NRSG 2350 COMPREHENSIVE EXAM UPDATED
QUESTIONS AND SOLUTIONS GRADED A+
✔✔Levodopa/Carbidopa (Sinemet) - ✔✔Treats: Parkinson's
Crosses BBB, metabolized into dopamine with combo, LESS Levodopa is used & AE
are REDUCED
✔✔Carbidopa - ✔✔Prevents breakdown of levodopa in GI & periphery
Allows more Levodopa to get to the brain
✔✔Baclofen - ✔✔Relax spastic muscles in patients with MS
✔✔Benzodiazepines - ✔✔Dilantin, Valium, Atvivan
✔✔Dilantin (phenytoin) - ✔✔Generalized seizures
Stabilizes nerve membranes
Reduces conduction movement
less sedating than other anti-seizure meds
Suppress sodium influx into cell
PO, SLOW IV (10-20 mcg/mL)
AE: CNS depression, liver/renal toxicity, gingival hyperplasia, bone marrow
suppression, bradycardia, hypotension
Fetal Toxicity
✔✔Valium (diazepam) - ✔✔FIRST LINE drug choice for status epilepticus
Potentiates effects of GABA: decrease nerve excitability
PO, IM, IV, Rectal
Dizzy, lethargy, resp depression
✔✔Ativan (lorazepam) - ✔✔Anxiety, hyper-excitability
Potentiates effects of GABA (decrease nerve excitability)
PO, IM
AE: same as Diazepam
, ✔✔Carbamazepine (Tegretol) - ✔✔Anti-seizure, seizure disorder (partial with complex,
tonic-clonic)
Stabilizes nerve endings by altering Na/Ca channels (blocks Na)
Prevents the repeated firing of AP
Increases GABA activity
PO
AE: drowsiness, dizzy, ataxia, N/V, Stevens-Johnson syndrome
Consider: Bone marrow suppression can occur follow CBC
Interactions with oral contraceptives, antidepressants (may not work)
Warfarin (less anticoagulation effects)
✔✔Phenobarbital (Luminal) - ✔✔Generalized Tonic-Clonic Seizures (GTC)
Inhibits impulse conduction to the brain
Decreases CNS/Excitation motor response
Decrease conduction through nerve pathways that go to muscles
PO, IV, SQ, IM
AE: CNS Depression Addiction + Withdrawal
✔✔Anti-epileptics in general - ✔✔Interventions:
Stop drugs for toxic effects
Administer with food to reduce GI upset
Monitor Labs
Wean Off to prevent seizure events
Pregnancy counseling
Medic-Alert bracelet
Cautions:
Barbs:
CNS DEP, Addiction + withdrawal
Benzos:
Pardoxical effects, watch for CNS effects when taken with alcohol or other depressors
Carbamazepine:
QUESTIONS AND SOLUTIONS GRADED A+
✔✔Levodopa/Carbidopa (Sinemet) - ✔✔Treats: Parkinson's
Crosses BBB, metabolized into dopamine with combo, LESS Levodopa is used & AE
are REDUCED
✔✔Carbidopa - ✔✔Prevents breakdown of levodopa in GI & periphery
Allows more Levodopa to get to the brain
✔✔Baclofen - ✔✔Relax spastic muscles in patients with MS
✔✔Benzodiazepines - ✔✔Dilantin, Valium, Atvivan
✔✔Dilantin (phenytoin) - ✔✔Generalized seizures
Stabilizes nerve membranes
Reduces conduction movement
less sedating than other anti-seizure meds
Suppress sodium influx into cell
PO, SLOW IV (10-20 mcg/mL)
AE: CNS depression, liver/renal toxicity, gingival hyperplasia, bone marrow
suppression, bradycardia, hypotension
Fetal Toxicity
✔✔Valium (diazepam) - ✔✔FIRST LINE drug choice for status epilepticus
Potentiates effects of GABA: decrease nerve excitability
PO, IM, IV, Rectal
Dizzy, lethargy, resp depression
✔✔Ativan (lorazepam) - ✔✔Anxiety, hyper-excitability
Potentiates effects of GABA (decrease nerve excitability)
PO, IM
AE: same as Diazepam
, ✔✔Carbamazepine (Tegretol) - ✔✔Anti-seizure, seizure disorder (partial with complex,
tonic-clonic)
Stabilizes nerve endings by altering Na/Ca channels (blocks Na)
Prevents the repeated firing of AP
Increases GABA activity
PO
AE: drowsiness, dizzy, ataxia, N/V, Stevens-Johnson syndrome
Consider: Bone marrow suppression can occur follow CBC
Interactions with oral contraceptives, antidepressants (may not work)
Warfarin (less anticoagulation effects)
✔✔Phenobarbital (Luminal) - ✔✔Generalized Tonic-Clonic Seizures (GTC)
Inhibits impulse conduction to the brain
Decreases CNS/Excitation motor response
Decrease conduction through nerve pathways that go to muscles
PO, IV, SQ, IM
AE: CNS Depression Addiction + Withdrawal
✔✔Anti-epileptics in general - ✔✔Interventions:
Stop drugs for toxic effects
Administer with food to reduce GI upset
Monitor Labs
Wean Off to prevent seizure events
Pregnancy counseling
Medic-Alert bracelet
Cautions:
Barbs:
CNS DEP, Addiction + withdrawal
Benzos:
Pardoxical effects, watch for CNS effects when taken with alcohol or other depressors
Carbamazepine:
