Pharmacology – Final Exam Study Guide 1
Module 2 – Neurological System Medications Part 1 (Chapters 24, 25, 26, 27, 28, 39)
• Class:
o Dopaminergic Drugs
• Medications:
o Levodopa/Carbidopa (Sinemet)
• MA:
o Levodopa – Leaves dopamine in the brain (unable to cross BBB)
▪ Most effective drug for PD
o Carbidopa – Conserves dopamine (prevents breakdown of Levodopa)
• TR:
o Parkinson’s Disease
▪ Does NOT cure or help with ▪ Allows pt. to carry out ADLs
memory.
• S/E:
o N/V o Orthostatic o Psychosis
o Dyskinesia hypotension o Blurred vision
o Angioedema o Dizziness
o Palpitations o Headache
• Interactions:
o Drugs:
▪ 1st generation antipsychotics, MAOIs & anticholinergic drugs
o Food:
▪ High in protein
• Decreases effectiveness
o Caution:
▪ Glaucoma
• Nur:
o Abrupt stopping of med -> r/o o Spread protein consumption
complete loss of movement. throughout day
o Dark urine = harmless o Monitor for orthostatic
o Full effect may take weeks-months hypotension
o Stand slowly
• Class:
o Cholinesterase Inhibitors
• Medications:
o Donepezil (Aricept)
• MA:
o Prevents breakdown of acetylcholine, increasing availability at cholinergic synapses
• TR:
o Alzheimer’s Disease
,Pharmacology – Final Exam Study Guide 2
▪ Does NOT cure AD or stop disease process
▪ Improves quality of life & cognitive function
• Route:
o PO
• S/E:
o N/V/D o Headache
o Dyspepsia o Bradycardia
o Dizziness o GI bleeds
o Bronchoconstriction
• Interactions:
o Drugs:
▪ 1st generation antihistamines ▪ Tricyclic antidepressants
▪ Conventional antipsychotics
• Reduce therapeutic effect
o Caution:
▪ Asthma ▪ COPD
• Nur:
o Take at bedtime with/without food. o Do not crush or chew
• Class:
o NMDA Receptor Antagonist
• Medications:
o Memantine (Namenda)
• MA:
o Modulates effects of glutamate on NMDA receptors
• TR:
o Alzheimer’s Disease
▪ Moderate-severe ▪ Improves symptoms
• Route:
o PO
• S/E:
o Dizziness o D/C o HTN
o Headache o SJS o Angina
o Confusion o Bradycardia
• Interactions:
o Drugs:
▪ Other NMDA antagonists or ketamine
• Undesirable effect
▪ Sodium bicarbonate
• Decreases renal excretions, creating toxic drug levels
• Nur:
,Pharmacology – Final Exam Study Guide 3
o Take with or without food o Do NOT crush/chew
o ER tablets swallowed whole, or
contents emptied onto soft food.
• Class:
o Immunomodulators
• Medications:
o Interferon Beta o Fingolimod o Natalizumab
(Avonex [IM]), (Gilenya) (Tysabri)
(Rebif [subQ])
• MA:
o Strengthens immune system to prevent infections
o Anti-inflammatory
• TR:
o Multiple Sclerosis
▪ Decreases frequency & severity of relapsing MS attacks.
▪ Delays progression of disability
• Route:
o IM o SubQ
• S/E:
o Headache o Injection-site reactions
o Fever o Depression
o Chills o Neutralizing antibodies
o Hepatotoxicity o Increases r/o infection
o Myelosuppression
• Interactions:
o Drugs:
▪ Bone marrow suppressors
o Caution:
▪ R/o suicide
▪ Hx. of liver disorders
▪ Pregnant
• Nur:
o Rotate injection sites o Acetaminophen for flu-like s/e
o Cold compress before & warm o Monitor LFTs & CBCs
after o Hydrocortisone cream for
o Take with or without food injection-site irritation
• Class:
o Traditional Antileptic Agents
• Medications:
o Phenytoin (Dilantin) o Carbamazepine (Tegretol)
, Pharmacology – Final Exam Study Guide 4
o Valproic Acid (Depakote) o Ethosuximide (Zarontin)
• MA:
o Suppresses Na influx from channels to inhibit action potential, decreasing neuronal
firing & limiting seizures.
• TR:
o Epilepsy, general seizures, tonic-clonic/absence seizures & mood disorders
• Ranges:
o Phenytoin: 10-20
▪ <10 = seizure risk ▪ >20 = toxicity risk
o Valproic Acid: 50-100
▪ <50 = seizure risk ▪ >100 = toxicity risk
o Carbamazepine: 4-10
▪ <4 = seizure risk ▪ >10 = toxicity risk
• Route:
o PO o IV
• S/E:
o Bradycardia o SJS o Hepatotoxicity
o Hypotension o Headache o Suicidal ideation
o Gingival o Dizziness o N/V/D
hyperplasia o Toxicity
• Interactions:
o Drugs:
▪ CNS depressants
o Food:
▪ Phenytoin: milk ▪ Lamotrigine: Alcohol
▪ Carbamazepine: grapefruit
juice
o Caution:
▪ Pregnant ▪ Asian
▪ Preexisting hematologic ▪ Preexisting liver dysfunction
abnormalities
• Nur:
o Assess type/frequency/duration of o Teratogenic
seizures o Screen for depression/suicidal
o Monitor LFTs ideation
o Do not stop abruptly o Monitor TR ranges & s/s of
o Avoid driving toxicity
• Class:
o Barbiturates
• Medications:
Module 2 – Neurological System Medications Part 1 (Chapters 24, 25, 26, 27, 28, 39)
• Class:
o Dopaminergic Drugs
• Medications:
o Levodopa/Carbidopa (Sinemet)
• MA:
o Levodopa – Leaves dopamine in the brain (unable to cross BBB)
▪ Most effective drug for PD
o Carbidopa – Conserves dopamine (prevents breakdown of Levodopa)
• TR:
o Parkinson’s Disease
▪ Does NOT cure or help with ▪ Allows pt. to carry out ADLs
memory.
