Autoinduction with carbamazepine leads to lower-than-expected drug concentrations.
- With carbamazepine doses may require adjustment over time.
- IV phenytoin must be given with normal saline solution only.
- IV phenytoin must be administered slowly.
- During IV phenytoin administration, the patient must be monitored for bradycardia and decreased blood pressure.
- Topiramate tablets should be taken whole and not crushed or broken.
- Diazepam administered rectally is an initial emergent drug for status epilepticus.
- A narrow therapeutic index means the range between safe and toxic drug levels is small.
- Plasma levels of drugs with a narrow therapeutic index require close monitoring.
- Abrupt discontinuation of gabapentin can lead to withdrawal seizures.
- AED therapy is typically lifelong.
- Compliance with consistent dosing is vital for effective seizure control.
- Abrupt discontinuation of AEDs can cause rebound seizure activity.
- The cheese effect from selegiline results in severe hypertension.
- The cheese effect is a major adverse effect of monoamine oxidase inhibitors (MAOIs).
- The cheese effect occurs because MAOIs interact with tyramine-containing foods, such as cheese, red wine, beer, and yogurt.
- Carbidopa allows more levodopa to reach the site of action without being broken down.
- The combination of levodopa and carbidopa is more efficient in increasing dopamine levels in the brain.
- Carbidopa allows for lower doses of levodopa
- Unlike levodopa, dopamine cannot cross the blood-brain barrier.
- Anticholinergics should be taken at bedtime to prevent drowsiness during the day.
- Therapeutic responses to antiparkinsonian drugs include improved mental status.
- There may also be improved ability to concentrate, think clearly, and perform activities of daily living.
- Amantadine works by eliciting the release of dopamine from nerve endings.
- Amantadine is most effective in the earlier stages of Parkinson's disease.
- Amantadine's effectiveness usually lasts for only 6 to 12 months.
- Galucoma is a contraindication of levodopa-carbidopa.
- Seizure disorder is a contraindication to the use of dopaminergic drugs.
- Patients receiving anticholinergic drugs are at risk for urinary retention.
- COMT inhibitors are associated with fewer "wearing-off" effects.
- COMT inhibitors have prolonged therapeutic benefits.
- Levodopa preparations may darken urine and sweat.
- Dyskinesia presents as difficulty in performing voluntary movements.
- One intramuscular injection of risperidone lasts approximately 2 weeks.
- Using fluoxetine with warfarin increases the anticoagulant effect.
- When taking MAOIs, caution should be taken to avoid OTC cold and flu products.
- Patients taking MAOIs should avoid consuming food and drinks high in tyramine.
- Extrapyramidal symptoms are involuntary motor symptoms resembling Parkinson's disease.
- Important to monitor for Motor restlessness and muscle spasms
- MAOI patients must avoid OTC cold and flu products.
- Patients taking MAOI need to avoid foods containing tyramine.
- Lithium levels exceeding 2.0 mmol/L produce possible adverse cardiac effects and moderate-to-severe toxicity.
- Dry mouth is an adverse affect of clozapine.
- Combining St. John wort and Zoloft can cause several drug interactions and is not recommended
- Asians need smaller doses of antidepressant drugs.
- St. Johns Wort is contradicted with Schizophrenia and Alzheimers
- Weeks may pass before therapeutic antidepressant effects become apparant
- The time between starting therapy and symptom improvement, is when suicide is most possible.
- SSRIs have fewer sexual adverse effects.
- Unlike tricyclics, SSRIs do not have drug food interactions.
- Tricyclics can causes serious cardiac toxicities if an overdose occurs
- Antidepressants take up to 4 weeks to notice any therapeutic effects.
- Buspirone hydrochloride treats anxiety
- A patient taking MAOIs should not eat Cheddar cheese omelet.
- A potentially hazardous effect called serotonin syndrome may occur while taking MAOIs.
- With MAOIs, therapeutic effects may not be seen for about 8 weeks after starting the medication.
- With MAOIs, a 2- to 5-week or longer span of time should elapse before beginning an SSRI medication.
- SSRIs are associated with fewer side effects than are the older first-generation antidepressants when taking MAOI's.
- St. Johns Wort is dangerous when a patient is taking MAOI's.
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Description
The content discusses antiepileptic drugs, and the importance of adherence to treatment for successful seizure management. It also highlights specific considerations for drugs like phenobarbital, phenytoin and carbamazepine, including dosing, administration, and potential interactions.
