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patho/pharm
exam 4
| Question | Answer |
|---|---|
| What movement-related adverse effect can occur with Levodopa/Carbidopa? | Dyskinesias such as tremors, twitching, and rigidity. |
| Is shaking concerning when taking Levodopa/Carbidopa? | No, shaking is normal for Parkinson’s and normal with the medication. |
| What major cardiovascular safety concern is associated with Levodopa/Carbidopa? | Orthostatic hypotension. |
| What gastrointestinal adverse effects can occur with Levodopa/Carbidopa? | Nausea and vomiting. |
| What psychiatric adverse effect can occur with Levodopa/Carbidopa? | Psychosis or hallucinations. |
| Why are patients on Levodopa/Carbidopa considered a fall risk? | Orthostatic hypotension increases fall risk. |
| What safety instruction should patients follow to prevent falls while taking Levodopa/Carbidopa? | Get up slowly. |
| What is the proper in-hospital technique for standing safely while on Levodopa/Carbidopa? | Use steady mind and standing technique. |
| What type of food should patients avoid taking with Levodopa/Carbidopa? | High-protein foods |
| Is Levodopa prescribed alone or with another medication? | It is always prescribed with Carbidopa. |
| Should nurse report increased shaking while a PT is taking Levodopa/Carbidopa to the provider? | No, shaking is normal and should not be reported. |
| What neurotransmitter does Levodopa convert into in the brain? | Dopamine |
| What does Carbidopa prevent in Levodopa therapy? | The breakdown of Levodopa. |
| What is the important exam term associated with the Levodopa/Carbidopa process? | Decarboxylase |
| Which neurotransmitter is decreased in Parkinson’s disease? | Dopamine |
| Which neurotransmitter is increased in Parkinson’s disease? | Acetylcholine |
| What type of gait is seen in Parkinson’s disease? | Shuffling gait. |
| Does Parkinson’s disease have a cure? | No, it is not curative. |
| What is the purpose of treating Parkinson’s disease? | To balance dopamine and acetylcholine and improve daily functioning and mobility. |
| What type of medication is Levodopa/Carbidopa? | A dopamine replacement medication. |
| What is the purpose of anticholinergic drugs in Parkinson’s disease? | They block acetylcholine receptors. |
| Why do Parkinson’s patients need dopamine replacement therapy? | Because dopamine levels are low. |
| What type of disorder is rheumatoid arthritis? | An autoimmune disorder. |
| What part of the body does rheumatoid arthritis attack? | The synovial fluid and joints. |
| What can rheumatoid arthritis eventually lead to in the joints? | Bone destruction |
| Which cytokines are involved in rheumatoid arthritis? | Interleukins and TNF. |
| Why are patients with rheumatoid arthritis at high risk for infection? | Due to autoimmune dysfunction. |
| What effect do DMARDs have on cytokine activity? | They decrease cytokine activity. |
| Why is it important not to stop checking liver function with DMARDs? | Because DMARDs can cause hepatotoxicity. |
| What must females taking DMARDs verify regarding pregnancy prevention? | Contraceptive use. |
| What is the purpose of methotrexate in rheumatoid arthritis? | It slows the progression of RA. |
| Should methotrexate be taken during pregnancy? | No, it must not be taken if pregnant. |
| What labs should be monitored on DMAR Methotrexate | Check bone marrow, liver, and kidney function. |
| who sould be contacted if a patient become pregnant while taking DMAR Methotrexate? | Consult their primary provider and rheumatologist. |
| Is DMAR methotrexate a “risk outweighs benefit” medication during pregnancy? | No, it should NOT be taken at all while pregnant. |
| What infection precaution should patients taking DMARDs follow? | Stay away from crowds. |
| Why must patients on methotrexate DMARDs follow immunocompromised-type teaching? | Because they are at increased infection risk. |
| What imbalance causes osteoporosis? | Osteoclast activity is greater than osteoblast activity. |
| What happens to bone in osteoporosis due to demineralization? | Fracture risk increases. |
| What hormone deficiency increases osteoporosis risk in females? | Low estrogen. |
| What long-term medication use can cause osteoporosis? | Long-term steroid use. |
| What is a major adverse effect of bisphosphonates? | Esophagitis |
| How much water must a patient take with a bisphosphonate? | A full glass of water (8 oz). |
| Why must patients sit upright after taking a bisphosphonate? | To prevent esophagitis. |
| What supplement is commonly given for osteoporosis? | Calcium |
| What electrolyte risk must be monitored when giving calcium supplements? | Hypercalcemia |
| What is the therapeutic effect of calcitonin? | It lowers calcium levels. |
| For which condition is calcitonin used? | Hypercalcemia |
| What do SERMs help preserve | Bone density in osteoporosis patients |
| What hormone effect do SERMs mimic? | Estrogen replacement effect |
| What does bone density measure | o Helps determine baseline bone density bc PT at risk for osteoporosis o Helps determine whether the medication is working o Helps see if the dose needs to be increased |
| What causes pain in gout? | Uric acid crystal buildup in joints. |
| What type of pain relief process does colchicine provide? | It lowers uric acid. |
| What gastrointestinal effect can colchicine cause? | Severe diarrhea. |
| What muscle-related adverse effect can occur with colchicine? | myopath and rhabdomyolysis |
| What life-threatening adverse effect is associated with gout medications? | Rhabdomyolysis |
| What symptom of rhabdomyolysis should be reported immediately? | New muscle tenderness or weakness. |
| What is the purpose of allopurinol? | To decrease uric acid production. |
| Is allopurinol used for acute gout flares? | No, it is for prevention. |
| What foods should gout patients avoid? | o Red meat o Organ meats (liver) o Shellfish o Alcohol/beer |
| What GI symptom should gout patients report immediately? | Severe gastrointestinal upset. |
| Why must gout patients maintain medication compliance? | To prevent flare-ups. |
| What adverse effect is caused by Hydantoin (Phenytoin) ? | Gingival hyperplasia. |
| What type of toothbrush should patients on Hydantoin (Phenytoin) use? | A soft-bristled toothbrush. |
| Should Hydantoin (Phenytoin) be stopped because of swollen gums? | No, gum swelling is expected. |
| What must patients do with AED medications? | Take them exactly as prescribed. |
| Can AEDs be stopped if the patient is seizure-free? | No, they must not stop them. |
| What identification should patients with seizures wear? | Medical alert ID. |
| What should patients avoid until seizure control is achieved? | Driving |
| Why must patients get plasma level checked while on AEDs? | : level helps adjust doses & detect nonadherence or toxicity. |
| Are AEDs used during active seizures? | No, they are maintenance medications. |
| Do AEDs have teratogenic effects? | Yes, they can harm the fetus. |
| Which AED is preferred during pregnancy? | Phenytoin (Dilantin). |
| What supplement must pregnant patients taking AEDs use? | Folic acid |
| How often should plasma levels be checked in pregnant patients taking AEDs? | Frequently |
| How long should a typical seizure last? | Less than 5 minutes. |
| What movement pattern is seen in tonic-clonic seizures? | Stiffening and jerking movements. |
| What is the normal patient condition in the post-ictal phase? | Sleepiness and fatigue. |
| What does the aura indicate before a seizure? | A sensory warning. |
| What skin reaction from carbamazepine indicates a medical emergency? | A rash indicating Stevens-Johnson syndrome. |
| What blood-related adverse effect can carbamazepine cause? | Bone marrow suppression. |
| What blood tests must be monitored with carbamazepine therapy? | Bome marrow- CBC (RBC/WBC/platelets) |
| What neurological condition, besides seizures, can carbamazepine treat? | Trigeminal neuralgia and bipolar. |
| A seizure lasting longer than 5 minutes is ? | status epilepticus |
| What airway intervention is required in status epilepticus? | Intubation |
| What medication is first-line for status epilepticus? | Benzodiazepines |
| What hospital unit should a patient with status epilepticus be transferred to? | The ICU. |
| Why is status epilepticus life-threatening? | There is no perfusion to the brain during prolonged seizure activity. |
| What PRN medication must patients with seizure history have on their chart? | A benzodiazepine PRN. |
| SERMs inhibit the activity of which bone cell? | Osteoclasts |
| What patient population is most likely to need SERM therapy? | Females with low estrogen. |
| What uric acid complication forms hard nodules under the skin? | Tophi |
| What should patients report when on colchicine for safety monitoring? | Severe diarrhea or nausea. |
| What is the major reason for increased seizures in AED patients? | Non-compliance. |
| Why are plasma drug levels drawn for AEDs? | To ensure the medication is in the therapeutic range. |
| Which ion channel do some AEDs block to prevent seizures? | Sodium channels. |
| Which inhibitory neurotransmitter is increased by some AEDs? | GABA |
| Is gingival hyperplasia caused by Hydantoin (Phenytoin) a reason to stop therapy? | No, it is expected. |
| What is something the nurse must ALWAYS check when a patient is having a seizure? | Their history of seizures. |
| Are regular AEDs used to stop an active seizure? | No, they are used only for maintenance. |
| In pregnant patients with seizure disorders, what is more dangerous to the fetus: uncontrolled seizures or AED medications? | Uncontrolled seizures. |
| Why is phenytoin (Dilantin) preferred over other AEDs during pregnancy? | It is easier to monitor with plasma levels and considered safer than some other AEDs. |
| What serious adverse effect is associated with valproic acid? | Hepatotoxicity |
| Which labs should be monitored in a patient taking valproic acid? | liver enzyme labs: AST ALT |
| What should the nurse do if a patient has a staring-type seizure | Still give benzodiazepine bc it's a type of seizure |
| Why must the nurse always know whether an AED is prescribed for seizures or bipolar disorder? | Because the indication changes what to monitor and how to teach the patient. |
| If the patient starts shaking on LEVODOPA/CARBIDOPA, are we worried? | NO — that goes with the disease process. |
| (DMARD (Methotrexate is absolutely contraindicated in what | pregnancy |
| LOW estrogen and LONG-TERM steroids cause | osteoporosis |
| Severe diarrhea on colchicine = | toxicity |
| All AEDs = | teratogenic |
| Do NOT stop checking liver function with which medication that she repeated in class | DMARD |
| MUST be on birth control so do not get pregnant due to the teratogenic affects of the fetus on which seizure med | DMARD |
| Imbalance between osteoblast (bone building) and osteoclast (bone resorption is | Osteoporosis |
| gastrointestinal upset( like diarrhea) myopathy, and rhabdomyolysis are side effects for which med | • Colchicine |
| Uric acid crystals accumulate in joints is | Gout |
| o Red meat o Organ meats (liver) o Shellfish o Alcohol/beer Avoid to prevent what | Gout flare up |
| Make sure to Check Bone marrow in | Carbamazepine DMARD wich is a med that helps w/ Rheumatoid Arthritis (RA) |
| Which AED(S) should be avoided in pregnancy | Valproic Acid, and DMARD |
| What reduce bone resorption by inhibiting osteoclast activity, helping preserve bone density. | SERMs |
| synovial fluid and joint that results in bone destruction is | Rheumatoid Arthritis |
Created by:
fsanoe