Diazepam and Barbiturates

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Questions and Answers

Diazepam's mechanism of action primarily involves potentiating the effects of which neurotransmitter?

Norepinephrine
Dopamine
GABA (correct)
Serotonin

A patient with a history of alcohol withdrawal is prescribed diazepam. What is the primary goal of using diazepam in this context?

To elevate mood and prevent depression.
To reduce anxiety and prevent seizures. (correct)
To increase appetite and prevent malnutrition.
To induce sleep and manage insomnia.

Which of the following adverse effects is most commonly associated with oral diazepam administration?

Insomnia
Increased appetite
Drowsiness (correct)
Hypertension

A patient taking barbiturates is also prescribed an anticoagulant. What potential interaction should the nurse monitor for?

Decreased effectiveness of the anticoagulant. (D) Signup and view all the answers

What is the primary mechanism of action of barbiturates in the central nervous system (CNS)?

Inhibiting neuronal impulse conduction in the ascending reticular activating system (RAS) (A) Signup and view all the answers

A patient with a history of which condition is most likely to have a contraindication to barbiturate use?

Latent porphyria (B) Signup and view all the answers

Which of the following instructions should a nurse prioritize when educating a patient newly prescribed phenobarbital for long-term seizure management?

Avoid alcohol and other CNS depressants (B) Signup and view all the answers

A patient taking oral contraceptives has started phenobarbital. What potential interaction should the patient be made aware of?

Decreased effectiveness of oral contraceptives (B) Signup and view all the answers

A patient experiencing alcohol withdrawal is prescribed a medication to manage hyperexcitability and agitation. Which drug class is MOST likely to be used?

Benzodiazepines (B) Signup and view all the answers

Which physiological process do benzodiazepines primarily influence to exert their anxiolytic and hypnotic effects?

Potentiating the effects of gamma-aminobutyric acid (GABA). (A) Signup and view all the answers

A patient taking an anxiolytic reports experiencing drowsiness and lethargy. What is the MOST appropriate initial nursing intervention?

Assess the patient’s vital signs and level of sedation, and educate about potential side effects. (C) Signup and view all the answers

A patient has been taking a benzodiazepine for several months and wants to discontinue it. What is the MOST important instruction to provide regarding discontinuation?

The medication should be tapered gradually under medical supervision. (B) Signup and view all the answers

Which of the following findings would be MOST indicative of benzodiazepine overdose?

Severe respiratory depression, hypotension, and unresponsiveness (C) Signup and view all the answers

A pregnant patient is prescribed a benzodiazepine during the first trimester. What potential risk should the nurse discuss with the patient?

Increased risk of cleft lip or palate in the neonate (A) Signup and view all the answers

A patient taking benzodiazepines reports combining the medication with alcohol. The nurse should be MOST concerned about:

A synergistic increase in CNS depression. (A) Signup and view all the answers

A newborn exhibits symptoms of neonatal abstinence syndrome (NAS). The mother has a history of long-term benzodiazepine use during pregnancy. Which of the following symptoms is LEAST likely to be associated with benzodiazepine withdrawal in the neonate?

Hypothermia and decreased respiratory rate (D) Signup and view all the answers

Which of the following classes of antidepressants should be avoided in patients with cardiovascular disease?

Monoamine Oxidase Inhibitors (MAOIs) (D) Signup and view all the answers

A patient taking a typical antipsychotic starts exhibiting muscle rigidity, fever, and altered mental status. Which of the following is the MOST likely cause?

Neuroleptic malignant syndrome (NMS) (A) Signup and view all the answers

A patient on haloperidol develops uncontrollable movements of their tongue and lips after several months of treatment. Which extrapyramidal side effect is the patient MOST likely experiencing?

Tardive dyskinesia (C) Signup and view all the answers

Which of the following is the PRIMARY mechanism of action of atypical antipsychotics?

Combined blockade of dopamine and serotonin receptors (D) Signup and view all the answers

A physician is considering prescribing clozapine for a patient with schizophrenia. What is an important consideration PRIOR to initiating treatment?

Ensuring the patient has failed other antipsychotic treatments (A) Signup and view all the answers

Which of the following is NOT typically an adverse effect associated with typical antipsychotics due to their dopamine receptor blockade?

Weight loss (B) Signup and view all the answers

A patient is prescribed venlafaxine for major depressive disorder. What additional therapeutic effect might the patient experience?

Smoking cessation (C) Signup and view all the answers

Which of the following is a potential risk associated with the use of haloperidol?

Neuroleptic Malignant Syndrome (C) Signup and view all the answers

A patient taking lithium presents with lethargy, slurred speech, nausea, and muscle weakness. What is the most likely lithium serum level range for this patient?

