NUR 2474 Exam 1 Study Guide
Benzodiazepine’s-
Examples: Lorazepam, Diazepam, Alprazolam
How do they work? Sustain GABA in the body (suppress the CNS)
GABA- a chemical that we produce internally that calms out neurons
Treats: Insomnia, Anxiety/Panic, seizure/muscle spasms, Alcohol
withdrawal
IV best for emergency anxiety/panic attack
Patient Education: Withdrawal slowly
Overdose: What is the Antidote for Benzodiazepines? Flumazenil
Barbiturates:
Examples: thiopental (Ultrashort-acting) secobarbital (Short to intermediate-acting)
phenobarbital (Long-acting)
• Treats: Seizure disorders, Induction of anesthesia, Insomnia
Overdose: Activated Charcoal (absorber)- helps to absorb medication in the gut,
prevent from being absorbed
ANTI-EPILEPTIC (treats Seizure)
Examples: Phenytoin, Oxcarbazepine, carbamazepine, Lamotrigine
• Goal of seizure treatment minimize side effects and allow patient to lead as normal
a life as possible
• Interferes with birth control, can cause birth defects should NOT take while
pregnant
• Should keep seizure chart (frequency, duration, etc.)
• Compliance very important! Should not self-prescribe, adjust does, or EVER
stop taking medication.
o Only Physician can change regimen
• Can cause severe skin reactions STEVENS-JOHNSONS SYNDROME
(SJS) & TOXIC EPIDERMAL NECROLYSIS (TEN)
Status Epilepticus: Continuous series of tonic-clonic seizures that lasts
20 to 30 minutes
• Treatment: Maintain ventilation, Correct hypoglycemia, terminate
seizures, Benzodiazepine lorazepam is recommended for first-line
management,
o Diazepam is used because it is a muscle relaxant, works
immediately-stops the seizures immediately, does NOT require a
loading dose to stop the seizure
, PHENYTOIN (anti-epileptic)
Major side effects: Gingival Hyperplasia (swelling, tenderness, bleeding
of gums), Nystagmus, Sedation, Ataxia, Diplopia, Cognitive impairment,
Skin rash
Therapeutic levels 10-20 mcg
Use in Pregnancy: ONLY if benefits outweigh risk. Use during
pregnancy can cause cleft palate, heart malformations, and fetal
hydantoin syndrome (characterized by growth deficiency, motor or
mental deficiency, microcephaly, craniofacial distortion, positional
deformities of limbs, hypoplasia of the nails and fingers, and impaired
neurodevelopment).
VALPROIC ACID - drug for Bi-Polar Disorder
Therapeutic level 50-100 mg
Hepatic toxic
• Valproic acid level is abnormal then the doctor needs to be notified
• If liver enzymes are elevated, it should be questioned to give patient Valproic
Acid – (Decrease dose if enzymes elevated)
o If you have a patient that you are giving Valproic Acid to and you notice the
levels is 180. You assess the patient—set of vitals and a neurological
assessment. Then notify DR.
Donepezil (Cholinesterase Inhibitor)
Treats Alzheimer’s
MOA- Prevents breakdown of acetylcholine more acetylcholine in the brain
Side effects: nausea, vomiting, diarrhea, loss of appetite, weight loss,
frequent urination, difficulty controlling urination, muscle cramps.
Adverse effects: brady cardia, lightheadedness, stomach pain, sob, bloody
stools, coughing up blood, convulsions, painful urination.
o With Alzheimer’s we can slow cognitive decline but there is no
cure
LEVODOPA -CARBIDOPA (use in Parkinson’s)
Benzodiazepine’s-
Examples: Lorazepam, Diazepam, Alprazolam
How do they work? Sustain GABA in the body (suppress the CNS)
GABA- a chemical that we produce internally that calms out neurons
Treats: Insomnia, Anxiety/Panic, seizure/muscle spasms, Alcohol
withdrawal
IV best for emergency anxiety/panic attack
Patient Education: Withdrawal slowly
Overdose: What is the Antidote for Benzodiazepines? Flumazenil
Barbiturates:
Examples: thiopental (Ultrashort-acting) secobarbital (Short to intermediate-acting)
phenobarbital (Long-acting)
• Treats: Seizure disorders, Induction of anesthesia, Insomnia
Overdose: Activated Charcoal (absorber)- helps to absorb medication in the gut,
prevent from being absorbed
ANTI-EPILEPTIC (treats Seizure)
Examples: Phenytoin, Oxcarbazepine, carbamazepine, Lamotrigine
• Goal of seizure treatment minimize side effects and allow patient to lead as normal
a life as possible
• Interferes with birth control, can cause birth defects should NOT take while
pregnant
• Should keep seizure chart (frequency, duration, etc.)
• Compliance very important! Should not self-prescribe, adjust does, or EVER
stop taking medication.
o Only Physician can change regimen
• Can cause severe skin reactions STEVENS-JOHNSONS SYNDROME
(SJS) & TOXIC EPIDERMAL NECROLYSIS (TEN)
Status Epilepticus: Continuous series of tonic-clonic seizures that lasts
20 to 30 minutes
• Treatment: Maintain ventilation, Correct hypoglycemia, terminate
seizures, Benzodiazepine lorazepam is recommended for first-line
management,
o Diazepam is used because it is a muscle relaxant, works
immediately-stops the seizures immediately, does NOT require a
loading dose to stop the seizure
, PHENYTOIN (anti-epileptic)
Major side effects: Gingival Hyperplasia (swelling, tenderness, bleeding
of gums), Nystagmus, Sedation, Ataxia, Diplopia, Cognitive impairment,
Skin rash
Therapeutic levels 10-20 mcg
Use in Pregnancy: ONLY if benefits outweigh risk. Use during
pregnancy can cause cleft palate, heart malformations, and fetal
hydantoin syndrome (characterized by growth deficiency, motor or
mental deficiency, microcephaly, craniofacial distortion, positional
deformities of limbs, hypoplasia of the nails and fingers, and impaired
neurodevelopment).
VALPROIC ACID - drug for Bi-Polar Disorder
Therapeutic level 50-100 mg
Hepatic toxic
• Valproic acid level is abnormal then the doctor needs to be notified
• If liver enzymes are elevated, it should be questioned to give patient Valproic
Acid – (Decrease dose if enzymes elevated)
o If you have a patient that you are giving Valproic Acid to and you notice the
levels is 180. You assess the patient—set of vitals and a neurological
assessment. Then notify DR.
Donepezil (Cholinesterase Inhibitor)
Treats Alzheimer’s
MOA- Prevents breakdown of acetylcholine more acetylcholine in the brain
Side effects: nausea, vomiting, diarrhea, loss of appetite, weight loss,
frequent urination, difficulty controlling urination, muscle cramps.
Adverse effects: brady cardia, lightheadedness, stomach pain, sob, bloody
stools, coughing up blood, convulsions, painful urination.
o With Alzheimer’s we can slow cognitive decline but there is no
cure
LEVODOPA -CARBIDOPA (use in Parkinson’s)
