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
,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
, 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.
