NU641 final Exam with verified detailed solutions ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Carbamazepine (Tegretol) - correct answer✔✔-also used for mood stabilizer ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Uses: Epilepsy-partial complex seizures and generalized, Bipolar disorders, Trigeminal and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
glossopharyngeal neuralgias ||//\\||
-CBC before & periodically during
||//\\|| ||//\\|| ||//\\|| ||//\\||
-Adverse effects: ||//\\||
-CNS symptoms—nystagmus, ataxia
||//\\|| ||//\\||
-Anemia, leukopenia, thrombocytopenia (Black box warning)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Birth defects ||//\\||
-Autoinduction (induces its own metabolism) as well as others ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Has anticholinergic effects
||//\\|| ||//\\||
insomnia - correct answer✔✔-inability to sleep for 3 successive night for 4 weeks
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Problems can be initiating or maintaining sleep ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Prevalence increases with age ||//\\|| ||//\\|| ||//\\||
-Women have insomnia after childbirth||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased metabolic rate and higher cortisol levels, ruminate, worry, intrusive thoughts
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Circadian factors influence sleep ||//\\|| ||//\\|| ||//\\||
insomnia treatment - correct answer✔✔-Ramelteon- does not increase risk for patients
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
engaging in activities while somnolent ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Non-drug therapy-sleep hygiene ||//\\|| ||//\\||
-Sleep diary ||//\\||
-Rule out psychophysiologic causes such as depression, anxiety, mood disorders, PTS,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
obstructive sleep apnea, medication side effects ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,insomnia treatment pharmacologic - correct answer✔✔-Not recommended for elderly
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Benzodiazepines
-Benzodiazepine-like drugs ||//\\||
-Antidepressants SSRI (paxil, trazadone, remeron and the atypical can be a little sedating) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Antihistamines (diphenhydramine) tylenol/advil pm ||//\\|| ||//\\|| ||//\\||
-Valerian root ||//\\||
rules for sleep fitness - correct answer✔✔-Regular times
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Don't over do it ||//\\|| ||//\\|| ||//\\||
-Sound proof the room ||//\\|| ||//\\|| ||//\\||
-Cool temperature ||//\\||
-Exercise early in the day ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-No naps
||//\\||
-Decrease fluids at night ||//\\|| ||//\\|| ||//\\||
-Hide the clock ||//\\|| ||//\\||
epilepsy - correct answer✔✔Group of disorders characterized by excessive neuron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stimulation within the central nervous system ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anticonvulsants - correct answer✔✔-know pts medication regimen; many drug-drug ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
interactions with anticonvulsants ||//\\|| ||//\\||
-anticonvulsants commonly carry narrow therapeutic indexes, i.e. their doses and blood ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
levels work in a narrow range balancing between being ineffective and toxic.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-NPs do not prescribe them
||//\\|| ||//\\|| ||//\\|| ||//\\||
types of seizures - correct answer✔✔-Partial (focal) seizures
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, -Simple partial ||//\\||
-Complex partial ||//\\||
-Secondarily generalized ||//\\||
-Generalized seizures ||//\\||
-Tonic-clonic (grand mal) ||//\\|| ||//\\||
-Absence (loss of consciousness) ||//\\|| ||//\\|| ||//\\||
-Atonic (loss of muscle tone-drop attack)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Myoclonic (sudden muscle contraction) ||//\\|| ||//\\|| ||//\\||
-Status epilepticus-seizure lasting > 30 minutes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Febrile seizures ||//\\||
Antiepileptic Drugs - correct answer✔✔-Suppress neuronal discharge at the seizure's focus
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and suppress propagation of seizure activity from the focus to other areas of the brain
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Mechanism of action: Suppression of sodium & calcium influx ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Antagonism of glutamate ||//\\|| ||//\\||
-Potentiation of GABA ||//\\|| ||//\\||
Epilepsy—Therapeutic Considerations - correct answer✔✔-Treatment goal ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Diagnosis
-Drug selection
||//\\||
-Surgery
-Vagus nerve stimulation ||//\\|| ||//\\||
-Ketogenic diet ||//\\||
-Plasma drug levels ||//\\|| ||//\\||
-Compliance