Less than 1.5 mEq/L (B) Signup and view all the answers

Lithium's therapeutic effect in treating mania is believed to be related to its influence on which neurotransmitters?

Altering sodium transport and inhibiting norepinephrine and dopamine release (A) Signup and view all the answers

Which of the following instructions should be given to a patient who is prescribed lithium?

Maintain consistent salt intake and stay hydrated. (D) Signup and view all the answers

Methylphenidate (Ritalin) is prescribed for a child with attention-deficit disorder. What monitoring is most important for this patient?

Growth, cardiac and psychosocial monitoring. (B) Signup and view all the answers

A patient is prescribed methylphenidate for narcolepsy. Which of the following potential adverse effects should the nurse prioritize in patient education?

Insomnia and nervousness (A) Signup and view all the answers

A patient taking phenytoin for seizure control reports gingival hyperplasia. What is the most appropriate action?

Emphasize the importance of good oral hygiene. (D) Signup and view all the answers

Which statement best describes the mechanism of action of antiepileptic medications in controlling seizures?

Enhance the inhibitory effects of GABA and slow the entrance of sodium and calcium into the neuron. (D) Signup and view all the answers

A patient experiences a seizure involving both hemispheres of the brain with loss of consciousness. Which type of seizure is the patient most likely experiencing?

Generalized seizure (A) Signup and view all the answers

A patient taking phenelzine reports experiencing a severe headache and elevated blood pressure. Which dietary change is least likely to have contributed to this reaction?

Increased consumption of fresh green beans. (D) Signup and view all the answers

Which combination of medications presents the highest risk of adverse interaction when administered concurrently, based on the information provided?

Fluoxetine and a tricyclic antidepressant (TCA). (D) Signup and view all the answers

A patient is prescribed fluoxetine for depression. What information should the healthcare provider emphasize regarding the expected time frame for experiencing therapeutic effects?

It may take up to 4 weeks to experience noticeable improvements. (B) Signup and view all the answers

A patient taking phenelzine is educated about potential food interactions. Which food item, if consumed in excess, would require the most immediate concern and monitoring by the healthcare provider?

Overripe bananas. (B) Signup and view all the answers

Which statement best describes the action of SSRIs compared to MAOIs in treating depression?

SSRIs selectively inhibit serotonin reuptake, while MAOIs affect multiple neurotransmitters by inhibiting their breakdown. (B) Signup and view all the answers

A patient is switched from fluoxetine to another antidepressant due to intolerable sexual side effects. Which of fluoxetine's characteristics most likely contributes to the increased incidence of this adverse effect?

Its selective blocking of 5HT, leading to a direct impact on sexual function. (D) Signup and view all the answers

A patient taking an MAOI is starting treatment with an oral antidiabetic agent. What critical adjustment to their medication regimen is likely needed?

Decrease the dose of the oral antidiabetic agent to prevent additive hypoglycemia. (D) Signup and view all the answers

A healthcare provider is considering prescribing fluoxetine to a patient with a history of mania. What should be their primary concern?

Fluoxetine's activating properties, which could exacerbate manic symptoms. (A) Signup and view all the answers

A patient is prescribed naltrexone for alcohol dependence. Which instruction is most important for the nurse to provide regarding potential adverse effects?

Headaches are expected and should subside with continued use. (C) Signup and view all the answers

A patient experiencing a migraine is prescribed sumatriptan. What is the primary mechanism of action of this medication?

Binding to serotonin receptors to cause vasoconstriction of cranial vessels. (C) Signup and view all the answers

A patient with a history of coronary artery disease (CAD) is prescribed sumatriptan for migraine headaches. What is the most important nursing consideration?

Educate the patient on the risk of vasospasm and cardiac side effects. (A) Signup and view all the answers

Which instruction should the nurse provide to a patient who is prescribed ergotamine for vascular headaches?

Avoid taking ergotamine with triptans due to the risk of vasospasm. (D) Signup and view all the answers

A patient is prescribed galcanezumab for migraine relief. What is the mechanism of action of this medication?

Inhibiting the release of calcitonin gene-related peptide (CGRP). (C) Signup and view all the answers

A patient is receiving naltrexone (Vivitrol) for opioid dependence. Which assessment finding would indicate the medication is having its desired therapeutic effect?

The patient reports a decreased desire to use opioids. (C) Signup and view all the answers

Which of the following is a contraindication for the use of sumatriptan?

History of CAD (D) Signup and view all the answers

A patient reports experiencing a severe, throbbing headache on one side of their head, accompanied by nausea and sensitivity to light and sound. Which type of headache is the patient most likely experiencing?

Migraine headache (D) Signup and view all the answers

Flashcards

Anxiolytics

Medications that reduce feelings of tension or fear.

Sedatives

Drugs that calm patients and reduce awareness of the environment.