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NUR315 TEST 2 (NEURO + RESP. DRUGS) – Q’s And A’s
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NUR315 TEST 2 (NEURO + RESP. DRUGS) – Q’s And A’s
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NUR315 TEST 2 (NEURO + RESP. DRUGS) – Q’s And A’sWhich drug is used as a first-line defense for depression due to it's safety
profiling? Right Ans - Fluoxetine(prozac) --SSRI - ANTIDEPRESSENTS
Adverse rxn: decreased libido.
What are the four rules of anti-depressants Right Ans - 1. increase the risk
of suicide (energy to perform the act)--- increase thoughts and wants for the
first few weeks of treatment. (new thoughts of suicide, sudden changes, and
abnormal)
2.slow onset and slow taper off
3. never mix SSRI +ST. JOHNS WORT
SNRI, TCA SSRI + MAOIs--- 2 WEEK WASHUP
4. all pycsh drug decrease bp and weight gain
What is the indication for SSRI (FLUOXETINE - PROZAC) and actions? Right
Ans - selectively inhibits the uptake of serotonin
Indications: PTSD, depression, panic disorder, chronic pain
What are the common side effects of fluoxetine(prozac)? Right Ans -
DECREASED LIBIDO / IMPOTENCE, INSOMNIA, nervousness, headaches,
diarrhea,
Be careful of serotonin syndrome + withdrawal syndrome
What is bupropion(Wellbutrin)? Right Ans - antidepressants prototype.
brand name: Wellbutrin
What are the indications for bupropion (Wellbutrin)? Right Ans -
depression, ptsd, anxiety, its also an aid for stopping smoking DOES NOT
TREAT BIPOLAR DISORDER.
ACTIONS: Bupropion (Wellbutrin) Right Ans - action: inhibition of
dopamine reuptake; diminishes the uptake of serotonin and norepinephrine
Side effects of bupropion(Wellbutrin) Right Ans - dysrhythmias, dry
mouth, insomnia, nausea, vomiting,
,Education: due to dysrhythmias you have to auscultate the lungs, rate
/rhythm of respiration, heart sounds.
NO ALCOHOL OR SEIZURES
NEVER CRUSH ENTCENTRIC COATED PILLS
A patient take antipsychotic drug clozapine(clozapril) states " im not hearing
any voices anymore". what does that mean? Right Ans - the drug
clozapine(Clozaril) is effectively working. it is therapeutic. EFFECTIVE
TREATMENT--
They may have a relapse if they aren't taking it right.
cloZapine -- schiZophrenia
What are the side effects of clozapine(clozapril)? Right Ans -
TACHYCARDIA, dry mouth, seizures (the action of the drug decreases the
threshold making it easier to have seizures).
For dry mouth encourage the patient to drink a lot of water to help dry mouth
Drug: Clozapine action and indications?
——atypical 2nd generation anti-psychotic Right Ans - indications:
schizophrenia
actions: blocks dopamine and serotonin receptors
What are the labs for mood stabilizer/ anti-psychotic drug: lithium carbonate
(lithobid) Right Ans - we want serum lithium levels to therapeutic: 0.4-1.4
mEg/ml if it goes outside we can have adverse reactions.
TOXIC= GREATER THAN 2mEQ
Normal Sodium: 135-145 mEq
Do not make any sudden changes to their diet of sodium. increase/decrease in
levels of salt it will make the drug go up/down
Drug serum is drawn 2-3 initially.... then 3-6months for maintenance
, Patient Education for Lithium Carbonate (lithobid)? Right Ans - drugs takes
7-21days before improved moods (long time to work sooo long Time to get
out)
-PATIENT DRUG COMPLACENCY
-monitoring drug levels & sodium levels
-teach symptoms of drug toxicity- decrease renal function or 30ml less urine
-Teach the client about the expected time frame of drug working.
-monitor and adequate sodium intake in the diet. no sudden changes in
sodium diet-food
Lithium Carbonate drug actions: Right Ans - alters sodium transport in
nerve and muscle cells; decreases symptom of mania; alters cation reuptake of
neurotransmitters. -- prevent the return of mania control and mania
depression.
Indications: bipolar disorder (schizoaffective disorder)
Lithium Carbonate side effects: Right Ans - GI distress, impaired memory,
fine hand tumors, muscle weakness, polyuria, weight gain, renal toxicity,
goiter, hypothyroidism, electrolyte imbalance, HEART BLOCK
(ARRTHYMIAS)--- heart issues so the nurse must access rate and rhythm
DRUG TOXICITY--- anything above 2 mEq
What are Phenytoin(Dilantin) Adverse Effects Right Ans - Drug to Drug:
causes an increases excretion of warfarin, birth control oral, digoxin
Side Effects: gingival hypertrophy, dizziness, Steven-johnson syndrome (early
indication are fever, rash, and blister) petechiae, epistaxis, hematuria
NURSE IMPLICATION: DM 2 patients will prob need to increase insulin cus it
causes high serum glucose.
EDU.- teach patients no mental alertness activities AND NEVER STOP ARUBTL,
LAND IT SLOW.
DRUG TOXICITY- ANYTHING ABOVE 20 (ATAXIA & CONFUSION)
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