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NR 566 Final Exam Summarized Study Guide Complete Rated A.
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NR 566 Final Exam Summarized Study Guide Complete Rated A.
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NR 566 Final Exam Summarized StudyGuide Complete Rated A.
First-line treatment for migraine prevention?
✔✔Beta Blockers: Metoprolol or Propranolol
First-line treatment for acute, mild to moderate migraine without nausea
or vomiting?
✔✔NSAID: Naproxen or aspirin
How to know someone would be appropriate for preventative migraine
therapy?
✔✔Indicated for patients who have frequent attacks (3+ a month), severe
attacks, or attacks that do not respond adequately to abortive therapy
Opioid analgesic reserved for severe migraines that don't respond to first-
line medications?
✔✔Butorphanol nasal spray; one spray each nostril every 60 minutes prn
mechanism of action for sumatriptan:
✔✔suppresses the release of CGRP from trigeminal neurons
leads to vasoconstriction and decreased perivascular inflammation to
relieve migraine pain
,contraindications for triptans
✔✔Pregnancy, uncontrolled HTN, previous MI, heart disease
The first dose of any triptan should be:
✔✔should be under direct supervision in case of any unknown underlying
cardiac disease
Rivastigmine (Exelon) Patch Patient teaching
✔✔· Change daily (don't re-use site for 14 days)
· Remove old patch before applying a new patch
When would it be appropriate to increase the dose of Donepezil (Aricep)?
✔✔Dosing starts at 5 mg and titrate up to 10mg for mild to moderate
symptoms. This can go up to a maximum dose of 23 mg orally once daily at
three months of treatment
Donepezil at a higher dose has a higher incidence of adverse effects
without increased cognitive benefit
Appropriate to increase dose if symptoms increase
Cholinesterase inhibitors Side effects
✔✔· Bradycardia, lightheadedness, fainting/falls, weight loss
· Dose related (increase dose gradually): Nausea, vomiting, diarrhea,
abdominal pain, tremors, anorexia, insomnia
, When on medications for Alzheimer's Disease (AD) and symptoms increase
What should be done?
✔✔Increase the AD medication than to add things like herbal medications,
vitamins, or NSAIDs
What to do when someone has an elevated creatinine clearance while on
Memantine?
✔✔Adjust dose for renal impairment (creatinine clearance of less than
30mL/min), discontinue in severe renal impairment
First-line treatment options for panic disorder?
✔✔SSRIs- fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) for
at least 6-9 months to prevent rebound anxiety
First-line treatment options for performance anxiety?
✔✔beta blockers- Propranolol to prevent associated tachycardia (1-2 hours
before)
Benzos for rapid relief
First-line treatment options for generalized anxiety disorder?
✔✔SSRIs- Paroxetine (Paxil) and Fluoxetine (Prozac)
SNRIs- Buspirone (Buspar)
Approach when first anti-depression drug doesn't seem to be working?
✔✔wait at least 4 weeks minimum before increasing/changing dose.
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