MG
PD
MS
Ischemic Stroke
Haemorrhagic Stroke/Anaesthesia
100
What is the class of Neostigmine?
Anti-cholinesterases
100
What is the class of Benserazide?
Decarboxylase inhibitor
100
What is the class of Fampridine?
K+ channel blocker
100
What is the class of Alteplase?
Thrombolytic/Fibrinolytic agent
100
What is the class of Mannitol?
Osmotic diuretic
200
State 1 adverse effect of Ciclosporin.
GI disturbances, Hirsutism
200
Why are decarboxylase inhibitors (Eg. Carbidopa) often administered alongside Levodopa?
To reduce the amount of Levodopa metabolised and used in the periphery, increasing the amount crossing the BBB for use in the CNS where it is required in the context of Parkinson's Disease. The clinical response to Levodopa is prolonged.
200
Why would Diazepam be prescribed to a patient with MS?
To provide relief from spasticity associated with the disease process.
200
State 2 adverse effects of Alteplase.
Bleeding, decreased BP, cerebral oedema.
200
Is tramadol considered an opioid or non-opioid medication?
Tramadol is a weak opioid.
300
State 2 adverse effects of Interferon-beta.
Influenza-type signs and symptoms that decrease with continued therapy, such as fever, joint and muscle pain, headache, injection site reaction.
300
List 3 adverse effects of Levodopa.
Nausea, vomiting, orthostatic hypotension, involuntary movements (head, lips, tongue), depression, agitation and confusion (due to disease itself)
300
Identify 2 adverse effects of Methylprednisolone.
GI upset, haemorrhage, ulcer, perforation; Na, fluid retention; increased BGL, K, Ca excretion; CHF; dyslipidaemia; thrombosis; PE; BP, mood change; psychic derangement, opportunistic infection.
300
What is the class of heparin and what is 1 adverse effect associated with its use?
Anti-coagulant.
Hemorrhage, increased LFTs, osteoporosis (prolonged high doses), aldosterone suppression.
300
Identify 2 side effects of Ketamine administration.
Hypertension, tachycardia, ECG changes, hallucinations and nightmares during emergence.
400
Describe the mechanism of action for Azathioprine.
Impairs lymphocyte proliferation, cellular immunity and the antibody response, thereby reducing destruction and the number of membrane bound acetylcholine receptors and capacity for acetylcholine to bind its receptors. In turn, electrical impulse transmission at the neuromuscular junction can occur.
400
Identify 1 nursing consideration associated with Selegiline use.
-Monitor renal and liver function tests
-Monitor BP as Selegiline can cause labile hypertension
-Perform frequent mouth hygiene as an adverse effect is dry mouth?
400
Describe the mechanism of action of Glatiramer.
Blocks presentation of myelin antigens to T cells and induces suppressor/regulatory T cells to minimise disease progression, reduce relapse frequency, promote remyelination, prevent demyelination and prevent disability.
400
Describe 1 nursing consideration when administering Aspirin.
-Monitor SpO2, auscultate lungs after administration at an appropriate time point as Aspirin can cause bronchospasm.
-Ensure that care is taken when administering parenteral medications as excessive bleeding may occur and/or for longer durations. Have cotton wool ready to stop bleeding and apply pressure.
400
Why might Propofol be administered in the context of surgery?
Administered as an inductive agent to produce unconsciousness which is pleasant, rapid (within seconds) and maintains haemodynamics. It is also suitable for maintenance and sedation.
500
Describe the mechanism of action for Pyridostigmine.
Reduces degradation of acetylcholine by inhibiting cholinesterase (enzymes that break down acetylcholine)), enhancing the level of available acetylcholine and thereby its action and neuromuscular transmission.
500
Describe the mechanism of action for Levodopa.
Precursor of dopamine which crosses the BBB to replenish depleted dopamine in the striatum.
500
Describe the mechanism of action for Fampridine.
Blocks potassium channels to reduce current leakage, restoring conduction in demyelinated axons.
500
Describe one nursing consideration associated with the use of Alteplase.
-Do not administer 4.5 hours post-stroke onset.
-Do not administer platelet aggregation inhibitors (Eg. Clopidogrel, Aspirin) within the first 24 hours of alteplase administration.
-Do not administer if BP >185 (sys) or >110 mmHg; treat with anti-hypertensives first.
-Special care in pt required if diabetes is uncontrolled (BGL <2.8 or >22 mmol/L), pre-existing neurological illness (Eg. prior stroke) (Therapeutic effect is reduced).
-Monitor potential bleeding sites (including catheter insertion sites, arterial and venous puncture sites, cutdown sites and needle puncture sites).
-Avoid non-essential pt. Handling, IM injections, venipunctures, & rigid catheters.
-Monitor BP during and 24 hours after treatment finishes.
500
Describe the mechanism of action of Mannitol in the context of increased intracranial pressure.
Mannitol creates an osmotic gradient across the blood-brain barrier, leading to the movement of water from the parenchyma to the intravascular space. Brain tissue volume is decreased and, therefore, ICP is lowered.
