NUR 2474 PHARM EVALUATION SET QUESTIONS
AND ANSWERS SET A+
✔✔what should we teach pregnant moms to do when taking phenytoin? - ✔✔Will need
to teach the patient importance of taking folic acid while use of the drug and importance
of taking the vitamin K shot before delivery of the baby, potential to switch oral
contraceptive use to another way to increase effect of the anti-epileptic
✔✔what is there therapeutic level of phenytoin? - ✔✔10-20
✔✔what is the therapeutic level of carbamazepine? - ✔✔5-12
✔✔what can we use carbamazepine to treat? - ✔✔epilepsy, bipolar, and trigeminal
neuralgias
✔✔why is a therapeutic level important with some medications? - ✔✔if the drug is not in
a certain range, it can be toxic. broad therapeutic range= good drug to use, narrow
range= not so good. must draw blood levels if in a narrow therapeutic range medication.
✔✔what medications cause EPS? - ✔✔antipsychotic drugs- 1st generation
✔✔what are the early EPS? - ✔✔acute dystonia, oculogyric crisis, opisthotonus, joints
dislocation, impaired breathing, akathisia, parkinsonism
✔✔what are the late EPS? - ✔✔tardive dyskinesia
✔✔explain acute dystonia - ✔✔slow muscle movement and spasticity
✔✔explain oculogyric crisis - ✔✔upward deviation of the eyes
✔✔explain opisthotonus - ✔✔back spasticity
, ✔✔explain joint dislocation - ✔✔from the muscle spasms, can be painful
✔✔explain impaired breathing - ✔✔the diaphragm cannot work correctly due to slowing
of movement
✔✔explain akathisia - ✔✔compulsive, restless movement, need to be in motion with
anxiety.
✔✔explain Parkinsonism - ✔✔drug induced Parkinson's: bradykinesia, mask like face,
tremor, rigidity, shuffling gait, drooling, cog wheeling, stooped posture
✔✔how do we treat early EPS? - ✔✔anticholinergics, bentos, beta blocker
✔✔explain tardive dyskinesia - ✔✔choreoathetoid movements of the tongue and face,
lip smacking movement, fly catching tongue, slow worm like tongue movement,
involuntary movements of limbs, tones, hips and fingers.
✔✔how do you treat late EPS? - ✔✔no treatment, but you can prevent it. D/C all
medications and switch to 2nd generation antipsychotic
✔✔what do TCAs treat? - ✔✔major depression
✔✔how do TCAs work - ✔✔blocks serotonin and NE reuptake
✔✔what are the side effects of TCAs - ✔✔sedation, orthostatic hypotension,
anticholinergic
✔✔what is the most dangerous effect of TCAs - ✔✔cardiac toxicity
✔✔S/S of cardiac toxicity in TCAs - ✔✔dysrhythmias, tachycardia, heart blocks, v tach,
v fib
✔✔how do we treat cardiac toxicity in TCAs? - ✔✔no antidote, treat with gastric lavage,
activated charcoal, IV HCO3
✔✔What do neuroleptics do? - ✔✔it blocks dopamine. only increase the effects of
Parkinson's disease, as they will induce Parkinson's symptoms with EPS, it is an
additive relationship.
✔✔what is the issue with using a neuroleptic with a patient with Parkinson's disease? -
✔✔will worsen the Parkinson's disease symptoms. would be appropriate to use a 2nd
generation antipsychotic
✔✔a neuroleptic is the same as an__________ - ✔✔antipsychotic
AND ANSWERS SET A+
✔✔what should we teach pregnant moms to do when taking phenytoin? - ✔✔Will need
to teach the patient importance of taking folic acid while use of the drug and importance
of taking the vitamin K shot before delivery of the baby, potential to switch oral
contraceptive use to another way to increase effect of the anti-epileptic
✔✔what is there therapeutic level of phenytoin? - ✔✔10-20
✔✔what is the therapeutic level of carbamazepine? - ✔✔5-12
✔✔what can we use carbamazepine to treat? - ✔✔epilepsy, bipolar, and trigeminal
neuralgias
✔✔why is a therapeutic level important with some medications? - ✔✔if the drug is not in
a certain range, it can be toxic. broad therapeutic range= good drug to use, narrow
range= not so good. must draw blood levels if in a narrow therapeutic range medication.
✔✔what medications cause EPS? - ✔✔antipsychotic drugs- 1st generation
✔✔what are the early EPS? - ✔✔acute dystonia, oculogyric crisis, opisthotonus, joints
dislocation, impaired breathing, akathisia, parkinsonism
✔✔what are the late EPS? - ✔✔tardive dyskinesia
✔✔explain acute dystonia - ✔✔slow muscle movement and spasticity
✔✔explain oculogyric crisis - ✔✔upward deviation of the eyes
✔✔explain opisthotonus - ✔✔back spasticity
, ✔✔explain joint dislocation - ✔✔from the muscle spasms, can be painful
✔✔explain impaired breathing - ✔✔the diaphragm cannot work correctly due to slowing
of movement
✔✔explain akathisia - ✔✔compulsive, restless movement, need to be in motion with
anxiety.
✔✔explain Parkinsonism - ✔✔drug induced Parkinson's: bradykinesia, mask like face,
tremor, rigidity, shuffling gait, drooling, cog wheeling, stooped posture
✔✔how do we treat early EPS? - ✔✔anticholinergics, bentos, beta blocker
✔✔explain tardive dyskinesia - ✔✔choreoathetoid movements of the tongue and face,
lip smacking movement, fly catching tongue, slow worm like tongue movement,
involuntary movements of limbs, tones, hips and fingers.
✔✔how do you treat late EPS? - ✔✔no treatment, but you can prevent it. D/C all
medications and switch to 2nd generation antipsychotic
✔✔what do TCAs treat? - ✔✔major depression
✔✔how do TCAs work - ✔✔blocks serotonin and NE reuptake
✔✔what are the side effects of TCAs - ✔✔sedation, orthostatic hypotension,
anticholinergic
✔✔what is the most dangerous effect of TCAs - ✔✔cardiac toxicity
✔✔S/S of cardiac toxicity in TCAs - ✔✔dysrhythmias, tachycardia, heart blocks, v tach,
v fib
✔✔how do we treat cardiac toxicity in TCAs? - ✔✔no antidote, treat with gastric lavage,
activated charcoal, IV HCO3
✔✔What do neuroleptics do? - ✔✔it blocks dopamine. only increase the effects of
Parkinson's disease, as they will induce Parkinson's symptoms with EPS, it is an
additive relationship.
✔✔what is the issue with using a neuroleptic with a patient with Parkinson's disease? -
✔✔will worsen the Parkinson's disease symptoms. would be appropriate to use a 2nd
generation antipsychotic
✔✔a neuroleptic is the same as an__________ - ✔✔antipsychotic
