PARKINSON DISEASE
The expected benign side effect of carbidopa/levodopa often startles patients when they notice it
red, orange and brown urine
What antidepressant class carries a black box warning for increased suicidal ideation in youth?
SSRIs
What fast acting anxiolytic class carries a high risk of physiological dependence
Benzodiazepines
What classic AED frequently causes gingival hyperplasia requiring strict oral hygiene?
Phenytoin (Dilantin)
Which electrolyte depletion causes the kidney's to reabsorb Lithium leading to toxicity?
SODIUM
135-145 IS THE NORMAL RANGE
When reviewing a patient's chart who is newly prescribed Donepezil, the nurse flags a specific cardiac diagnostic value as a critical safety prerequisite before administration. What is it and why?
Baseline ECG/Heart Rate (to screen for pre-existing bradycardia or QT prolongation risks, as cholinesterase affect cardiac conduction
What property of TCAs like Amitriptyline causes blurred vision, constipated and urinary retention
Anticholinergic properties (muscarinic receptor blockade)
Don't give your patient this beverage with buspirone due to CYP3A4 inhibition
Grapefruit
Whats an adverse effect associated with Lamotrigine (KEPPRA)
Stevens Johnson syndrome
Dont take _____ with Donepezil because _______
RISPERIDONE; BOTH CUASE PROLONGATE QT which can lead to cardiac risks and torsade's de pointes
Which specific receptor mechanism explains why over inhibition by memantine causes hallucinations and lethargy?
Excessive NMDA receptor blockade
What life threatening condition occurs from switching too quickly from a SSRI to an MAOI
Serotonin Syndrome
What life threatening emergency can result from abruptly stopping long term high dose benzodiazepines?
Status epilepticus/ Seizures
Signs of toxicity when taking phenytoin
ATAXIA, SLURRED SPEECH, CONFUSION, NYSTAGMUS
CAN'T WALK!!! CAN'T TALK
THE DIFFERENCE BETWEEN TYPICAL AND ATYPICALS ANTI PSYCHOTICS
**BONUS FOR EXTRA 500 PTS**
What medical condition makes atypical antipsychotics contraindicated on a black box warning and what is the primary risk.
TYPICALS BLOCKS DOPAMINE RECEPTORS IN THE BRAIN AND ATYPICALS BLOCK DOPAMINE AND SEROTONIN RECEPTORS IN THE BRAIN
DEMENTIA; INCREASED MORTALITY RATE
cholinergic excess (increased acetylcholine levels overstimulate the parasympathetic nervous system)
What OTC herbal supplement triggers Serotonin Syndrome when combined with an SSRI
ST JOHN'S WORT
What is the primary safety priority for an elderly patient paradoxical excitation from a benzodiazepines
Fall precautions/ Risk for injury
What is the strict therapeutic serum range for phenytoin?
10 - 20 mcg/mL
What serum concentration threshold defines the lower limit of acute lithium toxicity?
1.5 mEq/L
THERAPEUTIC RANGE
0.6-1.2 MEQ/L
A client with Parkinson disease is prescribed an MAO -B inhibitor. The nurse intervenes immediately upon seeing a specific dietary selection on the patient's plate. Which food group caused this intervention?
Tyramine rich foods (aged cheese, red wine, cured meats)
What primary vital sign spikes acutely when MAOI is combined with tyramine?
Hypertensive Crisis
What substance combined with a CNS depressant synergistically suppresses respiratory distress?
Alcohol and opioids
What three primary blood panels require routine monitoring for Valproic acid toxicity?
LIVER FUNCTION TESTS, LIPASE/AMYLASE AND CBC WITH PLATELETS
Signs of NEUROLEPTIC MALIGNANT SYNDROME (NMS)
EXTREME HYPERTHERMIA, MUSCLE RIGIDTY, AUTONOMIC INSTABILITY, ALTERED MENTAL STATUS