Synch Session #3
1. The nurse prepares to administer a new prescription for bethanechol. Which diagnosis in
the pts hx would prompt the nurse to consult with the prescriber before giving the drug?
Asthma Bethanechol = muscarinic agonist. Parasympathomimetic. Decreases HR, N/V,
increase salivation, opposite effects of fight or flight. Induces bronchospasm. Used for
urinary retention.
2. The nurse is preparing to administer sumatriptan (Imitrex) to a pt suffering from a
migraine. This medication works to relieve migraine symptoms by affecting which
substance in the brain? Calcitonin gene related peptide = potent neuropeptide
neurotransmitter, released from peripheral and central nerve endings during a migraine.
Causes pain and vasodilation. Sumatriptan blocks the pain transmission, vasoconstriction
occurs. Avoid prescribing this to patients with HTN.
3. Which medication would the nurse anticipate being prescribed for a pt with a new
diagnosis of cluster headaches? Verapamil (calan) =CCB. Lithium is 2nd line for tx of
cluster headaches.
4. Which of the following measurements would prompt the nurse to hold the sumatriptan
dose and contact the hcp? BP of 190/100. Causes vasoconstriction, avoid giving to
patients with HTN. Can cause hypertensive crisis.
Toradol
5. Pt with a hx of moderate to severe h/a pain associated with n/v is diagnosed with
migraines. Which medication would the nurse anticipate the pt will be prescribed
initially? Sumatriptan (Imitrex)- 1st choice for mod to severe migraines. Migraine
referactory= difficult to treat and failed to fix with other methods- you can use
stadol/meperidine/demoral
6. The nurse is assessing a pt taking ergotamine. Which assessment result requires
immediate action? Pale extremities= sign of serious toxicity-ergotism. N/V, overdose,
can cause ischemia secondary to constriction of peripheral arteries. Good for acute
headaches, not for long term use. Ergotamine is a naturally occurring vasoconstrictor,
decreases blood blow in cerebral arteries; binds selectively to serotonin 5H21D receptors;
Ergotism- ischemia of large vessels.
7. A pt has been admitted with a h/a of unknown origin. Which med will the nurse
administer first while assessing for cause? Acetaminophen
, 8. When reviewing the pts current medication lsit, which drug does the nurse recognize as a
first line drug for migraine? Propranolol= used for migraine prevention HA; 1st line for
prevention of h/a; Topiramate= 2nd line choice; Metoclopramide (Reglan) for n/v
associated with migraines.
9. The nurse is reviewing the meds order for a pt on sumatriptan and sertraline (Zoloft) –
which possible interaction? The combined medications can cause serotonin
syndrome.= sumatriptan increases BP, sertraline-SSRI- should not be combined with
triptans. s/s- AMS, agitation, anxious, poor concentration, fever, tremors, profuse
sweating, hallucinations, hyperreflexia, death can occur.
10. Pt is taking sumatriptan for migraines tells nurse she and her husband are attempting to
conceive, what is best response? Please talk with your provider about changing your
migraine medication. – sumatriptan is classified as category C. not recommended for
use during pregnancy. Subq lidocaine is 2nd choice for cluster HA. No NSAIDs in 1st
trimester.
11. Pt who takes ergotamine for migraines calls the clinic to report numbness in the feet,
which are also cold and pale- which response? You should get to the hospital as soon as
possible for treatment!- possible ergotism.
12. Pt is being treated for persistent migraines. Pt wil be treated with which adrenergic
blocking dug? Propranolol- used for migraine HA. The other choices are not used for
migraines.
13. Pt is be d/c home with a new script for prazosin (minipress) (HTN) which is most
important to teach? You should move slowly from a sitting to a standing position.- can
cause orthostatic hypotension. Move slowly to prevent falls. Even on first dose. Pts on
tamsulosin will have floppy eyes during cataracts surgery and makes it difficult to
perform surgery.
14. Which drug is used as an adjunct therapy with levodopa/carbidopa to treat parkinsons
disease? Selegiline- MAOI-B, to decrease fluctuating symptoms. Used to increase
efficacy of carbidopa levodopa.
Amantadine- musce tremors and rigidity
Benztropine- tremors and rigidity
Entacapone is 3rd drug combo with cabi/levo (Stalvo) decreases breakdown of dopamine;
manages on/off phenomenon.
1. The nurse prepares to administer a new prescription for bethanechol. Which diagnosis in
the pts hx would prompt the nurse to consult with the prescriber before giving the drug?
Asthma Bethanechol = muscarinic agonist. Parasympathomimetic. Decreases HR, N/V,
increase salivation, opposite effects of fight or flight. Induces bronchospasm. Used for
urinary retention.
2. The nurse is preparing to administer sumatriptan (Imitrex) to a pt suffering from a
migraine. This medication works to relieve migraine symptoms by affecting which
substance in the brain? Calcitonin gene related peptide = potent neuropeptide
neurotransmitter, released from peripheral and central nerve endings during a migraine.
Causes pain and vasodilation. Sumatriptan blocks the pain transmission, vasoconstriction
occurs. Avoid prescribing this to patients with HTN.
3. Which medication would the nurse anticipate being prescribed for a pt with a new
diagnosis of cluster headaches? Verapamil (calan) =CCB. Lithium is 2nd line for tx of
cluster headaches.
4. Which of the following measurements would prompt the nurse to hold the sumatriptan
dose and contact the hcp? BP of 190/100. Causes vasoconstriction, avoid giving to
patients with HTN. Can cause hypertensive crisis.
Toradol
5. Pt with a hx of moderate to severe h/a pain associated with n/v is diagnosed with
migraines. Which medication would the nurse anticipate the pt will be prescribed
initially? Sumatriptan (Imitrex)- 1st choice for mod to severe migraines. Migraine
referactory= difficult to treat and failed to fix with other methods- you can use
stadol/meperidine/demoral
6. The nurse is assessing a pt taking ergotamine. Which assessment result requires
immediate action? Pale extremities= sign of serious toxicity-ergotism. N/V, overdose,
can cause ischemia secondary to constriction of peripheral arteries. Good for acute
headaches, not for long term use. Ergotamine is a naturally occurring vasoconstrictor,
decreases blood blow in cerebral arteries; binds selectively to serotonin 5H21D receptors;
Ergotism- ischemia of large vessels.
7. A pt has been admitted with a h/a of unknown origin. Which med will the nurse
administer first while assessing for cause? Acetaminophen
, 8. When reviewing the pts current medication lsit, which drug does the nurse recognize as a
first line drug for migraine? Propranolol= used for migraine prevention HA; 1st line for
prevention of h/a; Topiramate= 2nd line choice; Metoclopramide (Reglan) for n/v
associated with migraines.
9. The nurse is reviewing the meds order for a pt on sumatriptan and sertraline (Zoloft) –
which possible interaction? The combined medications can cause serotonin
syndrome.= sumatriptan increases BP, sertraline-SSRI- should not be combined with
triptans. s/s- AMS, agitation, anxious, poor concentration, fever, tremors, profuse
sweating, hallucinations, hyperreflexia, death can occur.
10. Pt is taking sumatriptan for migraines tells nurse she and her husband are attempting to
conceive, what is best response? Please talk with your provider about changing your
migraine medication. – sumatriptan is classified as category C. not recommended for
use during pregnancy. Subq lidocaine is 2nd choice for cluster HA. No NSAIDs in 1st
trimester.
11. Pt who takes ergotamine for migraines calls the clinic to report numbness in the feet,
which are also cold and pale- which response? You should get to the hospital as soon as
possible for treatment!- possible ergotism.
12. Pt is being treated for persistent migraines. Pt wil be treated with which adrenergic
blocking dug? Propranolol- used for migraine HA. The other choices are not used for
migraines.
13. Pt is be d/c home with a new script for prazosin (minipress) (HTN) which is most
important to teach? You should move slowly from a sitting to a standing position.- can
cause orthostatic hypotension. Move slowly to prevent falls. Even on first dose. Pts on
tamsulosin will have floppy eyes during cataracts surgery and makes it difficult to
perform surgery.
14. Which drug is used as an adjunct therapy with levodopa/carbidopa to treat parkinsons
disease? Selegiline- MAOI-B, to decrease fluctuating symptoms. Used to increase
efficacy of carbidopa levodopa.
Amantadine- musce tremors and rigidity
Benztropine- tremors and rigidity
Entacapone is 3rd drug combo with cabi/levo (Stalvo) decreases breakdown of dopamine;
manages on/off phenomenon.
