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Neuro Meds
Anti-Parkisons & Anti-Seizure
| Question | Answer |
|---|---|
| What is dopamine? | A neurotransmitter that is responsible for transmitting signals in between the nerve cells (neurons) of the brain. |
| What is dopamine involved in? | The motor control, regulating muscle movement, behavior, cognition and emotions; motivations, punishment and reward, sexual gratification, sleep; mood, attention, memory and learning. |
| What percent is dopamine decreased by in Parkinson's disease? | 50% |
| What are the three Anti-Parkinson's medications? | Carbidopa/Levodopa, Levodopa and Benztropine |
| What is Levodopa? | The enzyme dopa decarboxylase converts levodopa to dopamine in the brain which converts dopamine in the PNS before it reaches the brain (1% reaches the brain) |
| What will cause the decrease in absorption of levodopa? | High protein foods |
| What is Carbidopa-Levodopa? | Carbidopa-Levodopa inhibits the enzyme dopa decarboxylase in the peripheral nervous system and intestines so more levodopa reaches the brain |
| What's the difference between Levodopa and Carbidopa-Levodopa? | Carbidopa-Levodopa allows more levodopa to the brain due to going through the intestines. |
| What are the side effects of Carbid-Levo? | Nausea/Vomiting, Involuntary movements, angioedema, palpitations, orthostatic hypotension, urinary retention, impulse control, hallucination, muscle twitching (esp. spasms), dark urine |
| What is a contraindication for Carbid-Levo? | Patients with glaucoma |
| What is life threatening with carbide-levo? | Thrombocytopenia (low platelet levels), Cardia dysthymias, agranulocytosis (acute, severe dangerous neutropenia that leads to high risk of sever infection) |
| What do we want to assess when considering Carbid-levo for a patient? | Health History, baseline vitals, medication history including OTC and herbal |
| What are some patient problems that we should be aware of whole on Carbid-levo? | Reduced motor functions, decreased functional ability, increase fall risk, and health teaching |
| What can we teach the patient about the drug Carbid-levo? | There will be urine discoloration, don't stop abruptly, do not chew or crush extended release tablets, report symptoms of dyskinesia (uncontrolled, involuntary muscle movement) |
| What are some nursing interventions for Anti-Parkinsons/Anticholinergic agent-benztropine patients? | Monitor urine output for early detection of urinary retention. encourage patients to relieve a dry mouth with hard candy, ice chips or sugarless gum. |
| What are some nursing interventions for Anti-Parkinsons/Anticholinergic agent-benztropine patients? | Increase fluid intake, fiber, and exercise to avoid constipation. |
| What are some nursing interventions for Anti-Parkinsons/Anticholinergic agent-benztropine patients? | Instruct the patient to avoid alcohol, cigarettes, and caffeine when taking anticholinergic drugs |
| What are some nursing interventions for Anti-Parkinsons/Anticholinergic agent-benztropine patients? | Use sunglasses tot reduce photophobia |
| What are some nursing interventions for Anti-Parkinsons/Anticholinergic agent-benztropine patients? | Counsel patients who take anticholinergic to have routine eye exams because anticholinergics are contraindicated in patients with glaucoma. |
| What are some adverse reactions of antiparkisons medications? | Paralytic iLeus, megacolon, ocular hypertension |
| What are the five anti-seizure medications? | Carbamazepine, Gabapentin, Phenobarbital, Valproic acid, and Phenytoin |
| Why should pregnant women not take anti-seizure drugs? | Many are teratogenic (severe birth defects) |
| What does anti-seizure drugs tend to inhibit? | Vitamin K |
| When should vitamin K be given to pregnant women? | During the last few days of pregnancy or given to the infant soon after birth. (contributes to infant hemorrhage soon after birth) |
| What does a pregnant woman need to take daily and why? | Folate supplements because anti-seizure drugs increase the loss of folate (folic acid) in pregnant patients. |
| What is Phenytoin use? | Reduce motor cortex activity |
| What is the therapeutic serum range for phenytoin? | 10-20mcg/ml |
| What are the life threatening reactions of phenytoin? | Agranulocytosis, leukopenia, thrombocytopenia, SJS, V-fib, suicidal ideations |
| What are the side effects/ patient teachings of Phenytoin? | Gingival hyperplasia, nystagmus, urine may turn pink, hyperglycemia |
| What are the signs of toxicity while on Phenytoin? | Confusion, coma, dizziness, low blood pressure, sleepiness |
| What are some nursing interventions for phenytoin? | monitor serum levels, Use additional contraceptive method, do not drive or perform hazardous activities, wear a medic bracelet, do not stop abruptly |
| What should a nurse explain to a patient about herbs and Phenytoin? | Certain herbs can interact and dose adjustments may be required. (Do not take OTC drugs unless approved) |
| What is valproic acid used for? | Tonic-clonic, absence and partial seizures |
| What does Valproic acid toxicity result in? | Does-related and reversible hepatotoxicity, CNS depression. |
| How do you treat Valproic Acid? | L-carnitine IV, Meropenem (carbapenem antibiotic) |
| What is Phenobarbital-barbiturate used for? | Treat tonic-clonic, partial, myoclonic seizures, also status epilepticus. |
| What is the therapeutic range for Pheno-barb? | 15-40mcg/mL |
| What is a teaching for Pheno-barb? | Take with food to decrease gastrointestinal irritation. |
| What are some risks associated with Pheno-barb? | Sedation, bradycardia, bronchospasm, and drug tolerance. |
| What is Carbamazepine-anticonvulsant used for? | It's used for tonic-clonic and partial seizures. Bipolar disorder, neuropathic pain and an analgesic in trigeminal neuralgia. |
| What are some nursing interventions for Carbamazepine-anticonvulsant? | NO GRAPEFRUIT JUICE. Carefully monitor drug levels, liver function tests , WBC and platelet count. Use a back up contraceptive. |
| What are some adverse reactions for Carb-anticonvulsant? | SJS, toxic epidermal necrosis, agranulocytosis, suicidal ideation, angioedema, hyponatremia. |
| What is a contraindication of Carb-anticonvulsant? | Asian ancestry patients |
| What is the therapeutic range for Carb-anticonvulsant? | 4-12mcg/mL |
| What does Gabapentin-anticonvulsant used for? | Treats partial seizures |
| What is the off label use for Gbapentin? | Restless leg syndrome, neuropathic pain, hot flashes, fibromyalgia, essential tremors, ETOH withdrawal, advanced Parkinsons. |
| What are some side effects with Gabapentin? | Rash, itching, swelling of the face, throat, tongue, lips or eye. Difficulty swallowing, seizures |
| What are some contraindications for Gabapentin? | Valproate, lithium, carbamazepine |
| What drug can Gabapentin interact with? | Phenobarbital. |
| When should you take Maalox, Mylanta? | 2 hours before taking Gabapentin |
Created by:
Felicitylee92
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