-Withdrawing antiepileptic drugs-slowly over a period of 6 weeks to several months ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Carbamazepine (Tegretol) - correct answer✔✔-also used for mood stabilizer ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Uses: Epilepsy-partial complex seizures and generalized, Bipolar disorders, Trigeminal and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
glossopharyngeal neuralgias ||//\\||
-CBC before & periodically during
||//\\|| ||//\\|| ||//\\|| ||//\\||
-Adverse effects: ||//\\||
-CNS symptoms—nystagmus, ataxia
||//\\|| ||//\\||
-Anemia, leukopenia, thrombocytopenia (Black box warning)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Birth defects ||//\\||
-Autoinduction (induces its own metabolism) as well as others ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Has anticholinergic effects
||//\\|| ||//\\||
insomnia - correct answer✔✔-inability to sleep for 3 successive night for 4 weeks
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Problems can be initiating or maintaining sleep ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Prevalence increases with age ||//\\|| ||//\\|| ||//\\||
-Women have insomnia after childbirth||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased metabolic rate and higher cortisol levels, ruminate, worry, intrusive thoughts
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Circadian factors influence sleep ||//\\|| ||//\\|| ||//\\||
insomnia treatment - correct answer✔✔-Ramelteon- does not increase risk for patients
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
engaging in activities while somnolent ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Non-drug therapy-sleep hygiene ||//\\|| ||//\\||
-Sleep diary ||//\\||
-Rule out psychophysiologic causes such as depression, anxiety, mood disorders, PTS,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
obstructive sleep apnea, medication side effects ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,insomnia treatment pharmacologic - correct answer✔✔-Not recommended for elderly
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Benzodiazepines
-Benzodiazepine-like drugs ||//\\||
-Antidepressants SSRI (paxil, trazadone, remeron and the atypical can be a little sedating) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Antihistamines (diphenhydramine) tylenol/advil pm ||//\\|| ||//\\|| ||//\\||
-Valerian root ||//\\||
rules for sleep fitness - correct answer✔✔-Regular times
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Don't over do it ||//\\|| ||//\\|| ||//\\||
-Sound proof the room ||//\\|| ||//\\|| ||//\\||
-Cool temperature ||//\\||
-Exercise early in the day ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-No naps
||//\\||
-Decrease fluids at night ||//\\|| ||//\\|| ||//\\||
-Hide the clock ||//\\|| ||//\\||
epilepsy - correct answer✔✔Group of disorders characterized by excessive neuron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stimulation within the central nervous system ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anticonvulsants - correct answer✔✔-know pts medication regimen; many drug-drug ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
interactions with anticonvulsants ||//\\|| ||//\\||
-anticonvulsants commonly carry narrow therapeutic indexes, i.e. their doses and blood ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
levels work in a narrow range balancing between being ineffective and toxic.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-NPs do not prescribe them
||//\\|| ||//\\|| ||//\\|| ||//\\||
types of seizures - correct answer✔✔-Partial (focal) seizures
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, -Simple partial ||//\\||
-Complex partial ||//\\||
-Secondarily generalized ||//\\||
-Generalized seizures ||//\\||
-Tonic-clonic (grand mal) ||//\\|| ||//\\||
-Absence (loss of consciousness) ||//\\|| ||//\\|| ||//\\||
-Atonic (loss of muscle tone-drop attack)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Myoclonic (sudden muscle contraction) ||//\\|| ||//\\|| ||//\\||
-Status epilepticus-seizure lasting > 30 minutes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Febrile seizures ||//\\||
Antiepileptic Drugs - correct answer✔✔-Suppress neuronal discharge at the seizure's focus
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and suppress propagation of seizure activity from the focus to other areas of the brain
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Mechanism of action: Suppression of sodium & calcium influx ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Antagonism of glutamate ||//\\|| ||//\\||
-Potentiation of GABA ||//\\|| ||//\\||
Epilepsy—Therapeutic Considerations - correct answer✔✔-Treatment goal ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Diagnosis
-Drug selection
||//\\||
-Surgery
-Vagus nerve stimulation ||//\\|| ||//\\||
-Ketogenic diet ||//\\||
-Plasma drug levels ||//\\|| ||//\\||
-Compliance
-Withdrawing antiepileptic drugs-slowly over a period of 6 weeks to several months ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
