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Pharm F Neuro

QuestionAnswer
Levodopa/Carbidopa education "wearing off" may occur at end of dosing interval "on-off" may occur at any time (alternating periods of mobility and immobility) Eat several small portions of protein Take 30 mins before or 1 hour after meals Avoid pyridoxine (b6)
Levodopa/Carbidopa ADRs N/V, loss of appetite Drowsiness orthostatic hypotension tachycardia darkened sweat and urine activation of malignant melanoma Psychosis (take clozapine)
Tolcapone education May be effective with "end-of-dose" and "on-off" Monitor LFTs For Parkinson's Caution in hx of liver dysfunction, alcohol use
Tolcapone ADRs N/V/D, constipation Orange/red urine Rhabdomyolysis (kidney breakdown, monitor CK labs) Liver failure/hepatotoxicity
Selegiline education MAOI No tyramine Contraindicated (heart disease, cerebral vascular, liver/renal dysfunction) NO MEPERIDINE For depression/parkinson's
Selegiline ADRs Anxiety, insomnia Orthostatic hypotension Overdose (miosis, hyperthermia, tachycardia, seizure, coma)
Paroxetine and Sertraline education Admin once in AM 2-4 weeks for effects Don't suddenly stop (irritability, dizzy, HA) DO NOT MIX w/ St. John's wart, MAOIs, TCAs
Paroxetine and Sertraline ADRs Weight gain sex dysfunction insomnia, agitation bruxism (teeth grinding)
Benzos education PRN For (anxiety, seizures, alcohol withdrawal, anesthesia induction) Flumazenil is reversal agent Taper off Avoid grapefruit, disulfiram, tobacco, cimetidine
Benzos ADRs CNS depression toxic w/ ETOH, opioids Respiratory depression contraindicated w/ glaucoma DONT USE if pregnant May cause anterograde amnesia
Amitriptyline education TCA Question order if... hx of MI or dysrhythmia Taper off 2-4 weeks for effects Take at night
Amitriptyline ADRs Sedation orthostatic hypotension seizures anticholinergic effects Toxic (Convulsions, Cardiotoxicity, Coma)
Clozapine and Olanzapine education Atypical antipsychotic
Clozapine and Olanzapine ADRs Weight gain Glucose dysregulation/debates Anticholinergic effects dyslipidemia Hypertriglyceridemia HTN, atherosclerosis neutropenia
Haloperidol and Chlorpromazine education For aggressive/violent schizophrenics High potency (haloperidol) Low potency (chlorpromazine) Consider depot injections BID dosing Takes weeks-monthsH
Haloperidol and Chlorpromazine ADRs EPS (dystonia, akathisia, pseudoparkinsonism, Tardive dyskinesia, NMS) Anticholinergic Orthostatic hypotension Agranulocytosis Seizures Photosensitivity Sex dysfunction
Lithium education For bipolar Narrow therapeutic index (monitor every 3 months) Low sodium = risk of toxicity High sodium = sub therapeutic Swallow whole, take w/ meals
Lithium ADRs Common (GI distress, tremor, thirst, weight gain, lethargy) Problem (polyuria, renal toxicity, goiter/hypothyroid, hypotension, bradydysrythmias)
Created by: Haydenmeh
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