Psychiatric Drugs and Medications Q 32
The priority nursing intervention for a client receiving amantadine is to teach the client to:
A. Monitor the pulse for rate and regularity.
B. Take the last dose of medication at bedtime.
C. Inspect the skin for erythematous rash.
D. Stop taking the drug if the mouth becomes dry.
Correct Answer: A. Monitor the pulse for rate and regularity.
Dopaminergic agents can cause heart rate changes and cardiac arrhythmias. The main advantage of amantadine is that it has a low side effect profile. The primary adverse effects of amantadine may include orthostatic hypotension, syncope, peripheral edema, dizziness, delusions, hallucinations, falls, xerostomia, and constipation.
Option B: Amantadine can cause insomnia. When administering amantadine, renal monitor function, mental status, such as depression/suicidality and psychosis, and blood pressure. Those with seizure disorders have monitoring for seizure activity. Patients with heart failure require vigilance for increased water retention and lower leg edema. Clinicians also need to watch liver enzymes in patients with liver disease as an irreversible elevation in transaminases has been reported.
Option C: An adverse effect of amantadine is a mottled discoloration of the skin. Although livedo reticularis is a less common side effect, amantadine is one of the best-known drugs to cause it. This side effect is reversible with the withdrawal of medication.
Option D: Dry mouth is an expected side effect and not an indication to discontinue amantadine. Amantadine is a weak, non-competitive antagonist of the NMDA receptor, which increases dopamine release and prevents dopamine reuptake. Although amantadine does not have anticholinergic activity, there may be anticholinergic side effects such as dry mouth, urinary retention, and constipation clinically.