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Pharm > ANS/CNS > Flashcards

ANS/CNS Flashcards

1
Q

________ is to parasympathetic NS

…as _______ is to sympathetic NS

A

parasymp: cholinergic

sympath: adrenergic

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2
Q

Symptoms of benzodiazepine withdrawals….

A

*drowsiness
*dizziness
*respiratory depression
*increased heart rate
*fever
*muscle cramps

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3
Q

Symptoms of serotonin syndrome include…

A

*hyperthermia and diaphoresis
*tremor, confusion, restlessness, hyperreflexia, agitation

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4
Q

Phenobarbital MOA is…

A

increasing GABA that calms down the excitability in the brain

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5
Q

Two major categories of cholinergic receptors are….

A

muscarinic and nicotinic receptors

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6
Q

cholinergic agent

A

*parasympathomimetic
*Prototype drug: bethanechol (Urecholine)
*MOA: induce rest/digest response
*Adverse: profuse salivation, sweating, increased muscle tone, urinary frequency, bradycardia

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7
Q

Cholinergic-Blocking Agents (AKA: Anticholinergerics)

A

*Prototype drug: atropine
*Adverse: tachycardia, CNS stimulation, dry mouth, constipation, urinary retention, dry eyes, decreased sweating, photophobia

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8
Q

Adrenergic Agents (Sympathomimetics)

A

*Prototype drug: phenylephrine
*Adverse: tachycardia, hypertension, dysrhythmias, CNS excitation and seizures, dry mouth, N/V, anorexia, rebound nasal congestion
*Black Box: death may occur with IV infusion

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9
Q

Adrenergic-Blocking Agents

A

*Prototype drug: prazosin
*MOA: inhibit the sympathetic NS
*Use: hypertension, dysrhythmias, angina, heart failure, etc
*Adverse: dizziness, drowsiness, headache, loss of energy and strength, palpitations, dry mouth

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10
Q

buspirone (BuSpar) when taken for depression may take _______________ to demonstrate effectiveness.

A

several weeks

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11
Q

antidepressant

A

*Prototype drug: escitalopram
*MOA: increases availability of serotonin at postsynaptic receptor sites in the CNS
*Use: anxiety and depression
*Adverse: dizziness, nausea, insomnia, somnolence, confusion, seizures

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12
Q

benzodiazepine (for seizures)

A

*Prototype drug: diazepam
*MOA: intensify effects of GABA, safer than barbs
*Use: short-term seizure control
*Adverse: drowsiness, dizziness

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13
Q

benzodiazepine (for anxiety)

A

*Prototype drug: lorazepam
*MOA: increases effects of GABA , an inhibitory neurotransmitter
*Use: anxiety and insomnia
*Adverse: drowsiness, dizziness, respiratory depression

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14
Q

barbituates

A

*phenobarbital
*MOA: intensifies effects of GABA
*Use: sedative/hypnotic, seizures
*Adverse: tolerance, respiratory depression, psychological and physical dependence, drowsiness, vitamin deficiencies, laryngospasm

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15
Q

Nonbarbiturates and Nonbenzodiazepines

A

*Prototype: zolpidem
*MOA: binds to GABA receptors
*use: as hypnotic for anxiety
*Adverse: mild nausea, dizziness, diarrhea, daytime drowsiness, amnesia, sleepwalking, eating while asleep

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16
Q

antiseizure pharmacotherapy

A

*Goal: suppress neuronal activity enough to prevent abnormal/repetitive firing AND to increase activity of GABA, stimulating the an influx of chloride ions
*Delay an influx of sodium ions
*Delay an influx of calcium ions
*Correcting neurotransmitter imbalance
*Block glutamate receptors in the brain

17
Q

antiseizure drugs that potentiate GABA action

A

*phenobarbital
*diazepam

18
Q

hydantoins

A

*Prototype drug: phenytoin
*MOA: to desensitize sodium channels
*Use: epilepsy except absence seizures. May affect the threshold of neuronal firing
*Adverse: CNS depression, gingival hyperplasia, skin rash, cardiac dysrhythmias, and hypotension

19
Q

valproic acid

A

*phenytoin-like drug (Depakene)
*hydantoin
*MOA: desensitizes sodium channels
*Use: seizures, including absence and mixed types
*Adverse: limited CNS depression, visual disturbances, ataxia, vertigo, headache

20
Q

ethosuximide

A

*succinimide
*MOA: suppress calcium influx
*Use: absence seizures
*Adverse: rare but include drowsiness, dizziness, lethargy
*Very rare : systemic lupus erythematosus, aplastic anemia, agranulocytosis, pancytopenia

21
Q

natural therapy for seizures

A

*ketogenic diet
*chiropractor

22
Q

Nursing Considerations for Seizure Medications

A

*Monitor neurological status
*Protect from injury
*Labwork (maintain safe/effective level in the blood)
*Avoid alcohol or other CNS depressants

23
Q

sertraline

A

*Selective Serotonin Reuptake Inhibitors (SSRIs)
*MOA: inhibits reuptake of serotonin
*Use: depression
*Adverse: sexual dysfunction, nausea, HA, weight gain, anxiety, insomnia
*Less common: sedation, anticholinergic effects, sympathomimetic effects

24
Q

Duloxetine and venlafaxine and Buproprion

A

*Serotonin-Norepinephrine Reuptake Inhibitors (SNRI’s)
*Inhibit reuptake of serotonin and norepinephrine to elevate mood
*Bupropion —contraindicated in patients with seizures
*Black box: avoid taking these w/ other antidepressants or other meds (migraine drugs )
**watch for suicidal ideation when dose changed or beginning treatment

25
Q

imipramine

A

*Tricyclic Antidepressants (TCA)
*MOA: blocks reuptake of norepinephrine and serotonin
*Use: major depression
*Adverse: orthostatic hypotension, sedation, anticholinergic effects, cardiac dysrhythmias

26
Q

phenelzine

A

*Monoamine Oxidase Inhibitors
*MOA: decrease effectiveness of monoamine oxidase
*Use: depression
*Adverse: orthostatic hypotension, HA, insomnia, and diarrhea
*Interacts w/ many foods/other meds
*Hypertensive crisis = MAOI + food w/ tyramine

27
Q

foods that contain tyramine

A

Avocado, banana, raisin, papaya, canned figs, cheese (not cottage), sour cream, yogurt, beer and wine, meat, broad beans, soy sauce, all yeast, chocolate

28
Q

natural therapies for depression

A

*St. John’s wart
*inhibits serotonin reuptake for mild - moderate depression
*Interacts with many meds (birth control), warfarin, digoxin
*Photosensitive

29
Q

nursing considerations for antidepressants

A

*Antidepressants may take 1-4 weeks
*Avoid use of alcohol: increases sedative effects for barbs & tranqs
*Never abruptly stop med
*Never miss a dose

Pharm (8 decks)

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