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Nursing Pharmacology > C8- Central Nervous System (stimulants/ benzo / barbiturates) > Flashcards

C8- Central Nervous System (stimulants/ benzo / barbiturates) Flashcards

1
Q

Your brain communicates with electrical impulses that signal a release of ____________?

A

Neurotransmitter

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2
Q

Neurotransmitters bind to targeted ______?

A

Cells

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3
Q

The chemicals used to suppress or stimulate effectors at the nerve synapse are?

A

Neurotransmitters

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4
Q

A neurotransmitter must be released by?

A

A nerve

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5
Q

When will the neurotransmitter be released into the synapse?

A

When the nerve is stimulated and need to react with a specific receptor site

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6
Q

NT is synthesized from substances that enter or may enter neuron in what form?

A

Intact

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7
Q

Neurotransmitters are stored where?

A

In storage vesicles

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8
Q

Neurotransmitters are released by what kind of impulse?

A

Electrical

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9
Q

Neurotransmitters have specific _________?

A

Messages

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10
Q

After NT communication, what three things happen to the NT?

A

NT inactivated
NT reabsorbed (reuptake)
NT diffuse AWAY from synapse

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11
Q

CNS medications influence which two things in the CNS?

A

Neurotransmitter concentration
Electrical activity

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12
Q

CNS medications pass which barrier? Because it passes through this barrier what are these meds soluble with? What conditions must be careful taking these medications?

A

BLOOD BRAIN BARRIER
Lipid-soluble
Pregnancy lactation category D or X

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13
Q

CNS drugs work _______ to block or mimic neurotransmitters?

A

DIRECTLY

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14
Q

Drugs work_______ by influencing neurotransmitter synthesis, formation, storage, release, reuptake, destruction.

A

Indirectly

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15
Q

What break down the Neurotransmitters in the synapse?

A

Neurotransmitter enzymes

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16
Q

Anti enzyme drugs interact with what? Which allows for what?

A

Interacts with the enzyme allowing for more neurotransmitters

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17
Q

Norepinephrine/Noradrenaline (concentration NT) affects what?

A

Attention and responding actions in the brain
Fight or flight response
Contracts blood vessels
Increases blood flow

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18
Q

Dopamine (pleasure neurotransmitter) effect? What drug type blocks receptors of dopamine?

A

Feelings of pleasure, addiction
Movement
Motivation
people repeat behaviors that lead to dopamine release
Antipsychotics block DA receptors

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19
Q

Serotonin (mood NT) affects? What type of drug elevates serotonin?

A

Mood
Well-being and happiness
Sleep cycle
Digestive system regulation
Affected by:
-exercise
-light exposure
Antidepressants elevate 5HT

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20
Q

GABA (calming NT) effects: What type of drugs regulate GABA sites?

A

Firing nerves in CNS = calming
Motor control
Vision
Improve focus (high levels)
Cause anxiety (low levels)
Benzodiazepines work on GABA sites

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21
Q

Acetylcholine (learning NT) involved in

A

Thought
Learning
Memory
Attention
Awakening
Activates:
-muscle action in the body

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22
Q

MAOI (monoamine oxidase) inactivates what neurotransmitters?

A

NE (norepinephrine)
DA (Dopamine)
5HT (Serotonin)

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23
Q

Insomnia is:

A

Chronic inability to sleep or remain asleep

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24
Q

Anxiety is defined as

A

A feeling of tension, nervousness, apprehension or fear that usually involves unpleasant reaction to a stimulus

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25
Depression is defined as
Abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, dejection, worthlessness, emptiness, and hopelessness that are out of proportion to reality
26
Bipolar disorder is defined as
Manic depressive haracterized by alternate episodes of mania, depression or mixed mood One or the other present at a given time
27
What is psychosis?
Any major mental disorder of organic or emotional origin gross impairment in reality
28
Psychosis is characterized by these 3 things
Regressive behavior Inappropriate mood and affect Diminished impulse control
29
Symptom of _______ includes delusions and hallucinations
Psychosis
30
Parkinson’s disease is defined as
A slowly progressing degenerative neurological disorder
31
What characterizes someone with Parkinson’s?
Resting tremor Pill rolling of fingers Mask like faces Shuffling gait Forward flexion of the trunk Loss of postural reflexes Muscle rigidity no weakness
32
What is seizure disorder?
Hyper excitation of neurons in the brain leading to a sudden, violent involuntary series of contraction by a group of muscles
33
Grand mal seizures are also called:
Tonic clonic
34
Grand mal seizures are described as?
Generalized involuntary muscular contraction and cessation of respiration followed by tonic and clonic spasms of muscles
35
What is another term for a petit mal seizure?
Absence seizure
36
What happens to the body during a petit mal seizure?
Sudden momentary loss of consciousness. Sometimes accompanied by minor spasms of the neck or upper extremities (symmetric twitching to face or loss of muscle tone)
37
What is a psychomotor seizure>
Temporary impairment of consciousness characterized by psychic symptoms, loss of judgment, automatic behavior and abnormal acts
38
What two CNS stimulants are used for treatment of ADHD/ADD?
Methylphenidate Amphetamine/dextroamphetamine
39
What is ADHD/ADD? What neurotransmitters are affected?
Dysregulation of transmitters (serotonin, norepinephrine, dopamine)
40
When does ADHD/ADD start affecting people?
Usually occurs in children before 7 years
41
What are some characteristics of ADD/ADHD
Inattentiveness (inability to concentrate) Restlessness Hyperactivity Impulsivity Inability to complete tasks Poor coordination
42
What effects do stimulants induce on the body/mental state?
Induce a feeling of increased energy and alertness, increase feelings of well-being.
43
What do stimulants do to the CNS?
Can cause an increase in dopamine that affects the brain reward system. Increase in HR BP Respiration
44
What are the medically approved uses for stimulants?
ADD/ADHD Narcolepsy Reversal of respiratory distress
45
Amphetamines action-
Act on cerebral cortex
46
Amphetamines prototype drug name?
Amphetamine/dextroamphetamine (Adderall)
47
Amphetamines action-
Elevates Norepinephrine and dopamine by stimulating their release. Inhibits reuptake of NE & DA
48
Side effects of amphetamines?
Tachycardia HTN Insomnia Restlessness Anorexia Dry mouth Weight loss Growth retardation (children)
49
Excess use of amphetamines can lead to?
Psychosis/Mania
50
What increases the effects of amphetamines?
Caffeine oral anticoagulants tricyclic antidepressants monoamine oxidase inhibitors
51
What do amphetamines decrease the effects of?
antihypertensives
52
What should nurses assess/evaluate in regards to amphetamines?
HR & BP attention span behavior (calm not manic) height and weight in children (compare to growth charts) peripheral circulation (numbness/tingling, cool, pale, painful)
53
What should nurses teach in regards to amphetamines?
take with meals avoid caffeine and alcohol report palpitations and tachycardia/irregular hr sugarless gum or hard candy for dry mouth do not stop abruptly (withdrawl/depression)
54
What are the prototype drugs for Sedative/anxiolytics/hypnotics?
Lorazepam Phenobarbital
55
What are some non pharmacological methods to help with insomia?
Arise at a specific hour take a few daytime naps avoid caffeine avoid heavy meals/ exercise before bed take a warm bath read avoid drinking large amounts of fluids before bed
56
What are physical signs of anxiety?
tachycardia/palpitations dry mouth sweating/weakness
57
What are some psychological signs of anxiety?
Fear/apprehension dread/uneasiness
58
What are some non pharmacological methods to anxiety?
Relaxation techniques psychotherapy support groups
59
Hypnotics help with what?
induce sleep (CNS depressant)
60
Sedatives help with what?
Induce a sense of calm and decrease anxiety (CNS Depressant)
61
The three types of sedative-hypnotics are?
benzodiazepines (common) barbiturates benzodiazepine-like medications (common)
62
Anxiolytics help with what?
decrease intensity or frequency of anxiety
63
What is the pharmacological action of sedative/hypnotics/anxiolytics?
enhance the action of (GABA) in the CNS
64
What are the therapeutic uses of sedative/hypnotics/anxiolytics?
insmonia induction of anesthesia anxiety disorders panic disorder seizure disorder muscle spasm alcohol withdrawal tranq/antipsychotic
65
The distinction between sedative/hypnotics/anxiolytics is often a matter of _________?
Dosage!
66
What is the action of Barbiturates?
Depress CNS Motor and sensory centers
67
What is the long acting barbiturate?
Phenobarbital it is also used for seizures.
68
Uses of phenobarabital
insomnia relief suppresion of seizures preop sedation general anesth. acute mania anxiety
69
What are some cautions regarding barbiturates?
Dependence/withdrawl (Schedule 2) cross tolerance (requires higher dose over time) multiple drug interations (accelerate metabolism of drugs) respiratory depression renal/hepatic impairment REM rebound when D/C'd
70
REM Rebound is
A significant increase in the percentage of time spent in REM over normal levels
71
Nurses should monitor these in regards to barbiturates?
sedation/respiration liver function tests pain levels drug interactions
72
What might be important to teach about regarding barbiturates?
may cause drowsiness avoid alcohol/sedatives do not stop abruptly avoid pregnancy/breastfeeding barrier birth control (inactivates estrogen BC)
73
What pregnancy category are barbiturates?
D- DO NOT USE
74
Example of Benzodiazepines?
Lorazepam
75
Action of benzodiazepines
enhance GABA receptors (NOT direct GABA agonists)
76
Uses for benzodiazepines?
anxiety (major use) insomnia seizures alcohol withdrawl muscle spasms preop med conscious sedation.
77
Benzodiazepines are relatively safer than barbiturates? T or F
true
78
Side effects of benzodiazepines
CNS Depression/sedation drowsiness/hangover decreased reaction time confusion anterograde amnesia hypotension- IV doses
79
Contraindications of benzodiazepines
allergies psychosis glaucoma shock/coma alcohol intox pregnancy children/elderly renal/hepatic disfunction
80
IV administration of benzodiazepines include?
SLOW IV push 1 min/ 5 mg
81
Reversal agent of benzodiazepines?
Flumazenil
82
Flumazenil action
antagonizes the effects of benzodiazepines on CNS such as sedation impairment of recall psychomotor impairment
83
Uses of flumazenil
reversal of sedation benzodiazepine overdose (does not work with opiates)
84
What should the nurse monitor after administering flumazenil
respritory status until risk of re-sedation is unlikely 120 mins - T1/2= 54 mins

Nursing Pharmacology (11 decks)

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