Central Nervous System Stimulants and Related Drugs
Central Nervous System Stimulants and Related Drugs
Stacy weighs 300 lb, and she has been trying to lose weight for the past 5 years. She has attempted numerous short-lived diets, as well as vigorous exercise. Over these years, she has been able to lose between 50 and 125 lb and has, within the next 6 months, gained the weight back. She comes to the weight loss clinic today to attempt weight loss again. In addition to a diet of 1200 calories per day, she will begin to take the drug phentermine (Ionamin). She has many questions.
Question 1 Stacy asks the nurse, “How effective will this medication be in helping me lose weight?” How will the nurse respond? Question 2 Stacy is worried about experiencing side effects. What information will the nurse provide Stacy about potential side effects? Question 3 Finally, Stacy asks if phentermine has any interactions with other drugs. How will the nurse respond?
Case Study
Chapter 13 Central Nervous System Stimulants and Related Drugs
Nancy has been unsuccessful in preventing migraine headaches and has been prescribed a selective serotonin receptor agonist (SSRA), sumatriptan (Imitrex).
Question 1 What patient teaching would be included for Nancy regarding the action and route of administration of sumatriptan? Question 2 What patient teaching should be included for Nancy regarding adverse effects or contraindications? Question 3 What medications would Nancy have been prescribed for first- and second-line preventive therapy? Question 4 Nancy asks the nurse about the effects of caffeine on migraines. What should the nurse’s response be? Question 5 Nancy also asks the nurse if there are effective nonpharmacologic treatments for migraines. What evidence-based answer can the nurse provide?
Case Study
Chapter 14 Antiepileptic Drugs
The camp nurse has been called to the field outside the recreation center. As the nurse arrives, there is a large crowd that begins to separate. The nurse notes that one of the campers is lying on the ground, and the camper’s arms and legs are thrashing back and forth. The nurse also notes a small cut above the camper’s right eye. The nurse recognizes the camper as one who comes to see her every day for medication administration, and the nurse remembers that the medication the camper takes is carbamazepine (Tegretol). As the nurse moves closer, she also sees two of the counselors preparing to attempt to restrain the camper.
Question 1 What should be the nurse’s initial response? Question 2 The camper is transferred to a local emergency department, where she is stabilized. A blood level of carbamazepine is drawn, and the result is 1.2 mcg/mL. How will the nurse interpret this finding?
Case Study
Chapter 15 Antiparkinson Drugs
A 65-year-old patient with a 2-year history of PD has been experiencing an increase in symptoms, especially muscle tremors and rigidity. The patient has been taking carbidopa– levodopa (Sinemet CR) and selegiline (Eldepryl) since diagnosis. The physician has chosen to add benztropine (Cogentin) to the patient’s medication regimen. The nurse is administering the first dose of benztropine and intends to provide patient teaching about the drug and its side effects. Question 1 What side effects are associated with benztropine? Question 2 Given the effect the medication has on the pupils, what condition if present in the patient would cause concern? Question 3 An indication that the addition of benztropine is effective in this patient would be relief of which PD symptom?
Case Study
Chapter 16 Psychotherapeutic Drugs
The patient is a 54-year-old man with a history of schizophrenia. The patient was started on haloperidol (Haldol) 6 months ago. Today the patient’s family calls the clinic to discuss symptoms that have occurred more frequently over the past 2 weeks. The family describes that the patient has had stiffness, a shuffling gait, hand tremors, and a delay in response to questions.
Question 1 What advice will the nurse offer to the family?
Question 2 The nurse anticipates that the physician will order which medication to treat these symptoms?
Question 3 The family asks the nurse if there are any other adverse effects of haloperidol that the family should anticipate. How will the nurse respond?
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