NUR 2474 Pharm Module 2 Quiz 2023 (solved)

S/S of Alzheimers Disease? - Answer- memory loss, confusion, feeling disoriented, impaired judgement, inability to self care, cannot do ADLs What is happening in the brain before one begins medication with Alzheimers? - Answer- there is reduced Ach or cholinergic transmission with levels below 90%, the neurons are degenerated. Main medication given for Alzheimers disease? - Answer- donepezil What is the prognosis with Alzheimers? - Answer- it is irreversible and incurable, but medication use can slow its progression What does donepezil do? - Answer- prevent Ach breakdown at the neural level, therefor increasing concentration of the neurotransmitter available for reuptake. SE of donepezil? - Answer- HA, dizziness, GI effects- N,V, bronchoconstriction What is one thing we need to teach the patient and family about use of the medication donepezil? - Answer- remember to take the medication on time and to follow correct dose. often times patient who take this drug may forget to take it or that they have already taken it, so having a supportive person will help with management. S/S of Parkinson's - Answer- dyskinesia, tremors, rigidity, postural instability, bradykinesia, mask like face, shifting gait, pill rolling movements, autonomic disturbance, depression and psychosis. What is happening in the brain before one begins medication with Parkinsons? - Answer- There is a low amount of dopamine, and increase Ach stimulation of GABA Main medications for Parkinsons - Answer- Levodopa/Carbidopa selegiline Lasting effects of levodopa/carbidopa over time - Answer- lasts 2-5 years then will wear off over time Why is levodopa used with carbidopa? - Answer- enhances the effects of levodopa and helps reduce N and V associated. How does levodopa/carbidopa work? - Answer- increases dopamine synthesis at the BBB that is converted to dopamine and is then reuptaked. carbidopa has no effects. SE levodopa/carbidopa - Answer- N,V,postural hypotension, increase Na and water, CNS effects, anxiety, cognitive impairment, insomnia, nightmares, behavior changes. Toxicity SE levodopa/carbidopa - Answer- psychosis, vital hallucinations, vivid dreams, nightmares, paranoia- too much dopamine in the brain Food drug interaction with levodopa/carbidopa - Answer- high protein foods- spread protein out with meals MAOB inhibitors (selegiline)- what do we not give with these drugs? - Answer- tyramine rich foods due to causing a hypertensive crisis What is MS? - Answer- chronic inflammatory autoimmune disorder that damages myelin along the CNS and other organs - relapse and exacerbation S/S MS - Answer- paresthesia, muscle problems (spasm/paralysis), visual impairment, bladder/bowel problems, sexual dysfunction, fatigue, depression, slurred speech, dysphagia, dizziness, neuropathy. What is happening in the body before medication use with MS? - Answer- there is inflammation form lymphocytes that migrate and destroy the myelin through inflammation. Main drugs used for MS - Answer- interferon beta What does interferon beta do? - Answer- reduces severity and frequency of MS attacks and slows down the progression, but will also suppress the immune system. SE interferon beta - Answer- flu like symptoms-fever chills, malaise, hepatotoxicity, myelosupression, injection site reactions, suicide thoughts What is important to teach our patients related to the use of interferon beta? - Answer- they may have flu like symptoms but not the flu itself, injection site reactions may occur and it will help by rotating sites, using hydrocortisone or Benadryl for rash and itchy, higher risk of infection with the immunosuppression types of seizures - Answer- partial, generalized, absence, tonic-clonic What is the purpose of seizure drugs - Answer- suppress discharge of neurons at seizure focus, suppress the seizure activity, inhibits, Na, Cal, antagonize glutamate and increase GABA Types of seizure drugs - Answer- carbamazepine, valproic acid, phenytoin What things should we do when evaluating one for use of a seizure drug? - Answer- evaluate risks and benefits of the drug, increase it to max dosage one can handle at a therapeutic level, monitor drug levels to check for the level in case we must increase or decrease the drug,. What should we do to keep track of seizures - Answer- keep a seizure frequency chart, time seizures and document s/s of the seizure and what happens during it. therapeutic level of phenytoin - Answer- 10-20 mcg therapeutic level of valproic acid - Answer- 60-120 mcg Food to drug interaction with carbamazepine - Answer- no grapefruit juice SE of carbamazepine - Answer- nystagmus, ataxia, hematological effect, birth defects, hypo-osmolarity, rash and photosensitivity. What should we do before stopping any drug? - Answer- call HCP What can happen if we stop any of these medications (PD/ ALZHEIMERS/SEIZURES/SPASMS/ADHD) - Answer- the s/s of disease can come back, the disease progression may speed up, withdrawal can occur What is important about the use of amphetamines and methylphenidate? - Answer- give in the am before breakfast and repeat 2nd dose before 4pm to promote nighttime sleep Amphetamines/Methlyphenidate is a - Answer- controlled substance class 2 - high risk for it to be abused Why do we not stop amphetamines abruptly - Answer- abstinence syndrome can occur What is the purpose of ADHD drugs? - Answer- inhibit NE/dopamine to increase focus and attention SE ADHD drugs - Answer- insomnia, nervousness, high HR and palpitation, decreased growth and appetite, seizures, psychosis