402 Exam 2 Study Guide Flashcards

1
Q

Which nerves release the parasympathetic neurotransmitter acetylcholine

A

Cholinergic nerves

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2
Q

Which medication class produces the characteristics symptoms of the rest and digest response

A

Parasympathomimetic (cholinergic)

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3
Q

What should be monitored prior to administration of bethanechol

A

BP, HR, and RR

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4
Q

What side effect does bethanechol have on liver enzymes

A

May increase them. (ALT, AST)

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5
Q

Which medication stimulates smooth muscle contraction of bladder and GI

A

Bethanechol

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6
Q

What type of drug is bethanechol

A

Cholinergic

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7
Q

What kind of drug is Physostigmine, how does it work, what is it used for

A

It is an acetylcholine esterase inhibitor Antidote for anti cholinergic toxicity. (Like too much Atropine)
Inhibits the destruction of ACh.
5-10 min onset.

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8
Q

What are administration alerts and contraindications for physostigmine

A

Admin slowly over 5 minutes to avoid seizures and respiratory distress
Contraindicated for aspirin or salicylate allergy, and those with severe asthma.

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9
Q

Side effects for physostigmine

A

Bradycardia
ASystole
Seizures
Urinary frequency
Hypotension, sweat, lacrimation, fast gut motility. (Cholinergic wet symptoms)

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10
Q

What is atropine used for and do

A

Anticholinergic medication.
Antidote for anticholinesterase poisoning (ediphonium, neostigmine)
It can be given pre operatively to decrease secretions.
Blocks parasympathetic actions of Ach
Induces fight or flight.

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11
Q

Side effects of atropine

A

Dry mouth
Constipation
Urinary retention
Tachycardia

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12
Q

What is monitored prior to atropine admin

A

Monitor BP, HR, and RR

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13
Q

What is Neostigmine(Prostigmin) used for and do

A

Cholinesterase inhibitor
Indicated for Myasthenias Gravis and
post up urinary retention

It stimulates skeletal muscle contraction

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14
Q

What are catecholamines

A

Neurotransmitters that bind to the same target tissue as adrenaline thus creating an adrenaline-like response.

Natural examples: Norepinephrine, epinephrine, dopamine
Synthetic examples: isoproterenol and dobutamine

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15
Q

What are examples of non-catecholamine drugs and how are they different from catecholamine drugs

A

Ephedrine, phenylephrine, and terbutaline

These can be direct, indirect, or dual acting and do not contain catechol where catecholamine drugs are primarily direct acting.

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16
Q

Which adrenergic receptor is located in the heart and kidneys

A

Beta 1

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17
Q

Which adrenergic receptor is located in all sympathetic target organs except heart and is responsible for constricting blood vessels and dilation of pupils

A

Alpha1

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18
Q

Which adrenergic receptor is located in all sympathetic target organs except the heart and is responsible for inhibition of smooth muscle?

A

Beta2

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19
Q

Which adrenergic receptor is located in the presynaptic adrenergic nerve terminals and is responsible for the inhibition of release of norepinephrine

A

Alpha 2

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20
Q

Which adrenergic receptor is located in the adipose tissue and urinary bladder

A

Beta3

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21
Q

What are the drug phenylephrine uses and its side effects

A

Nasal decongestant
Mydriatic eye drop
Antihypotensive IV in critical care for BP support
It is an adrenergic drug.
Side effects:
Anxiety
Tremor
High IV doses can cause reflex bradycardia

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22
Q

What is the drug Prazosin (minipress) used for, its mode of action, administration alerts, and side effects

A

It is an adrenergic blocking agent- it competes with norepinephrine on smooth muscles, causing rapid decrease in peripheral vascular resistance.
It is an antihypertensive.
Short half life, taken 2-3 times a day
Give low dose first to avoid hypotension
Side effects:
Orthostatic hypotension
Dizziness
Reflex tachycardia

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23
Q

Which adrenergic receptor will be targeted in the treatment of asthma and bronchoconstriction?

A

Beta 2

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24
Q

Phentolamine (Regitine) is used for what

A

Used in the diagnosis of pheochromocytoma (tumor of adrenal medulla that increases catecholamine) in a hypertensive patient where it is suspected.
It will cause a sudden reduction in BP that was created by excess catecholamines.
Can be used for hypertensive emergency caused by overuse of phenylephrine.

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25
Q

What type of drug is Clonidine and what are its uses

A

Adrenergic drug targets alpha 2 in CNS
Indicated for hypertension, ADHD, and pain.

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26
Q

What is propranolol, class, what it’s used for and side effects

A

It is a beta adrenergic antagonist (non selective) it decreases cardiac workload.
Side effects:
Hypotension
Bradycardia
SOB
Fatigue
Depression

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27
Q

What type of seizure last a few seconds, is seen most often in children “staring into space”, misdiagnosed as ADHD or daydreaming

A

Absence seizure

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28
Q

What type of seizure involves major muscle groups with large jerking movements, falling from a sitting position, or dropping when held

A

Myoclonic

29
Q

What type of seizure is caused by rapid increase in body temp and usually occurs in children 3mo-5 years old

A

Febrile.

30
Q

What kind of seizure can be preceded by auras, includes intense muscle contraction followed by relaxation, can involve loss of bowel/bladder control, has periods of apnea and is followed by disorientation

A

Tonic Clonic (Grand mal)

31
Q

What is phenobarbital used for, its mode of action, and side effects

A

Anti seizure med
GABA receptor agonist
It is first line treatment for status epilepticis
Side effects:
Dizziness
Confusion
Drowsiness
Somnolence (sleepy)

32
Q

What is Diazepam (Valium) used for and the side effect

A

It is a benzodiazepine
Used for seizure prevention in alcohol withdrawal
Side effects:
Drowsiness
Sedation
Respiratory depression
Tolerance/dependency

33
Q

Phenytoin (Dilantin, Phenytek) is what kind of drug, used for what, and what administration alerts does it have

A

It is an anti seizure drug. In the Hydantoin class; it is a sodium influx-suppressing drug.
It is effective in most seizures except absent.
Infuse slowly max rate of 50mg/min (there is a risk for severe hypotension)
It has a narrow therapeutic range of 10-20mcg/mL
Always flush IV with saline (soft tissue irritant)
Toxicity signs effects:
Ataxia, slurred speech, nystagmus- all should be reported to HCP.
Common side effect: gingival hyperplasia,

34
Q

What is Valproic acid, side effects, and admin alerts.

A

Valproate; anti seizure drug
It is a GI irritant.
do not take with carbonated beverages as it can trigger immediate release and cause severe throat and mouth irritation
Side effects:
Sedation/drowsiness
Prolonged bleeding time
Hepatotoxicity

35
Q

Ethosuximide(Zarontin) is what kind of drug, admin alerts, side effects

A

It is a succinimide, and the preferred drug for absence seizures.
Do not abruptly withdrawal, it may induce tonic clonic seizures.
Side effects:
Psychosis
Mood swings
Dizziness.

36
Q

What is carbamazepine used for, its side effects and how it works

A

It is a phenytoin related drug. Anticonvulsant for all seizure except absence.
It affects threshold of neuronal firing.
Side effects:
Dizziness
Headache
Cardiac Arrest!
Agranulocytosis (very low neutrophil count-risk for severe infection)

37
Q

What kind of pain is caused by direct injury to a nerve

A

Neuropathic pain

38
Q

What kind of pain is caused by direct damage to tissue

A

Nociceptor pain

39
Q

What do you call pain that is generalized, dull and internal; throbbing or aching

A

Visceral

40
Q

What do you call pain that is localized in the body and often described as sharp

A

Somatic

41
Q

What kind of drug is fentanyl and its side effects

A

Opioid agonist with high effectiveness
Side effects:
Drowsiness
Pruritis
Constipation
Severe respiratory depression
Cardiac arrest

42
Q

Oxycodone (OxyContin) is what kind of drug and has what side effects

A

Opioid agonist with moderate effectiveness
Side effects:
Constipation
Sedation
Nausea
Respiratory depression
Hepatotoxicity

43
Q

Morphine is what kind of drug with what side effects

A

Opioid agonist with severe effectiveness
Side effects:
Constipation
Severe respiratory depression
Nausea

44
Q

Naloxone is what kind of drug and has what side effects

A

Opioid antagonist and reverses effects of opioids
Side effects
Anxiety
Sleep disturbances
Withdrawal symptoms
Hepatotoxicity
Nausea /vomiting

45
Q

What kind of drug is sumatriptan (imitrex)
Its mode of action; side effects and adverse effect warning

A

Anti migraine medication.
5-HT (serotonin) receptor drug; vasoconstrictor of intracranial arteries.
Side effects:
Dizziness
Drowsiness
Vasoconstriction
-admin alert- may produce cardiac ischemia and hypertension (caused by. Vasoconstriction)

46
Q

What kind of anesthesia causes a loss of sensation to a part of the body without loss of consciousness (and how does it work)

A

Local anesthesia
Work by blocking sodium channels

47
Q

What kind of anesthesia causes a loss of sensation to the entire body with loss of consciousness

A

General anesthesia

48
Q

What is the drug lidocaine and its mode of action; serious adverse effects…

A

Local anesthetic and antidysrhythmic
Blocks sodium channels
Serious adverse effects: cardiac arrest, respiratory depression, convulsions

49
Q

What does lidocaine toxicity symptoms are…

A

Irritability and confusion

50
Q

What kind of drug is Proprofol; how and why is it used and what are the side effects

A

General anesthesia without analgesic properties.
NMDA receptor agonist
IV admin only - resulting in immediate sedation
Side effects:
Respiratory depression
Apnea
Hypotension

51
Q

Isoflurane is what kind of drug with what side effects

A

Inhaled general anesthetic. (Volatile liquid)
GABA and glutamate receptor
Used for rapid onset of induction.
Side effects:
Respiratory depression
Hypotension
Malignant hyperthermia

52
Q

What is the drug succinylcholine, its use, duration and side effects

A

Skeletal muscle paralytic, neuromuscular blocker. Blocks acetylcholine at neuromuscular junctions.
Used during intubation

Lasts only a few minutes after discontinuing (it is broken down quickly).
Side effects: paralysis of diaphragm, so mechanical vent is needed when in use.
Malignant hyperthermia

53
Q

How many mL is 1 cup

A

240mL

54
Q

How many mL is one tsp

A

5mL

55
Q

How many ounces are in 1 pound

A

16oz

56
Q

What does the term neuroleptanalgesia mean

A

Basically conscious sedation where the client is dissociated but able to follow commands

57
Q

A patient receives propofol for a surgical procedure and is showing signs of metabolic acidosis. What is the patient most likely developing

A

Propofol infusion syndrome.
Propofol should be discontinued and another anesthesia agent should be used instead.

58
Q

What is the method of local anesthetic that is often used before dental procedures and involves direct injection into tissue immediate to the surgical site to block a specific group of nerves in a small area.

A

Infiltration (field block) anesthesia

59
Q

What is the method of local anesthesia that involves direct injection I to tissue that may be distant from the operation site and block sensation to a large area of the face it a limb

A

Nerve block.

60
Q

A patient who received an amide local anesthetic develops anxiety. For which reason should the nurse suspect the patient is experiencing an allergic reaction?

A

Sulfites

61
Q

If a patient is allergic to soybeans or eggs, which general anesthetic would be avoided

A

Propofol

62
Q

The nurse assesses blanching in a patient who received a local anesthetic. What should the nurse determine from this finding

A

Epinephrine was also used. Does not indicate a problem.

63
Q

Which inhaled anesthetic has a low metabolism and high safety and effectiveness for general anesthesia

A

Isoflurane (Forane)

64
Q

What are contraindications for the medication bethanechol

A

Epilepsy
Parkinsons disease
Hyperthyroid
PuD
Bradycardia

65
Q

What kind of side effects would you expect from a cholinergic antagonist

A

Slow peristalsis
Drying effects
Photosensitivity

66
Q

How long until a patient feels the effects of the drug bethanechol

A

30-60 minutes. With a 6 hour duration

67
Q

What drug would be anticipated to treat symptoms of IBS, such as cramping and diarrhea.

A

Dicyclomine (a gastrointestinal antispasmodic)

68
Q

What muscarinic antagonist would you anticipate being prescribed for a patient with urge urinary incontinence.

A

Oxybutynin (limits the smooth muscle spasms in bladder)