DONEPEZIL
A nurse is reviewing prescriptions for a client newly diagnosed with Alzheimer’s disease. Which condition would require the nurse to question an order for donepezil?
What is Sinus bradycardia?
This stage of Alzheimer’s disease is the primary indication for memantine therapy.
What is moderate to severe Alzheimer’s disease?
This chronic autoimmune disease is treated with interferon beta-1a.
What is multiple sclerosis?
This type of multiple sclerosis can be treated with interferon beta-1b.
What is relapsing-remitting MS or secondary progressive MS?
A client presents with an acute migraine and chest pressure after receiving sumatriptan. What is the nurse’s priority action?
A. Reassure the client that this is expected
B. Administer oxygen
C. Obtain a STAT ECG
D. Give a second dose
What is C. Obtain a STAT ECG
This cardiac condition is a contraindication due to donepezil’s ability to slow heart rate.
What is bradycardia or heart block?
This adverse effect makes fall risk an important nursing concern.
What is dizziness?
This flu-like adverse effect is expected and should be anticipated after injections.
What are fever, chills, and myalgias?
This injection complication distinguishes beta-1b from beta-1a.
What is injection site necrosis?
This cardiovascular condition is an absolute contraindication to therapy.
What is coronary artery disease, prior MI, or stroke?
These common adverse effects often limit patient tolerance to this medication.
What are nausea, vomiting, and diarrhea?
This drug is commonly combined with memantine to enhance treatment in later-stage Alzheimer’s.
What is donepezil?
This lab value must be closely monitored due to hepatotoxicity risk.
What are liver enzymes (AST/ALT)?
This laboratory abnormality reflects bone marrow suppression.
What is leukopenia?
This expected adverse effect often alarms patients but is usually benign.
A. Chest tightness and/or pressure
B. S.O.B
C. Fever and/or Chills
D. Dizziness and/or Nausea
What is chest tightness and/or pressure?
This finding best indicates therapeutic effectiveness of donepezil.
What is improved cognition, memory, orientation, or ability to perform ADLs?
A nurse explains the mechanism of action of memantine to a client’s family. Which explanation is correct?
A. Increases dopamine levels in the brain
B. Enhances acetylcholine availability
C. Blocks glutamate receptors to prevent neuronal damage
D. Inhibits beta-amyloid plaque formation
What is C?
Which statement by a client receiving interferon beta-1a for multiple sclerosis indicates a need for further teaching?
A. “I will take acetaminophen to reduce flu-like symptoms.”
B. “This medication will cure my multiple sclerosis.”
C. “I should rotate injection sites.”
D. “I will report feelings of depression.”
What is B. “This medication will cure my multiple sclerosis.”
This dosing frequency is typical for interferon beta-1b.
What is every other day?
This physiologic effect is responsible for migraine pain relief.
What is vasoconstriction of cranial blood vessels?
Which assessment finding best indicates that donepezil therapy is effective?
What is Decreased agitation and improved ability to perform ADLs?
Which adverse effect should the nurse monitor most closely in an older adult prescribed memantine?
A. Severe diarrhea
B. Dizziness and confusion
C. Bradycardia
D. Bronchospasm
What is B. Dizziness and confusion
A nurse should question an order for interferon beta-1a in a client with which history?
What is Major depressive disorder with suicidal ideation
This is the major structural difference between interferon beta-1a and beta-1b.
What is that beta-1a is a natural human protein while beta-1b is a modified protein?
This serotonin receptor is stimulated to relieve migraine pain
What is the 5-HT1 receptor?