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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Identify the major types of anxiety disorders.

A

Generalized anxiety disorder

  • Social anxiety disorder
  • Specific phobias
  • Separation anxiety disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Identify the common degenerative diseases of the CNS.

A

Parkinsons

huntingtons/alzheimers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

A

CNS Stimulants (methylphenidate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Identify symptoms of attention deficit-hyperactivity disorder.

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Identify drugs used for treatment of psychoses.

A

Halosideral/Risperdal

Seroquel Zyprexa Clozaril others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Identify drugs used for treatment of mood disorders.

A

lithium

SSri-fluoxtine
amitriptlyne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Identify drugs used for treatment of anxiety disorders.

C

A

Sertraline and citalopram

Lorezopam

SSRI-

maybe fluextine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
Identify the two fundamental divisions of the nervous system.
the central nervous system (CNS) and the peripheral nervous system (PNS)
26
Compare and contrast the actions of the sympathetic and parasympathetic nervous systems
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
d. Explain how medications that mimic and block the sympathetic and parasympathetic nervous systems have opposite effects and similar effects on organ tissue.
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
e. Identify situations in which autonomic nervous system medications may be administered.
cardiovascular, respiratory, urinary tract, and gastrointestinal disorders.
29
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
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
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,
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
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
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
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.
Relax smooth muscle Vasodilation Decreased blood pressure Bladder: increase blood flow “Selective Beta blocker” used to decrease heart rate and blood pressure bronchoconstriction
33
Identify the classifications and actions of autonomic nervous system drugs
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
Identify the side effects and special considerations associated with autonomic nervous system drugs Atr Psudo tam dob met alb pro
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
Include considerations and implications of using autonomic nervous system drugs across the lifespan
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
Include evidence-based concepts when using the nursing process related to medications that affect the autonomic nervous system
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
L Provide examples of the scheduled categories for controlled substances.
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
Identify the impact of medication legislation on drug therapy and nursing.
to establish a legal framework for the safe and effective distribution of prescription drugs
39
Identify the process involved in development of new medications, including investigational new medication application, phases of investigational medication studies, and informed consent.
Step 1: Discovery & Development. Step 2: Preclinical Research. Step 3: Clinical Drug Development Process . Step 4: FDA Review. Step 5: Post-market Monitoring.
40
Analyze the ethical aspects of medication administration.
always work for the patent and fight for their right no matter where they are
41
Explain the effect of socio-cultural factors in regard to a patient's response to and compliance with medication therapy.
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
Summarize the nurse's role in educational management of medication therapy.
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
Explain the relationship between plasma concentration and half-life of a medication.
Half-life (t1/2) refers to the time required for plasma concentration of a drug to decrease by 50%
44
Differentiate among adverse medication reactions: side effects, toxic effect, allergic reaction, idiosyncratic reaction, and teratogenic reaction.
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
Compare the action of agonist and antagonist medications.
agonist-work with the receptor-stimulate antagonist-work againts-inhibit
46
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.
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
Compare the significance of the chemical name, generic name, and brand name of a medication.
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
Discuss the process of pharmacokinetics
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
Describe the process of pharmacodynamics
* Agonist Activates receptors * Antagonist Blocks receptor Therapeutic window Peak drug level through level therapeutic index
50
Consider pharmacodynamic differences across lifespan
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
Differentiate among prescription drugs, over-the- counter drugs, herbals, and dietary supplements
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