• S/E:
o N/V o Orthostatic o Psychosis
o Dyskinesia hypotension o Blurred vision
o Angioedema o Dizziness
o Palpitations o Headache
• Interactions:
o Drugs:
▪ 1st generation antipsychotics, MAOIs & anticholinergic drugs
o Food:
▪ High in protein
• Decreases effectiveness
o Caution:
▪ Glaucoma
• Nur:
o Abrupt stopping of med -> r/o o Spread protein consumption
complete loss of movement. throughout day
o Dark urine = harmless o Monitor for orthostatic
o Full effect may take weeks-months hypotension
o Stand slowly
• Class:
o Cholinesterase Inhibitors
• Medications:
o Donepezil (Aricept)
• MA:
o Prevents breakdown of acetylcholine, increasing availability at cholinergic synapses
• TR:
o Alzheimer’s Disease
,Pharmacology – Final Exam Study Guide 2
▪ Does NOT cure AD or stop disease process
▪ Improves quality of life & cognitive function
• Route:
o PO
• S/E:
o N/V/D o Headache
o Dyspepsia o Bradycardia
o Dizziness o GI bleeds
o Bronchoconstriction
• Interactions:
o Drugs:
▪ 1st generation antihistamines ▪ Tricyclic antidepressants
▪ Conventional antipsychotics
• Reduce therapeutic effect
o Caution:
▪ Asthma ▪ COPD
• Nur:
o Take at bedtime with/without food. o Do not crush or chew
• Class:
o NMDA Receptor Antagonist
• Medications:
o Memantine (Namenda)
• MA:
o Modulates effects of glutamate on NMDA receptors
• TR:
o Alzheimer’s Disease
▪ Moderate-severe ▪ Improves symptoms
• Route:
o PO
• S/E:
o Dizziness o D/C o HTN
o Headache o SJS o Angina
o Confusion o Bradycardia
• Interactions:
o Drugs:
▪ Other NMDA antagonists or ketamine
• Undesirable effect
▪ Sodium bicarbonate
• Decreases renal excretions, creating toxic drug levels
• Nur:
,Pharmacology – Final Exam Study Guide 3
o Take with or without food o Do NOT crush/chew
o ER tablets swallowed whole, or
contents emptied onto soft food.
• Class:
o Immunomodulators
• Medications:
o Interferon Beta o Fingolimod o Natalizumab
(Avonex [IM]), (Gilenya) (Tysabri)
(Rebif [subQ])
• MA:
o Strengthens immune system to prevent infections
o Anti-inflammatory
• TR:
o Multiple Sclerosis
▪ Decreases frequency & severity of relapsing MS attacks.
▪ Delays progression of disability
• Route:
o IM o SubQ
• S/E:
o Headache o Injection-site reactions
o Fever o Depression
o Chills o Neutralizing antibodies
o Hepatotoxicity o Increases r/o infection
o Myelosuppression
• Interactions:
o Drugs:
▪ Bone marrow suppressors
o Caution:
▪ R/o suicide
▪ Hx. of liver disorders
▪ Pregnant
• Nur:
o Rotate injection sites o Acetaminophen for flu-like s/e
o Cold compress before & warm o Monitor LFTs & CBCs
after o Hydrocortisone cream for
o Take with or without food injection-site irritation
• Class:
o Traditional Antileptic Agents
• Medications:
o Phenytoin (Dilantin) o Carbamazepine (Tegretol)
, Pharmacology – Final Exam Study Guide 4
o Valproic Acid (Depakote) o Ethosuximide (Zarontin)
• MA:
o Suppresses Na influx from channels to inhibit action potential, decreasing neuronal
firing & limiting seizures.
• TR:
o Epilepsy, general seizures, tonic-clonic/absence seizures & mood disorders
• Ranges:
o Phenytoin: 10-20
▪ <10 = seizure risk ▪ >20 = toxicity risk
o Valproic Acid: 50-100
▪ <50 = seizure risk ▪ >100 = toxicity risk
o Carbamazepine: 4-10
▪ <4 = seizure risk ▪ >10 = toxicity risk
• Route:
o PO o IV
• S/E:
o Bradycardia o SJS o Hepatotoxicity
o Hypotension o Headache o Suicidal ideation
o Gingival o Dizziness o N/V/D
hyperplasia o Toxicity
• Interactions:
o Drugs:
▪ CNS depressants
o Food:
▪ Phenytoin: milk ▪ Lamotrigine: Alcohol
▪ Carbamazepine: grapefruit
juice
o Caution:
▪ Pregnant ▪ Asian
▪ Preexisting hematologic ▪ Preexisting liver dysfunction
abnormalities
• Nur:
o Assess type/frequency/duration of o Teratogenic
seizures o Screen for depression/suicidal
o Monitor LFTs ideation
o Do not stop abruptly o Monitor TR ranges & s/s of
o Avoid driving toxicity
• Class:
o Barbiturates
• Medications:
