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d-nursing pharmacology > ans cns learnign objecftives > Flashcards

ans cns learnign objecftives Flashcards

1
Q

Anxiety and
sleep

A

Drug names lorazepam/fluoxetine

How does the
drug work? Binds to GABA receptors & F-inhibit reuptake of serotonin

Nursing considerations in using the drug

Risk for suicide
Watch elderly close
watch respirations
discontinue if adverse effects

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2
Q

Seizures

A

Drug names
phenytoin/lorazepam/phenobarbituate

How does the
drug work?
interferes with sodium channels in brain

alters cerebellar function to depress actions of sensory cortex

Nursing considerations in using the drug

narrow theraputic levels
may cause fetal harm
may cause depression

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3
Q

Depression

A

Drug names : fluoxetine /amitriptyline/ tranylcypromine

How does the
drug work?
inhibit reuptake of serotonin & inhibits reuptake of norepinephrine

Nursing considerations in using the drug

administer at bedtime
contradicted with MAOI

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4
Q

Bipolar disorder

A

Drug names
lithium

How does the
drug work?
alters sodium transport in nerve and muscle cells

Nursing considerations in using the drug
narrow therapeutic range
serum levels
manic episode may normalize in 1-3 week

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5
Q

ADHD

A

Drug names
methylphenidate

How does the
drug work?
Thought to block reuptake of norepinephrine and dopamin

Nursing considerations in using the drug
DO NOT CRUSH
do not after 4pm
high calorie food

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6
Q

Psychosis

A

Drug names
haloperidol/ risperidone

How does the
drug work?
Block dopamine receptors in the brain

Nursing considerations in using the drug

Monitor elderly patient with dementia-related psychosis closely for cardiovascular events and pneumonia

monitor lithium intake fot neurotoxicity

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7
Q

Parkinson’s
Disease

A

Drug names : carbidopa/levodopa

How does the
drug work?
restore the balance of dopamine and acetylcholine

Nursing considerations in using the drug

Use caution with positional changes and operating heavy equipment

contraindicated with MAOI

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8
Q

Identify the major types of anxiety disorders.

A

Generalized anxiety disorder

  • Social anxiety disorder
  • Specific phobias
  • Separation anxiety disorder
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9
Q

Use the Nursing Process to care for patients receiving drug therapy for treatment of CNS disorders

A

Assessment
- Is it appropriate to give this medication?
- Assessment consists of subjective vs. objective data

  • Diagnosis
  • Anxiety r/t unmet security and safety needs AEB change in economic status
  • Planning
  • Patient will identify and verbalize symptoms of anxiety each day when symptoms are present.
  • Implementation
  • Administer anti-anxiety medication, demonstrate breathing exercises, etc.
  • Evaluation
  • Is the medication working?
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10
Q

Identify the common degenerative diseases of the CNS.

A

Parkinsons

huntingtons/alzheimers

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11
Q

Identify drugs used for treatment of attention deficit-hyperactivity disorder.

A

CNS Stimulants (methylphenidate)

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12
Q

Identify symptoms of attention deficit-hyperactivity disorder.

A

Hyperactivity
* Inability to concentrate
* Difficulty with self-control
* Lack of emotional control

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13
Q

Explain the symptoms associated with extrapyramidal side effects of antipsychotic drugs.

A

an inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements.

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14
Q

Identify drugs used for treatment of psychoses.

A

Halosideral/Risperdal

Seroquel Zyprexa Clozaril others

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15
Q

Identify drugs used for treatment of mood disorders.

A

lithium

SSri-fluoxtine
amitriptlyne

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16
Q

Identify the two major categories of mood disorders and their symptoms.

A

Depression-Diminished interest / Weight loss insomnia/hypersomnia/Agitation/fatigue

BipolarRapid speech
* Hyperactivity
* Flight of ideas
* Grandiosity
* Poor judgement
* Aggression/hostility
* Risky sexual behavior

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17
Q

Compare the terms epilepsy, seizures, and convulsions.

A

E-recurring seizures not caused by another known condition

C- sudden, violent, irregular movement of a limb or of the body

S-Sudden, uncontrolled electrical disturbance in the brain.

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18
Q

Identify drugs used for treatment of anxiety disorders.

C

A

Sertraline and citalopram

Lorezopam

SSRI-

maybe fluextine

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19
Q

Identify indications, side effects, and potential drug interactions associated with the use of herbal supplements

A

allergic reactions, rashes, asthma, headaches, dizziness, agitation, dry mouth, seizures, fatigue, tachycardia, nausea, vomiting, and diarrhea

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20
Q

Identify considerations and implications of using central nervous system medications across the lifespan

A

younger kids could get addicted much easier due to less of knowledge of drugs

older people have much greater risk of toxic effects happening

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21
Q

Identify the side effects and special considerations associated with central nervous system drug therapy

park
phen
antisp
lith
moai
depres
meth
benzo
phone

A

antiparksinsons-dizziness/drowsiness

phenytoin-TEN and SJS

antipsychotics- tardive dyskenia / NMS

lithium-toxicity-diahria vomit bleeding

MAOI-severe hypertension

Antidepressents-increased suicide

meth-inc bp and hr

benzo-resp depression
coma/death

phenobarbital-suical thoughts

22
Q

Give examples of when, how, and to whom central nervous system drugs may be administered

A

anxiety, panic, acute stress reactions, and sleep disorders

pill capsule or liquid form

23
Q

Cite the classifications and actions of central nervous system drugs
barbituates
benzodiapzipenes
stimulate
tricyclic
SSRI
MAOI
Antimania
antipsychotics
anticovulsants
antiparkinsons

A

barbituates-depressant-seizures

benzodiapzipenes-depressant-anxiety,sedation

stimulate-adhd

tricyclic antidepressant-

SSRI-antidepresent

MAOI- antidepressants

Antimania-bipolar

antipsychotics-schizophrenia

anticovulsants- seizures

antiparkinsons

24
Q

A
Define the autonomic nervous system.

A

a control system that acts largely unconsciously and regulates bodily functions such as the heart rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal

25
Q

Identify the two fundamental divisions of the nervous system.

A

the central nervous system (CNS) and the peripheral nervous system (PNS)

26
Q

Compare and contrast the actions of the sympathetic and parasympathetic nervous systems

A

P_______S
Con eyes dilate
sec mouth inhbit
con lungs dialate
dec heart increase
sec stomach inhibit
sec intestines inhibit
go bladder realx
go reproductive inhibit
store pancreas release glucose

27
Q

d. Explain how medications that mimic and block the sympathetic and parasympathetic nervous systems have opposite effects and similar effects on organ tissue.

A

Where sympathetic will dilate one action, the parasympathetic will inhibit the other reaction

for each one reaction. the other one will have the opposite reaction.

28
Q

e. Identify situations in which autonomic nervous system medications may be administered.

A

cardiovascular, respiratory, urinary tract, and gastrointestinal disorders.

29
Q

f. Explain the mechanism of drug action, therapeutic effects, uses, adverse and toxic effects, and antidotes to overdose for each of the drug classes:

parasympathomimetics

A

Contract smooth muscle
PNS stimulation
Blood vessels: vasodilation

Decreased heart rate & BP

Lungs: bronchoconstriction

GI: increase motility

Bladder: contraction

Pupil: constriction

Example: betanechol (direct-acting)
donepezil (indirect-acting)

30
Q

f. Explain the mechanism of drug action, therapeutic effects, uses, adverse and toxic effects, and antidotes to overdose for each of the drug classes:

, anticholinergics,

A

Relax smooth muscle

Blood vessels: vasoconstriction to nonessential organs
Increased heart rate & BP

Salivation
Lacrimation
Urinary retention
Drowsiness/dizziness
GI upset

Eyes (blurred vision/dry eyes)
Use caution in elderly d/t constipation &
confusion
Example: atropine

31
Q

f. Explain the mechanism of drug action, therapeutic effects, uses, adverse and toxic effects, and antidotes to overdose for each of the drug classes:

sympathomimetics

A

Primarily stimulates heart with increased heart rate and contractility

Primarily relaxes smooth muscles
Blood vessels: vasodilation
Lungs: bronchodilation
GI: decreased motility
Liver: glyconeogenesis
Uterus: relaxatio

32
Q

f. Explain the mechanism of drug action, therapeutic effects, uses, adverse and toxic effects, and antidotes to overdose for each of the drug classes:

adrenergic antagonists.

A

Relax smooth muscle
Vasodilation
Decreased blood pressure
Bladder: increase blood flow
“Selective Beta blocker” used to decrease heart rate and blood pressure

bronchoconstriction

33
Q

Identify the classifications and actions of autonomic nervous system drugs

A

Nicotnic agonist-nictone patch

musc agon-pilocarpine

musc antan-atropine

aplh1 agonist- pseudoephedrine

alph2 antagon-tamsulosen

Beta1
anon-dobutamine

antag-metoplrol

beta2
anon-albetorl

antag-propanolol

34
Q

Identify the side effects and special considerations associated with autonomic nervous system drugs

Atr
Psudo
tam
dob
met
alb
pro

A

Atropine- overdose includes urine termination, dizziness, abnormal heartbeat and difficulty breathing—also dry mouth

pseudoephedrine-increased BP
- Urinary retention
- Nervousness
- Difficulty sleepin

tamsulosin- hypotension

dobutamine-increase in bp/hr too much
labored breathing/dizziness

metotprlol-
shortness of breath, bradycardia, fatigue,depression

albuterol
hypersensitivity,bronchospams, increase hr/bp

propanolol-
bromchocontriction
hypotension
bradycardia

35
Q

Include considerations and implications of using autonomic nervous system drugs across the lifespan

A

As patients get older, they are going to need bp and other vital sign medications more. Also with decreased metabolism it will sit in system for longer

36
Q

Include evidence-based concepts when using the nursing process related to medications that affect the autonomic nervous system

A

Asess-many type of medications stimulate or inhibit specific ANS receptors- assessing which ones will help specific problems

Plan-
atient will adhere to the drug regimen.
Patient’s vital signs will be within the desired range

implement- give drug. make sure to give medications when patient is right

evaluate- document wether patient is doing as well an presribed

37
Q

L
Provide examples of the scheduled categories for controlled substances.

A

1- no accepted medical use

2-high potential for abuse

3-low potential for dependance

4-low potentialfor abuse

5-lowest potential for abuse

38
Q

Identify the impact of medication legislation on drug therapy and nursing.

A

to establish a legal framework for the safe and effective distribution of prescription drugs

39
Q

Identify the process involved in development of new medications, including investigational new medication application, phases of investigational medication studies, and informed consent.

A

Step 1: Discovery & Development.

Step 2: Preclinical Research.

Step 3: Clinical Drug Development Process
.
Step 4: FDA Review.

Step 5: Post-market Monitoring.

40
Q

Analyze the ethical aspects of medication administration.

A

always work for the patent and fight for their right no matter where they are

41
Q

Explain the effect of socio-cultural factors in regard to a patient’s response to and compliance with medication therapy.

A

Patients with strong belief in the harm of medications were found 4 times more likely to have poor medication adherence than those with weak belief in the harm of medications

nurses need to have knowledge of all culture and beliefs. some cultures and beliefs don’t allow certain types of medications

42
Q

Summarize the nurse’s role in educational management of medication therapy.

A

Nurses need to explain side affects and adverse affects to the patient. This allows for patient education so the patient knows what will happen to their body when they take the drugs

43
Q

Explain the relationship between plasma concentration and half-life of a medication.

A

Half-life (t1/2) refers to the time required for plasma concentration of a drug to decrease by 50%

44
Q

Differentiate among adverse medication reactions: side effects, toxic effect, allergic reaction, idiosyncratic reaction, and teratogenic reaction.

A

Side affects- non inteefdned affects- can be predictable

toxic afects- its ability to cause harmful effects

ido-an abnormal susceptibility to a drug peculiar to the individua

terat-drug is a teratogen if its administration to the pregnant mother, directly or indirectly,

45
Q

Compare the action of agonist and antagonist medications.

A

agonist-work with the receptor-stimulate

antagonist-work againts-inhibit

46
Q

Identify the significance of the following terms in the measurements of medication concentrations in the body: minimum effective concentration (MEC), minimum toxic concentration (MTC), plateau or steady-rate concentration, peak concentration, and trough concentration.

A

MEC- is the minimum plasma concentration of a drug needed to achieve sufficient drug concentration at the receptors to produce the desired pharmacologic response,

MTC- represents the minimum blood level at which a toxic effect occurs

plateau C-At steady state, the amount of drug administered on each dosing occasion is matched by an equivalent amount of drug leaving the body between each dose.

Pc–when drug is highest in blood

t-when blood is lowest in blood

47
Q

Compare the significance of the chemical name, generic name, and brand name of a medication.

A

Chemical name-they tell us about the elements present

generic name-generic names are a shorthand version of the drug’s chemical name, structure, or formula- all the same

brand name-brand names are usually catchy, often related to the drug’s intended use, and relatively easy to remember

48
Q

Discuss the process of pharmacokinetics

A

absorption-Occurs when a medication enters the body and travels from
site of administration into the body’s circulatio

distribution-Movement of the drug within the body (blood/plasma to intra/extracellular compartments)

metabolism-Breakdown of drugs so they can be eliminated more easily

excretion-Process of elimination of waste

49
Q

Describe the process of pharmacodynamics

A
  • Agonist
    Activates receptors
  • Antagonist
    Blocks receptor

Therapeutic window
Peak drug level
through level
therapeutic index

50
Q

Consider pharmacodynamic differences across lifespan

A

target cell sites and changing numbers of protein receptors. Immature systems and changing body compositions mean that drugs affect children differently.

body composition, immature systems, and genetics. Total body water, fat stores, and protein levels change throughout childhood and greatly influence the effectiveness of drugs in the pediatric population.

As you get older. your body has less to fight off the drug with, so it will stay in system for longer

51
Q

Differentiate among prescription drugs, over-the- counter drugs, herbals, and dietary supplements

A

OTC

-Do not require a prescription
* Regulated through FDA
* Prescribed meds may be available OTC in smaller doses

Dietary-
Includes vitamins, minerals, enzymes, and botanicals
* Not regulated by FDA

Prescription

-requires perscriprion
regulated FDA
larger doses
need doctor order

d-nursing pharmacology (14 decks)

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