Little Phrama
Which neurotransmitter has an inhibitory action within the central nervous system?
Gamma-aminobutyric acid
or
GABA
A family member of a patient using topical patches reports that the patient keeps taking the patches off his chest. Where will you suggest the family member apply the patches to avoid this problem?
On the upper or lower back
When assessing a patient before starting the first dose of a newly prescribed antiepileptic drug, what is the most important nursing action to perform?
Ask the patient about all other prescribed or over-the-counter drugs he or she takes daily.
Which precaution is most important to tell parents of young children prescribed the newer ANTIEPILEPTIC DRUG lamotrigine for epilepsy?
a. “Check your child daily for a rash and call your healthcare provider immediately if one develops.”
b. “Weigh your child weekly and be sure to report a weight loss of 2 lb or more to your healthcare provider at your next visit.”
a. “Check your child daily for a rash and call your healthcare provider immediately if one develops.”
Which traditional ANTIEPILEPTIC DRUG has the longest duration of action (also the oldest drug used to control seizures)?
a. phenobarbital (Luminal)
b. phenytoin (Dilantin)
c. carbamazepine (Tegretol)
d. valproic acid (Depakene)
a. phenobarbital (Luminal)
A patient taking a newer ANTIEPILEPTIC DRUG for the past 2 weeks reports to the nurse sudden symptoms of feeling lethargic, confused and chills. The nurse takes his temperature and it is 94.7° Fahrenheit. Which drug was the patient likely taking?
topiramate (Topamax)
lamotrigine (Lamictal)
lacosamide (Vimpat)
oxcarbazepine (Trileptal)
topiramate (Topamax)
Why is intramuscular (IM) injection of phenytoin avoided?
The drug is very irritating to the tissues.
A patient taking lacosamide tells you that he never forgets to take his prescribed doses because he feels so good and happy when he is on the drug. What is your best response?
a. “Even though you feel good on this drug, do not increase the dose or number of times you take it.”
b. “Anything that helps you remember to take your drug on time is helpful in preventing seizures.”
a. “Even though you feel good on this drug, do not increase the dose or number of times you take it.”
Which newer ANTIEPILEPTIC DRUG has 3 different “starter kits” for when drug therapy is started?
a. lamotrigine (Lamictal)
b. oxcarbazepine (Trileptal)
c. lacosamide (Vimpat)
d. topiramate (Topamax)
a. lamotrigine (Lamictal)
Which traditional ANTIEPILEPTIC DRUG is most often used to control Epilepsy in children?
a. carbamazepine (Tegretol)
b. phenytoin (Dilantin)
c. ethosuximide (Zarontin)
d. phenobarbital (Luminal)
a. carbamazepine (Tegretol)
When reviewing the preoperative laboratory results of a patient taking oxcarbazepine for seizure control, you note all of the following values. For which one will you notify the surgeon immediately?
a. Serum sodium level of 128 mEq/L
International normalized ratio (INR) 0.9
White blood cell counts 8700 per mm3
Serum chloride level of 100 mEq/L
Serum sodium level of 128 mEq/L
Which of the following traditional ANTIEPILEPTIC DRUGs does not cause drowsiness?
a. phenytoin (Dilantin)
b. carbamazepine (Tegretol)
c. ethosuximide (Zarontin)
d. valproic acid (Depakene)
a. phenytoin (Dilantin)
Which newer ANTIEPILEPTIC DRUG does not reduce the effectiveness of oral contraceptives?
a. lacosamide (Vimpat)
b. lamotrigine (Lamictal)
c. oxcarbazepine (Trileptal)
d. topiramate (Topamax)
a. lacosamide (Vimpat)
You are caring for a patient who is paralyzed from the waist down and has a large open wound on her right heel. When asked about her pain in that foot, she tells you it is a 0 on a 0 to 10 pain rating scale. What does this response indicate?
a. The paralysis prevents her brain from perceiving the pain.
b. The patient has chronic pain that does not trigger the stress response.
a. The paralysis prevents her brain from perceiving the pain.
Administration of which one(s) of the following drugs may result in parkinsonism?
a. Thorazine
b. Prochlorperazine
c. Haloperidol
d. all of the above
d. all of the above
Your patient is a 43-year-old African American male taking a newer ANTIEPILEPTIC DRUG. Which of the following would you expect to see a lower dose due to lower clearance rates?
a. lamotrigine (Lamictal)
b. oxcarbazepine (Trileptal)
c. lacosamide (Vimpat)
d. topiramate (Topamax)
a. lamotrigine (Lamictal)
Which newer ANTIEPILEPTIC DRUG can cause memory impairment and electrolyte imbalances, and at higher doses can elevate ammonia levels and lead to encephalopathy?
a. topiramate (Topamax)
b. lamotrigine (Lamictal)
c. lacosamide (Vimpat)
d. oxcarbazepine (Trileptal)
a. topiramate (Topamax)
The patient is prescribed to take an antidepressant for neuropathic pain. The patient tells you that this must be a mistake because he does not have depression. What is your best response?
a. Explain that the antidepressant was prescribed because it is less likely that he will become addicted to it than to other painkillers.
b. Explain that the antidepressant works by increasing chemicals in the brain that are helpful in relieving pain.
b. Explain that the antidepressant works by increasing chemicals in the brain that are helpful in relieving pain.
You have an order to give isosorbide dinitrate 40 mg PO twice daily. On hand you have 20 mg tablets. How many tablets will you administer in 24 hours?
a. 4 tablets
b. 8 tablets
a. 4 tablets
Which traditional ANTIEPILEPTIC DRUG is used to decrease seizures during pregnancy due to being less likely to cause birth defects?
a. ethosuximide (Zarontin)
b. carbamazepine (Tegretol)
c. phenytoin (Dilantin)
d. valproic acid (Depakene)
a. ethosuximide (Zarontin)