N115 - Quiz 2 with Correct Answers

N115 - Quiz 2 with Correct Answers Levodopa - Ans:-dopamine replacement; increase dopamine in brain; used for Parkinson's; AE: N/V, loss of effect, psychosis, postural HTN; -identify high-risk pt -eval therapeutic effects -manage acute loss of effect -minimize adverse effects -minimize adverse interactions Carbidopa - Ans:-dopamine replacement; inhibits peripheral decarboxylase (prevents breakdown of Levodopa); used for Parkinson's; AE: N/V, loss of effect, psychosis, postural HTN; -identify high-risk pt -eval therapeutic effects ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/17 -manage acute loss of effect -minimize adverse effects -minimize adverse interactions Donepezil (Aricept) - Ans:-acetylcholinesterase inhibitor; increase cholinergic transmission by reducing ACh metabolism; used for Alzheimer's; AE: N/V, diarrhea, bradycardia, lightheadedness, insomnia, vivid dreams; -monitor b/p, HR, HTN -assess mental status -assess GI and GU status: urinary frequency incontinence Memantine (Namenda) - Ans:-NMDA inhibitor; blocks N-methyl-D-aspartate receptor in ion channels; used for Alzheimer's; AE: lightheadedness, confusion, headache; -advise to report SE: restlessness, psychosis, visual hallucinations, stupor -advise pt to avoid alc, nic ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/17 -teach pt to avoid OTC Phenytoin (Dilantin) - Ans:-traditional anti-epileptic; suppresses action potential through inactivation of sodium channels; used as seizure med; -cerebellar-vestibular symptoms: nystagmus, ataxia, diplopia, vertigo -not usually sedating -cardiac toxicity: Arrhythmias, Hypotension, Gingival hyperplasia, Hirsutism -Black box warning: SJS (may test for HLA-B* 1502 if asian descent) -Many drug interactions: Induces hepatic microsomal enzymes → can reduce oral contraceptives, warfarin, glucocorticoids; Phenytoin may be decreased by diazepam, alcohol, valproic acid, (CYP inhib.; poss breakthrough seizures) -small increase in dose may cause a large change in blood levels (due to saturation of metabolism and zero order kinetics): At low blood levels 5-7 days to ready steady state after dosage change; At high blood levels may take 4-6 weeks before blood levels are stable ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/17 - assess dosage level - promoting adherence - evaluating therapeutic effects - minimizing danger from uncontrolled seizures - minimizing adverse effects - CNS effects - gingival hyperplasia - dermatological interaction - withdrawal seizures - usage in pregnancy - suicidal thought and behavior ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/17 - minimizing adverse interactions - CNS depressants such as alcohol and other drugs with CNS-depressant properties - warfarin and oral contraceptives: phenytoin can decrease the effects of these agents by inducing hepatic drug-metabolizing agents Carbamazepine (Tegretol) - Ans:-traditional anti-epileptic; inactivates sodium channels; used as seizure med; -Not sedative in usual dosage range -Vertigo, ataxia, diplopia, and blurred vision (cerebellar-ve