Scenario 1
S.S., a 26-year-old woman, takes diazepam to control grand mal seizures. S.S. and her husband are contemplating starting a family.
List the antiepileptic and an anticonvulsant medication prototype this week and then briefly explain how they work. Describe a situation in which each could be prescribed. (USLO 3.2, 3.3, 3.4)
Explain the general teaching points of antiepileptic and anticonvulsants. (USLO 3.3, 3.4, 3.8)
What is status epilepticus? (USLO 3.1)
As S.S is contemplating pregnancy, what would you say to her? How do anticonvulsants impact pregnancy? (USLO 3.6, 3.8)
Scenario 2
An 82-year old woman who resides in a nursing facility is admitted to the hospital with pneumonia. She has a history of agitation and is ordered the antipsychotic haloperidol.
How do antipsychotics work? What neurotransmitter is greatly affected by antipsychotics? (USLO 3.1, 3.3)
When you assist the patient up you notice muscle rigidity and shuffling gait. What is the patient experiencing? Explain the characteristics of this syndrome. How is it treated? (USLO 3.6, 3.8)
What are the major side effects and adverse effects seen with haloperidol? (USLO 3.5, 3.6)
What is included in education for a patient taking antipsychotics? (USLO 3.8)
Scenario 3
You are assigned to care for a patient prescribed fluoxetine. The patient’s son arrives and tells you that his mother already has a prescription for fluoxetine, but stopped taking the medication after 1 week because she did not feel any better.
What drug classification is fluoxetine? How does this classification work? (USLO 3.2, 3.3)
What side effects and adverse reactions will you monitor for? (USLO 3.5, 3.8)
What teaching needs to be included when giving this medication? (USLO 3.8)
How will you address the son’s concern over his mother’s compliance with the antidepressant? (USLO 3.3, 3.6, 3.8)
Briefly explain the mechanism of just one other serotonin-modulating drug prototype this week. (USLO 3.2, 3.3, 3.4)
Scenario 4
A 63-year-old woman returns with a 4-year history of advanced Parkinson’s disease. Currently, her medication is only effective for 4 hours, after which her tremors become more severe, handwriting “cramped”, and walking is worse. She denies involuntary movements with her medication (dyskinesias), falls, or “freezing” of gait. Her neuropsychiatric review demonstrates no history of depressed mood, anxiety, hallucinations, or significant cognitive impairment. She continues to work part-time, is driving, and has no sleep impairment or daytime somnolence from her medication. Presently she is taking levodopa-carbidopa 25/100 mg po tid.
Explain the mechanism of actions and adverse effects of levodopa-carbidopa. (USLO 3.3, 3.4)
Why is ‘carbidopa’ a critical part of levodopa-carbidopa? Include the term ‘peripheral’ in your answer and explain it. (USLO 3.1, 3.2, 3.4)
For a patient diagnosed with Parkinson’s disease, what other prototype medication from this week may be used? How is it different/similar to levodopa-carbidopa? (USLO 3.1, 3.2, 3.4)
Upon completing this assignment, you will be able to:
Recognize variables contributing to CNS function.
Identify the major pharmacological classes of CNS drugs.
Summarize mechanisms of action of the pharmacological classes and major prototypes of CNS drugs.
Classify the major pharmacological indications of CNS drugs.
Identify the side effects of each major prototype of CNS drugs.
Explain adverse (toxic) reactions of each major prototype of CNS drugs as applicable.
Recognize contraindications of each major prototype of CNS drugs.
Recognize therapeutic considerations of each major prototype of CNS drugs as applicable.
