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Neurologic and psychiatric medications

Bridgeman, Mary Barna PharmD, BCPS; Dalal, Kavitha S. PharmD

doi: 10.1097/01.NURSE.0000472521.17234.ad
Department: DRUG CHALLENGE
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At Rutgers University Ernest Mario School of Pharmacy in Piscataway, N.J., Mary B. Bridgeman is a clinical associate professor. Kavitha S. Dalal is a critical care clinical pharmacist at Virtua in Marlton, N.J.

Unless otherwise specified, the information in the preceding summaries applies to adults, not children. Consult the package insert for information about each drug's safety during pregnancy and breastfeeding. Also consult a pharmacist, the package insert, or a comprehensive drug reference for more details on precautions, drug interactions, and adverse reactions.

Can you identify these newer drugs indicated for neurologic and psychiatric disorders? Match the medications in Section I with the description in Section II.

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Section I

_____ 1. Aptiom (Sunovion Pharmaceuticals)

_____ 2. Lemtrada (Genzyme)

_____ 3. Nymalize (Arbor Pharmaceuticals)

_____ 4. Fetzima (Forest Laboratories)

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Section II

a. alemtuzumab. A new parenteral monoclonal antibody, this drug is indicated to treat relapsing forms of multiple sclerosis. It's given once daily as a 4-hour I.V. infusion for two treatment courses. Because of the risk of potentially serious autoimmune reactions, infusion reactions, and malignancies, this medication is available only via a restricted access program.

b. eslicarbazepine acetate. This once-daily oral medication is indicated as monotherapy or adjunctive therapy for partial-onset seizures. Monitor patients for suicidal ideation, serious dermatologic and hypersensitivity reactions, hyponatremia, and neurologic signs and symptoms such as dizziness and ataxia.

c. nimodipine. A dihydropyridine calcium channel blocker, this oral solution is indicated to reduce the incidence and severity of ischemic deficits following a subarachnoid hemorrhage (SAH). It should be started within 96 hours of the SAH. Give it by mouth, gastric tube, or nasogastric tube 1 hour before or 2 hours after a meal or feeding to avoid impaired absorption.

d. levomilnacipran. Indicated for major depressive disorder in adults, this extended-release serotonin and norepinephrine reuptake inhibitor is taken once a day. It carries a boxed warning about the risk of suicidal ideation and behavior. Teach patients to swallow each dose whole, without opening, chewing, or crushing the capsule.

Resources available on request.

ANSWERS: 1b, 2a, 3c, 4d

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