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[h]

Neuro Meds

[q] Anticholinesterase (neostigmine, Pyridostigmine)

[a] To treat myasthenia gravis, Alzheimer’s disease, and Parkinson’s disease

[q] Anticholinesterase Adverse Effect

[a] Increased gastrointestinal motility, increased GI secretions, bradycardia, and urinary urgency, Cholinergic crisis

[q] Med for neostigmine toxicity

[a] Atropine

[q] Levodopa /carbidopa (Parkinson’s disease) Adverse Effects

[a] GI (N/V), Dyskinesias (head bobbing, tics, tremor), Orthostatic hypotension, Cardiovascular effects (tachycardia, palpitations, irregular heartbeat), Psychosis, Discoloration of sweat/urine,

[q] Levodopa /carbidopa Nurse Notes

[a] Avoid administering with foods high in protein/pyridoxine, Monitor the client’s vital signs, ECG

[q] Antiepileptic Medicine

[a] Phenobarbital,Primidone,Phenytoin,Carbamazepine,Valproic Acid,Lamotrigine,Levetiracetam,Topiramate, Oxcarbazepine,Pregabalin,Gabapentin

[q] Barbiturates: phenobarbital, primidone Adverse Effect

[a] CNS effects : drowsiness,sedation, depression, confusion and anxiety. In children, irritability and hyperactivity. Avoid hazardous activities/alcohol

[q] Barburates Toxicity

[a] Signs : nystagmus, ataxia, respiratory depression, coma, pinpoint pupils, hypotension, death : Stop medication, take vitals, give oxygen/emergency care

[q] Phenobarbital, primidone, phenytoin special points

[a] They decreases effectiveness of warfarin (check PT/INR). They decreases effectiveness of oral contraceptives (use another form of contraception)

[q] Phenytoin Adverse Effects

[a] CNS effects (nystagmus, sedation, ataxia,double vision, cognitive impairment). Gingival hyperplasia (softening and overgrowth of gum tissue, tenderness, and bleeding gums), Skin rash (Stop medication if rash develops), Teratogenic, Cardiovascular effects (dysrhythmias, hypotension), Endocrine and other effects (coarsening of facial features, hirsutism, and interference with vitamin D metabolism)

[q] Carbamazepine Adverse Effects (also discussed in Psych med)

[a] CNS effects (nystagmus, double vision, vertigo, staggering gait, headache) , Associated with birth defects, Blood dyscrasias (leukopenia, anemia, thrombocytopenia), promotes secretion of ADH, Skin disorders (dermatitis, rash, Stevens‑Johnson syndrome), decrease in the effects of oral contraceptives and warfarin

[q] Lamotrigine Adverse Effect 1

[a] CNS effects (dizziness, somnolence, aphasia, double or blurred vision, headache, nausea or vomiting, depression), Teratogenic effects

[q] Lamotrigine CNS Effect Nurse Notes

[a] Monitor for manifestations of aseptic meningitis ((headache, fever, stiff neck, nausea, vomiting, rash,sensitivity to light), Monitor for suicidal ideation.

[q] Lamotrigine Adverse Effect 2

[a] Skin: Stevens-Johnson syndrome and toxic epidermal necrolysis: Discontinue medication if there is a severe reaction.

[q] Topiramate Adverse Effects

[a] CNS effects (dizziness, somnolence, ataxia, nervousness, diplopia, confusion, impaired cognitive function), Teratogenic effects, Metabolic acidosis (monitor Serum bicarbonate, Report hyperventilation, fatigue, anorexia). Angle-closure glaucoma (eye exam)

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