NU641 final Exam Study Guide with Complete Solutions

NU641 final Exam Study Guide with Complete Solutions Carbamazepine (Tegretol) - 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 - 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 EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 2/30 -increased metabolic rate and higher cortisol levels, ruminate, worry, intrusive thoughts -Circadian factors influence sleep insomnia treatment - 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 - 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 - Answer--Regular times -Don't over do it -Sound proof the room -Cool temperature EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 3/30 -Exercise early in the day -No naps -Decrease fluids at night -Hide the clock epilepsy - Answer-Group of disorders characterized by excessive neuron stimulation within the central nervous system anticonvulsants - 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 - Answer--Partial (focal) seizures -Simple partial -Complex partial -Secondarily generalized -Generalized seizures -Tonic-clonic (grand mal) -Absence (loss of consciousness) EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 4/30 -Atonic (loss of muscle tone-drop attack) -Myoclonic (sudden muscle contraction) -Status epilepticus-seizure lasting 30 minutes -Febrile seizures Antiepileptic Drugs - 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 - 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 EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 5/30 Phenytoin (Dilantin) - Answer--Used to treat partial and tonic-clonic seizures -Will worsen absence seizures -Mechanism of action—selective inhibition of sodium channels -Varied oral absorption -Half-life 8 to 60 hours long ½ life Adverse Effects of Phenytoin - Answer--Nystagmus -Gingival hyperplasia need good gum care -Skin rash -Sedation -Ataxia (staggering gai