What direct-acting dopamine receptor agonist is recommended to be used in the
treatments of neuroleptic malignant syndrome (NMS) fo help lower the
... [Show More] dopamine
blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane) - ANS-A) Bromocriptine (Parlodel) is the recommended
direct acting dopamine receptor agonist to help decrease the dopamine blockade.
Danrolene (Dantrium) is a muscle relaxant. Benzotropine (Cogentin) and
Trihexyphenidyl (Artane) are anticholinergic medications used for extrapyramidal side
effects (EPS).
Mr. Smith is a 56 year old white male who has been successfully treated on Selegiline
for over 4 years. Mr. Smith is going in for elective surgical procedure. Which medication
is strictly contraindicated with Selegiline?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine - ANS-D) Meperidine is strictly prohibited when a patient is treated on a
monoamine oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.
A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take which
of the following actions?
A) Consult with hematologist to determine appropriate antibiotic regimen and monitor
closely.
B) Institute twice-weekly complete blood count with differentials and monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication and monitor
closely.
D) Institute daily complete blood count with differentials and monitor closely. - ANS-B)
Institute twice-weekly complete blood count with differentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to
3,000 or granulocytes of 1,000 to 1,500 for agranulocytosis and severely compromised
immune system. At a WBC of 4,000, the recommendation is to closely monitor CBC
with differential twice a week while patient may continue clozapine in the absence of
any other signs or symptoms. [Show Less]